Last updated date: 06-Mar-2023
Originally Written in English
Gastritis During Pregnancy
Many physiological changes occur during pregnancy, which can cause a variety of symptoms, including heartburn, nausea, vomiting, and constipation. Knowledge of pregnancy-related disorders is essential, and collaboration between gastroenterologists and obstetricians is frequently required, even if they are not present in our day-to-day practice.
Gastrointestinal diseases during pregnancy
Some of the most frequent concerns during pregnancy are gastrointestinal (GI) problems. Some women may suffer gastrointestinal problems after getting pregnant. Gastrointestinal issues primarily affect the esophagus, stomach, small intestine, large intestine, and rectum, but they can also affect other digestive organs such as the liver, gallbladder, and pancreas. Some women may have persistent GI issues that can worsen during pregnancy and necessitate special attention.
Most gastrointestinal illnesses, including gastroesophageal reflux and inflammatory bowel disease, can be made worse by pregnancy. Furthermore, gastrointestinal issues are very prevalent in pregnant women. dyspepsia affects 50–90% of all patients Symptoms include bloating, nausea and vomiting.
The majority of these symptoms are a result of normal changed physiology, which includes both functional and structural alterations. These alterations could result in new symptoms, exacerbate pre-existing disease, or conceal a potentially fatal condition. The inability to deal with these symptoms due to a lack of experience can be fatal.
The doctor must be able to tell if these symptoms are normal pregnancy symptoms or signs of a potentially life-threatening condition like preeclampsia. The doctor must also be aware of which medications are safe to use during pregnancy, as well as which tests are safe to perform.
GERD (gastroesophageal reflux disease) is frequent during pregnancy, especially in the first or second trimester. It causes heartburn or acid indigestion by affecting the lower esophageal sphincter, a muscle that connects the esophagus and the stomach.
Causes of Gastrointestinal issues During Pregnancy
Although numerous gastrointestinal problems are prevalent, you may not have had any before becoming pregnant. Because they differ, the reasons can also differ. The following are some of the most common causes or risk factors for gastrointestinal problems during pregnancy:
- Poor diet
- Hormonal changes
This is due to fluctuating hormone levels combined with the pressure that a growing fetus places on the body.
- GI motility disorders
- Certain medications
- Thyroid disorders
- The growing baby pressing on your stomach
- The muscles between your stomach and gullet relaxing, allowing stomach acid to come back up
- Food intolerance or allergy
- Lack of exercise or activity
- History of overusing laxatives
- Viral or bacterial infection
You may be more likely to get indigestion or gastritis in pregnancy if:
- You've been pregnant before
- You suffered from dyspepsia before becoming pregnant.
Women who already live with gastritis will suffer an aggravation of the disease during pregnancy.
- You're in the later stages of pregnancy
Symptoms of Indigestion and Heartburn
Symptoms of indigestion and heartburn include:
- a burning sensation or pain in the chest
- feeling full, heavy, or bloated
- burping or belching
- feeling or being sick
- bringing up food
Symptoms usually come on soon after eating or drinking, but there can sometimes be a delay between eating and developing indigestion.
You can get symptoms at any point during your pregnancy, but they are more common from 27 weeks onwards.
Gastritis refers to a group of conditions that develop from the inflammation, irritation, or erosion of the protective lining of the stomach. It most commonly results from an infection by the same bacterium that triggers stomach ulcers.
Gastritis is more likely to develop during pregnancy. If you're pregnant and have symptoms of gastritis, it may be linked to all of the changes going on in your body.
Gastritis comes in either one of two forms, depending on the severity of the inflammation and the length of the incubation period. Acute gastritis and chronic gastritis share similar symptoms, namely loss of appetite, recurrent nausea and vomiting, indigestion, and a feeling of bloating particularly after a meal. However, the pain stemming from acute gastritis occurs more suddenly but is temporary, while chronic gastritis causes duller and longer-lasting pain. Left unchecked, both can lead to ulcers or an increased risk of stomach cancer.
Regardless, gastritis is not a huge worry with prompt and appropriate treatment.
