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Gastrointestinal Diseases During Pregnancy

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Medical Problems During Pregnancy

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Abstract

Gastrointestinal symptoms are common during pregnancy. Frequent complaints include gastroesophageal reflux (GERD) and functional bowel symptoms, such as constipation. These disorders can adversely affect quality of life. Screening and appropriate management of gastrointestinal disorders during pregnancy are key. In the case of GERD and function bowel disorders, it is important to identify associated triggers and lifestyle modifications should be recommended as initial strategy. Similarly, inflammatory bowel disease (IBD) is a disease that commonly affects women in their childbearing years. For women with IBD, preconception counseling and careful follow-up during pregnancy and the postpartum period are important in preventing negative pregnancy and birth outcomes. A thorough understanding of the mechanism of action of medications as well as their risk benefit profile is important when counseling patients on management options.

This chapter reviews the presentation, management, and complication of common gastrointestinal symptoms that women may report during pregnancy such as GERD and constipation. In this chapter, issues around fertility, pregnancy, and birth outcomes, as well as disease prognosis related to IBD, are also reviewed.

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Abbreviations

5-ASA:

5-aminosalicylic acid

6-MP:

6-mercaptopurine

AAP:

American Academy of Pediatrics

ADA:

Adalimumab

AGA:

American Gastroenterology Association

anti-TNF:

Antitumor necrosis factors

AZA:

Azathioprine

CD:

Crohn’s disease

CZP:

Certolizumab pegol

ECCO:

European Crohn’s and Colitis Organization

EGD:

Esophagogastroduodenoscopy

FDA:

Food and Drug Administration

FODMAP:

Fermentable oligo-, di-, and monosaccharrides and polyols

GERD:

Gastroesophageal reflux disease

GLB:

Golimumab

IBD:

Inflammatory bowel disease

IBS:

Irritable bowel syndrome

IFX:

Infliximab

IPAA:

Ileal pouch/anal anastomosis

LES:

Lower esophageal sphincter

NAT:

Natalizumab

PPI:

Proton pump inhibitor

RPC:

Restorative proctocolectomy

TCA:

Tricyclic antidepressants

UC:

Ulcerative colitis

VDZ:

Vedolizumab

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  1. Beth Israel Deaconess Medical Center, Department of Gastroenterology, Boston, MA, USA

    Mona Akbari MD, MPH & Jacqueline L. Wolf MD

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  1. Mona Akbari MD, MPH
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  1. Department of Neurology, Brigham and Womens Hospital, Boston, Massachusetts, USA

    Carolyn Bernstein

  2. Boston Maternal Fetal Medicine, Brookline, Massachusetts, USA

    Tamara C. Takoudes

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Akbari, M., Wolf, J.L. (2017). Gastrointestinal Diseases During Pregnancy. In: Bernstein, C., Takoudes, T. (eds) Medical Problems During Pregnancy. Springer, Cham. https://doi.org/10.1007/978-3-319-39328-5_1

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