In plain words
Gastroesophageal reflux disease, or GERD, is that causes ongoing trouble. The most common sign is heartburn, a burning feeling behind the breastbone. Some people also notice a sour taste, a cough, or a hoarse voice. In pregnancy, GERD is common. It tends to grow stronger as the pregnancy goes on, because the growing uterus presses upward and the valve between the stomach and esophagus relaxes more. It usually fades after birth. Some chest symptoms are not heartburn at all. Chest pain, trouble swallowing, or vomiting blood need prompt medical care, because other conditions can look similar. A clinician can sort out the cause by asking about symptoms and, when needed, testing.
The deeper version
GERD is defined by symptoms or mucosal injury attributable to reflux of gastric contents, with heartburn and regurgitation as the typical presentation (Katz and colleagues, American Journal of Gastroenterology, 2022). In pregnancy, prevalence rises across gestation. Drivers include progesterone-mediated lower esophageal sphincter relaxation, raised from the enlarging uterus, and slowed gastric emptying. Symptoms are generally self-limited after delivery. Clinicians distinguish GERD from conditions that present as heartburn, including with hepatic involvement, syndrome, , biliary disease, and cardiac ischemia. Diagnosis in pregnancy is usually clinical. Management follows stepwise approaches described by ACOG and the American College of Gastroenterology, with agent choice guided by safety data. The open question is how much pregnancy-specific safety data exist for newer agents.
Where it comes up
- Heartburn and refluxPregnancy: Your Body
- Reflux, spit-up, and feedingFeeding Your Baby
- High blood pressure and preeclampsiaPregnancy: Your Body
- Itching that won't stop: cholestasisPregnancy: Your Body
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Sources
- Katz PO and colleagues (American College of Gastroenterology) — ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease. American Journal of Gastroenterology, 2022