What different sorts of gastritis problems would occur with expecting mothers? Are any of these to be taken more seriously over the other?
Heartburn, vomiting, stomach pain, flatulence, and diarrhea pose minor inconveniences during pregnancy but could indicate serious health issues depending on the severity and frequency. Use self-help measures and home remedies to relieve negligible irritation. Visit your specialist should the problems persist.
Diagnosis of Gastritis
Diagnosing gastritis involves a variety of tests, including:
A thin flexible tube is introduced into the stomach through the esophagus. The endoscope is equipped with a small camera that allows the doctor to examine the stomach lining. Gastritis may be indicated by the reddish gastric mucosa. For confirmation, a biopsy is required.
During an endoscopy, small tissue samples are collected and examined in the lab. The pathologist will examine for inflammatory cells and damage to the epithelium, among other things.
Gastritis effect on pregnancy
- As we previously indicated, being pregnant increases your chances of developing non-chronic gastritis. While a pregnant woman afflicted with gastritis may encounter exacerbated symptoms, there is no negative effect on the course of pregnancy and the development of the child.
However, the reasons for this are unknown. You might have the following symptoms:
- Pain in your upper abdomen that comes and goes
- Feeling sick or retching
- Feeling of fullness in your upper abdomen after eating
- Loss of appetite
What are the main causes of gastritis in pregnancy?
Your stomach lining secretes mucus to protect against damage by corrosive digestive juices. Gastritis occurs due to the inflammation of this layer of tissue. The primary source of the condition is a bacterial infection of Helicobacter pylori (H. pylori), which can cause ulcers and in severe cases, stomach cancer. It is usually passed from person-to-person contact but may be transmitted via contaminated food or beverages as well.
Other risk factors can also engender gastritis, including alcohol, drug, and tobacco abuse, routine use of anti-inflammatory medication, extreme stress, chronic vomiting, and old age.
Many meals that you preferred prior to becoming pregnant can trigger a flare-up of symptoms when you're expecting. Many of these annoying meals are also items you may crave while pregnant: spicy foods, fried foods, high-fat foods, and acidic foods like tomato soup are all culprits. Limiting these items will help you avoid stomach distress during your pregnancy.
Some foods do not usually trigger an instant reaction, but they can aggravate pain over time. Reduce your intake of red meat and processed meals like white bread and sugar to avoid long-term difficulties. Lean meats should be substituted for beef and pork, and whole-grain bread should be used.
Caffeinated foods and beverages contribute to gastritis flare-ups as well. Even a single cup of coffee can raise stomach acid levels, resulting in an inflamed stomach lining. To avoid this issue, substitute herbal teas for coffee drinks and flavored water for caffeinated soda.
Peptic Ulcer Disease
Increased progesterone levels, according to many physiologists, diminish both basal and induced acid production, reducing acid-related symptoms. Increased amounts of histaminase generated by the placenta are also thought to contribute to lower acid secretion.
The association between H. pylori and pregnancy is still being researched now that it is evident that H. pylori plays a key role in peptic ulcer disease. Infection with H. pylori is common in patients from non-industrialized countries and women from lower socioeconomic strata.
Despite this, patients with chronic active gastritis caused by H. pylori account for more than 90% of ulcer illnesses in people who do not take nonsteroidal anti-inflammatory medications (NSAIDs).
H. Pylori Testing
Because of the relevance of this bacterium in ulcer etiology, all patients with peptic ulcers should be tested for it. Noninvasive methods include serologic testing and stool antigen analysis, as well as histology and fast urease testing during endoscopy.
Urea breath testing has a low radiation risk and should probably be avoided during pregnancy. Patients with peptic ulcers will be cured if H. pylori are detected and treated with antibiotics. Because eradication methods have not been tested during pregnancy, pregnant patients with peptic ulcers who test positive for H. pylori face a challenging situation.
Triple and double antibiotics, as well as proton pump inhibitors, are included in these regimens. Eradication therapy should generally be delayed until after birth, given the perceived hazards of treatment. Most patients will benefit from maintenance H2 receptor antagonists or proton pump inhibitors until eradication therapy is available postpartum.
