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Review article: the management of heartburn in pregnancy
Author(s) -
RICHTER J. E.
Publication year - 2005
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2005.02654.x
Subject(s) - medicine , heartburn , pregnancy , sucralfate , omeprazole , gastroenterology , disease , etiology , reflux , pharmacotherapy , surgery , biology , genetics
Summary Heartburn is a normal consequence of pregnancy. The predominant aetiology is a decrease in lower oesophageal sphincter pressure caused by female sex hormones, especially progesterone. Serious reflux complications during pregnancy are rare; hence upper endoscopy and other diagnostic tests are infrequently needed. Gastro‐oesophageal reflux disease during pregnancy should be managed with a step‐up algorithm beginning with lifestyle modifications and dietary changes. Antacids or sucralfate are considered the first‐line drug therapy. If symptoms persist, any of the histamine 2 ‐receptor antagonists can be used. Proton pump inhibitors are reserved for women with intractable symptoms or complicated reflux disease. All but omeprazole are FDA category B drugs during pregnancy. Most drugs are excreted in breast milk. Of systemic agents, only the histamine 2 ‐receptor antagonists, with the exception of nizatidine, are safe to use during lactation.