Gastrointestinal diseases during pregnancy: what does the gastroenterologist need to know?

Abstract

Pregnancy is characterized by numerous physiological changes that may lead to a diversity of symptoms and frequently to gastrointestinal complaints, such as heartburn, nausea and vomiting, or constipation. Chronic gastrointestinal diseases require treatment maintenance during this period, raising the challenging question whether outcomes beneficial to the mother may be harmful for the fetus. In addition, certain diseases, such as acute fatty liver of pregnancy, only develop during pregnancy and may require urgent procedures, such as fetus delivery. Even though they are not present in our day-to-day practice, knowledge of pregnancy-related diseases is fundamental and collaboration between gastroenterologists and obstetricians is often necessary. Herein, we review pregnancy-related diseases and systematize the most appropriate treatment choices according to the recent literature and guidelines, so that the article can serve as a guide to the gastroenterologist regarding the medical approach to pregnancy-related gastrointestinal and liver diseases and their therapeutic management.

Do the Dietary Intakes of Pregnant Women Attending Public Hospital Antenatal Clinics Align with Australian Guide to Healthy Eating Recommendations?

“…It is also important to acknowledge the large increases in food group recommendations between pregnant and non-pregnant women. Additionally, pregnant women are at increased risk of digestive complications such as nausea and vomiting [ 32 ], constipation [ 33 ] and reflux [ 34 ], potentially hindering their ability to meet the large amount of food recommended in the AGHE.…”

Fetal Movement Counting Using Optical Fibre Sensors

“…Further, pregnant women often have delayed gastric emptying or even constipation [45]. One reason for this is that there is an increase in the harmone progesterone which slows muscle contractions in the intestines [46]. Another reason is that the intestinal tract becomes squished as the baby grows, causing slow transit of bowel contents through the intestines [47].…”

Indian National Association for the Study of the Liver—Federation of Obstetric and Gynaecological Societies of India Position Statement on Management of Liver Diseases in Pregnancy

“…Gastric acidity is increased because of the higher production of gastrin by the placenta. 2,3 Among the physical findings, spider angiomata and palmer erythema can be seen especially in the later half of the pregnancy. 4 Pregnancy is characterized by a hemodilution state induced by volume expansion due to retention of salt and water.…”

“…4 Pregnancy is characterized by a hemodilution state induced by volume expansion due to retention of salt and water. 2 Hemodilution results in the decrease in hemoglobin and serum albumin that worsens as pregnancy progresses. Most of the liver biochemical tests remain within normal limits during pregnancy with a few exceptions.…”