Metronidazole and amoxicillin have been proved to be safe in pregnancy and are classified as class B medications in pregnancy. They can be taken with a proton pump inhibitor for a 14-day course to eliminate H. pylori if the ulcer condition is complex or refractory to antisecretory therapy. Other antibiotics that are effective at eradicating H. pylori, such as clarithromycin (class C) and tetracycline (class D), should be avoided during pregnancy unless necessary. Bismuth, a category C medication, has been linked to prenatal toxicity in animals and has been linked to an increased risk of fetal ductus arteriosus closure.
Gastritis can develop into stomach ulcers and bleeding if left untreated. Some types of persistent gastritis, especially if you have severe thinning of the stomach lining and alterations in the lining cells, may raise your risk of stomach cancer in rare circumstances.
Home Remedies for Gastritis during pregnancy
Changes should be made to your dietary habits. Cut out foods that are spicy, fried, acidic, and high in fat content as these can cause gastritis flare-ups. Caffeinated drinks are also culprits, so swap your coffees and sodas with herbal teas and flavored water.
Certain dishes like red meat, pork, and refined foods may not elicit immediate reaction but could exacerbate pain in the long term. Instead of having three big meals, space out about four to six reduced portions throughout the day.
Your plate should consist of foods that are easy for your stomach to break down, for example, low-fat dairy products, soup, porridge, as well as steamed or boiled lean meat, and fish. Wash it all down with a fresh juice made out of fruits and vegetables.
You may be able to control your indigestion with changes to your eating habits.
Indigestion is more likely if you are overly full. It may be beneficial to eat small meals frequently rather than larger meals three times a day and to avoid eating within three hours of going to bed at night. It may be tempting to eat more than usual while pregnant, but this may be harmful to both you and your baby.
Changes in diet and lifestyle may be enough to control your symptoms, particularly if they are mild. Learn more about a healthy pregnancy diet and foods to avoid.
Caffeine-containing beverages and foods that are rich, spicy, or fatty can also help alleviate symptoms. If your condition is mild, a simple dietary change may alleviate your symptoms. Certain foods have been linked to an increased risk of gastritis. To help prevent it, avoid hot and spicy foods, acidic foods, and processed or packaged foods. You should also avoid all alcohol and limit your caffeine intake, as recommended.
Some foods can help relieve the symptoms of gastritis, and you may want to include them in your diet. These healthy dietary changes include consuming foods that:
- Are rich in fiber, such as carrots, broccoli, oatmeal, and beans
- Not acidic, such as vegetables
- Low in fat, such as turkey breast, chicken, and fish.
- Contain flavonoids, such as cranberries, cranberry juice, apples, garlic, celery, onions, and tea
When you eat, sit up straight. This will relieve some of the pressure in your stomach. When you go to bed, prop your head and shoulders up to prevent stomach acid from coming up while you sleep.
Smoking while pregnant can cause indigestion and have a negative impact on the health of both you and your unborn child. The chemicals you inhale when you smoke can contribute to indigestion. These chemicals can relax the ring of muscle at the lower end of your gullet, allowing stomach acid to pass more easily. This is referred to as acid reflux.
Smoking also increases the risk of:
- Your baby being born with a low birth weight
- Your baby being born prematurely
- Sudden infant death syndrome (SIDS)
- There's lots of help available to stop smoking
Alcohol consumption can result in indigestion. It can potentially cause long-term harm to the infant if used during pregnancy. It's best not to drink any alcohol when pregnant.
What medications are recommended to alleviate these discomforts?
The doctor will be able to determine whether the medication you are currently taking is safe for you and your baby. If necessary, they will be able to recommend an alternative medicine or treatment.
