Gastroesophageal Reflux Disease (GERD) And Heartburn During Pregnancy

Acid Reflux (or heartburn) during pregnancy, while uncomfortable, is actually quite common. It is not known whether unexplained, transient relaxations of the sphincter, a common cause of reflux in women who are not pregnancy, it also occurs during pregnancy. It is not known if the contraction (motility) of the esophagus above the sphincter, a common contributor to GERD in women who are not pregnant is impaired in pregnancy, and is responsible for delaying the clearance of acid from the esophagus back into the stomach. What makes pregnancy different is the distortion of the organs in the abdomen and the increased abdominal pressure caused by the growing fetus. These changes clearly promote the reflux of acid.

Heartburn in pregnancy may occur because of changing hormone levels, which can affect the muscles of the digestive tract and how different foods are tolerated. Pregnancy hormones can cause the lower esophageal sphincter (the muscular valve between the stomach discover more and esophagus) to relax, allowing stomach acids to flow back up into the esophagus. In addition, the enlarged uterus can crowd the abdomen , pushing stomach acids upward. Although it’s rare, gallstones can also cause heartburn during pregnancy.

Proton pump inhibitors are similar to the H2 antagonists with respect to safety. Lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium) have been shown to be safe when tested in pregnant animals, but because they are newer, experience with them is less than with the H2 antagonists. They should be used only when H2 antagonists in normal doses fail to control heartburn. Omeprazole (Cimetidine, Zegerid ) probably should be avoided since although there are no studies in pregnant women showing problems, it has been shown to have effects on animal fetuses at very high doses in some studies.

The two major factors that promote acid reflux in pregnant women are changes in hormones and the growing baby. Changes in levels of estrogen and progesterone result in a decrease in pressure on a part of your body called the lower esophageal sphincter, thereby increasing acid reflux Additionally, the growing baby causes an increase in what is called intra-abdominal pressure, resulting in an increase in the development of reflux. Excess pregnancy weight gain can also make the problem worse, particularly in the third trimester.

Normally, acid reflux symptoms result in no complications. In a couple of circumstances, continued esophageal damage can bring about scarring, which may trigger the esophagus to narrow. The narrowing creates strictures and tends to make it hard to swallow. You may have dysphagia, a sensation that food is stuck in your esophagus. In some cases, cells inside the lining in the esophagus develop an abnormal shape and colour in response to the continuous acid irritation. This can be Barrett’s esophagus, which can develop into cancer.

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