Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting

Tytgat, G. N. J.; Heading, R C; Müller-Lissner, S; Kamm, MA; Schölmerich, J.; Berstad, Arnold; Fried, Michael; Chaussade, Stanislas; Jewell, David; Briggs, Andrew

doi:10.1046/j.1365-2036.2003.01679.x

Cited by 88 publications

(87 citation statements)

References 57 publications

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“…There is the well-understood caution in withholding of drugs from pregnant women. The recommended strategy to treat GERD during pregnancy indeed is a step-up approach [34]. Antacids are considered first-line drugs, especially if symptoms are not severe.…”

Section: Discussionmentioning

confidence: 99%

Gastroesophageal Reflux Disease and Management in Advanced Pregnancy: A Prospective Survey

Malfertheiner

Malfertheiner²,

Mönkemüller³

et al. 2009

Digestion

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Background: Heartburn is known to be common during pregnancy, however validated data on gastroesophageal reflux disease (GERD) are missing. The aim of this survey was to study the prevalence of GERD, the frequency and severity of typical GERD symptoms, and their impact on quality of life and therapeutic management in advanced pregnancy. Methods: One hundred and thirty-five consecutive pregnant women in the third trimester were included in a prospective study using validated questionnaires: RDQ, QOLRAD and a self-administered questionnaire detailing sociodemographic factors. Results: The prevalence for GERD in this unselected population was 56.3%. Among symptoms regurgitation was the most frequent with 47.3%, whereas heartburn was graded as the most severe symptom. The impact of GERD on the QOL of the pregnant women was significant (p < 0.001). 22.9% of the GERD population required medication because of severe symptoms, often reported to be insufficient for symptoms relief. Conclusion: GERD is common in late pregnancy with an important negative impact on the QOL. GERD in advanced pregnancy deserves more attention and better therapeutic management.

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Section: Discussionmentioning

confidence: 99%

Gastroesophageal Reflux Disease and Management in Advanced Pregnancy: A Prospective Survey

Malfertheiner

Malfertheiner²,

Mönkemüller³

et al. 2009

Digestion

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“…The aim of these discussions was to update a consensus and opinion-based treatment algorithm developed at an earlier meeting in 2002. 13 Several of the experts gave presentations concerning various aspects of GERD, focusing on current knowledge and clinical practice. This paper presents a summary of the discussions that enabled the panel to update the Gstaad Treatment Guidelines 13 for reflux disorders by reaching a consensus on a practical treatment algorithm for GERD.…”

Section: Introductionmentioning

confidence: 99%

New algorithm for the treatment of gastro‐oesophageal reflux disease

Tytgat

McColl

Tack

et al. 2007

Aliment Pharmacol Ther

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SUMMARY BackgroundGastro-oesophageal reflux disease (GERD) is associated with a variety of typical and atypical symptoms. Patients often present in the first instance to a pharmacist or primary care physician and are subsequently referred to secondary care if initial management fails. Guidelines usually do not provide a clear guidance for all healthcare professionals with whom the patient may consult.

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“…In a European consensus meeting conducted in 2003 (Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting), it was reported that the use of calcium-based antacids in pregnant women with GERD could be beneficial because it reduced the risk of hypertension and preeclampsia (8). Moreover, in a comprehensive randomized placebo-controlled study, it was demonstrated that the use of magnesium sulfate during pregnancy reduced eclampsia and maternal risk; it also caused no serious side effects in the short term.…”

Section: Antacidsmentioning

confidence: 99%

Treatment of reflux disease during pregnancy and lactation

Dağlı

Kalkan

2020

Turk J Gastroenterol

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PATIENTS WITH GERD?"Heartburn" is a symptom that can be seen in 30%-50% pregnancies. It particularly develops at the end of the first trimester, in the second trimester, and it becomes more apparent in the last trimester (1-3). Basal lower esophageal sphincter (LES) pressure may not change in the first trimester. The reason for this is demonstrated to be the low response to physiological stimuli such as pentagastrin, edrophonium chloride, methacholine, and food with protein in the first trimester of pregnancy. The LES pressure may decrease to 33%-50% of basal values in the second trimester. During the second and third trimesters, a decrease in the LES pressure can be observed due to the elevated intra-abdominal pressure, increased progesterone, abnormal gastric discharge, or delayed intestinal transit (4). AntacidsIn a previous retrospective case-controlled study on the use of antacids in pregnancy, no increase was detected in the development of congenital anomaly with aluminum hydroxide, sodium bicarbonate, magnesium trisilicate, and calcium carbonate (5,6). Authors of this study reported that antacids having therapeutic doses of aluminum, magnesium, and calcium can be safely used during pregnancy (7).In a European consensus meeting conducted in 2003 (Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting), it was reported that the use of calcium-based antacids in pregnant women with GERD could be beneficial because it reduced the risk of hypertension and preeclampsia (8). Moreover, in a comprehensive randomized placebo-controlled study, it was demonstrated that the use of magnesium sulfate during pregnancy reduced eclampsia and maternal risk; it also caused no serious side effects in the short term. Antacids having sodium bicarbonate must be avoided because they can lead to metabolic alkalosis and increased fluid load both in the mother and the fetus (5).Alginate builds a non-systemic strong barrier against acid and food reflux in the esophagus. In an open-labeled S53ABSTRACT Gastroesophageal reflux disease (GERD) is frequently seen during pregnancy. In the medical treatment of pregnant women with GERD, alginic acid and sucralfate can be used. Calcium-and magnesium-based antacids can also be used, particularly for patients with preeclampsia. In particular, ranitidine -a histamine-2 receptor blocker-is preferred. In the case of non-responsiveness to the abovementioned treatments, proton pump inhibitors (PPIs), except omeprazole, can be given considering the benefit-harm ratio for the mother and fetus after the first trimester. In cases with GERD during the lactation period, drugs having minimum systemic absorption, such as sucralfate and alginic acid, are preferable but there is no data. Keywords: Reflux, pregnancy, safety multi-centered study including 150 cases, the use of alginate for over 4 weeks yielded satisfying results both for physician and for patient, but fetal distress was observed in 3 fetuses (9). In another multi-centered...

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Contemporary understanding and management of reflux and constipation in the general population and pregnancy: a consensus meeting

Cited by 88 publications

References 57 publications

Gastroesophageal Reflux Disease and Management in Advanced Pregnancy: A Prospective Survey

Gastroesophageal Reflux Disease and Management in Advanced Pregnancy: A Prospective Survey

New algorithm for the treatment of gastro‐oesophageal reflux disease

Treatment of reflux disease during pregnancy and lactation

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