Among the medications used to treat indigestion and heartburn during pregnancy are:
- Antacids: to balance the acid in your stomach
- Alginates: to alleviate indigestion caused by acid reflux by preventing stomach acid from rising your gullet
If antacids and alginates do not relieve your symptoms, your doctor may prescribe a medication to lower the amount of acid in your stomach. The following are two medications that are commonly used during pregnancy and are not known to be harmful to an unborn baby:
- ranitidine – a tablet you take twice a day
- omeprazole – a tablet you take once a day
Antacids containing aluminum, calcium, and magnesium were not found to be teratogenic in animal studies and are recommended as first-line treatment of heartburn and acid reflux during pregnancy. Over-the-counter antacids such as Gaviscon may help you cope with occasional heartburn symptoms. The doctor may also prescribe Histamine-2 blockers (such as ranitidine or cimetidine) or proton pump inhibitors (such as omeprazole) if your symptoms do not respond well to antacids.
Although there is no evidence suggesting that this medication use is harmful during pregnancy, it is recommended that the drug only be used during pregnancy as needed, when no other options are available. If you are experiencing nausea and vomiting (especially during the early trimester), your doctor may prescribe you certain antiemetic medications, such as Metoclopramide (brand name Maxolon) and Domperidone (brand name Motilium). However, some women with the more severe form of pregnancy sickness, Hyperemesis Gravidarum, may require further hospitalization and investigation.
Some medications are not approved for use in pregnant women. If you are already taking gastritis medication and are pregnant or trying to become pregnant, you should consult a doctor for further guidance.
If you take iron supplements and antacids, don't take them at the same time. Antacids can prevent your body from absorbing iron.
Gastroenteritis in Pregnancy
Infectious gastroenteritis is a frequent illness that, in most cases, has a benign outcome during pregnancy. It does, however, cause unpleasant symptoms and anxiety for the mother about the well-being of the fetus.
Symptoms such as blood or mucus in the stool, frequency and volume of diarrhea and/or vomiting, fever, discomfort, and oliguria should all be mentioned in the history. It is necessary to determine the ability to tolerate oral consumption, interaction with other affected people, and contact with contaminated foods or water. Signs of preterm labor and fetal well-being, such as fetal movements, uterine activity, and vaginal loss, should also be questioned.
While most forms of infectious gastroenteritis in pregnancy have no long-term consequences for the mother or the fetus, Listeria monocytogenes infection is more dangerous. In pregnancy, listeriosis can cause nausea and vomiting, as well as fever and flu-like symptoms.
In most cases, rehydration is the primary treatment for gastroenteritis in pregnancy. Many women may achieve this on an ambulatory basis, either by oral rehydration or a brief stay in the hospital for intravenous fluids. If a woman is unable to accept oral rehydration, she is generally sick, or there is an indication of fetal distress or preterm labor, she may need to be admitted to the hospital.
To avoid serious neurological consequences like Wernicke's encephalopathy or central pontine demyelination, normal saline or Hartman's solution is preferred over 5% dextrose or hypertonic saline in severely dehydrated women. Loperamide is a Category B3 medicine that is not advised for use in pregnant women. It is commonly used to relieve diarrhea in non-pregnant patients. If admission is essential, appropriate infection-control measures should be implemented to protect staff and other patients from becoming infected.
When Should you see the Doctor for Gastrointestinal Issues During Pregnancy?
It is critical to notify your doctor even if you are only experiencing minor gastrointestinal problems. He or she can advise you on the best ways to treat those symptoms and then keep an eye on you throughout your pregnancy for signs of deterioration.
Call your doctor right away if your symptoms are severe, are becoming severe, and are continuous or protracted. If you have any of the following symptoms, you should contact your doctor right once and get medical attention.
- Vomiting blood
- Bloody or black stools
- Dramatic weight loss
- Severe discomfort that interferes with daily activities
- Episodes of choking
- Pain or difficulty when swallowing
- Extreme fatigue
Symptoms of pregnancy in the digestive system, include vomiting, acid reflux, constipation, and gastritis, a condition caused by inflammation of the stomach, which is an increase in its symptoms in pregnancy.
After we reviewed the most important symptoms of gastritis for pregnant women, there is no need to worry, as they do not occur commonly during pregnancy. However, you should pay attention to the symptoms, especially if the stool is dark, and consult a doctor and follow the previous advice to avoid any complications that may affect your pregnancy.