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Prevalence of gastroesophageal reflux (GER) increases during pregnancy, due to several factors like decreased lower esophageal sphincter pressure, increased intra-abdominal pressure secondary to the enlarged gravid uterus and alteration in gastrointestinal transit. The present study aimed to determine the prevalence of GER in pregnancy in a souther...
Context in source publication
Citations
... The prevalence of GERD in pregnancy is high, and can begin as early as the first trimester and worsen in the third trimester if left untreated. [107] Heartburn is the most common GERD symptom in pregnancy. [108,109] Medical treatment based on guidelines is the first step. ...
Gastroesophageal reflux disease (GERD) is one of the most common problems encountered in outpatient general medicine and gastroenterology clinics. GERD may present with classic esophageal symptoms, extraesophageal symptoms, or mixed symptoms. The diagnosis and treatment of GERD are challenging due to the variety of symptoms and multifactorial pathophysiology. Since there is no consensus on the diagnosis and treatment of GERD in Saudi Arabia, the Saudi Gastroenterology Association established an expert group to formulate a consensus on the clinical care pathway for the diagnosis and treatment of GERD to update health-care providers in Saudi Arabia. The expert group reviewed the literature including recently published international guidelines, clinical trials, and expert opinion and conducted virtual and in-person meetings. A total of 22 statements on the definition, diagnosis, and treatment of GERD were formulated, and three algorithms for the clinical care of GERD were developed with a detailed description for each step. The expert group endorsed the new definition of GERD, the practical principles of interpretation of the diagnostic GERD evaluation, and the practical guidance for GERD treatment including medical, surgical, and endoscopic therapy. The expert group recommends further studies to investigate local data on the diagnosis and treatment of GERD.
... The frequency of regurgitation increased gradually with respect to trimester among pregnant women compared to before pregnancy, (p<0.01). It was also observed that amongst the 136 patients, 3 patients presented with GERD, with one presenting in 2nd trimester and 3 rd trimester, while another presented in 2nd trimester only and third presented in 3rd trimester which is comparable with the previous studies [21,22] . Loss of appetite was present in 41.91% pregnant women compared to 11.03% non-pregnant women, (p<0.01). ...
... First, the included studies did not specifically ascertain medication adherence, and the assessment of PPI exposure was based on the claims data and prescription records. Further, the availability of PPIs as OTC drugs in two of the included studies may lead to an inaccurate assessment of their exposure and, thus, raise the possibility of confounding [37]. Second, only one study adjusted the findings for the body mass index (BMI), although the BMI is known to be associated with preeclampsia [38]. ...
Evidence from preclinical studies suggests a preventive effect of proton pump inhibitors (PPIs) in preeclampsia. Recently, several epidemiological studies have described a conflicting association between the use of PPIs during pregnancy and preeclampsia risk. This study aimed to evaluate the association between PPI use and the risk of preeclampsia. We searched databases, including MEDLINE, Embase, Scopus, Web of Science Core Collection, Emcare, CINAHL, and the relevant grey literature from inception until 13 September 2021. Studies reporting the preeclampsia risk with the use of PPIs were eligible for inclusion. Literature screening, data extraction, and the risk of bias assessment were performed independently by two investigators. Random-effect meta-analysis was performed to generate relative risks (RR) and 95% confidence intervals (CI). The risk of preeclampsia and preterm preeclampsia among women receiving PPIs during pregnancy were the primary outcomes of interest. This meta-analysis comprised three studies involving 4,877,565 pregnant women, of whom 119,017 were PPI users. The included studies were judged to have a low risk of bias. The risk of preeclampsia among pregnant women who received PPIs anytime during pregnancy was significantly increased (RR 1.27 (95% CI: 1.23–1.31)), although the increase was trivial in absolute terms (2 per 1000). The subgroup analysis revealed that the risk was increased in each of the three trimesters. The risk of preterm preeclampsia among pregnant women receiving PPIs anytime during pregnancy was not significantly increased (RR 1.04 (95% CI: 0.70–1.55)). The certainty evaluated by GRADE in these estimates was low. PPI use may be associated with a trivial increase in the risk of preeclampsia in pregnant women. There is no evidence supporting that PPI use decreases the risk of preeclampsia or preterm preeclampsia.
... Table 3 describes the frequency of reflux symptoms indicated by the results of the GERD-Q. The median GERD-Q score of the pregnant women with GERD was 8.0 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Said score was significantly higher in the second trimester (8.0, 5-12) and in the third trimester (8.0, 5-16), compared with the first trimester (7.0, 4-14) (p = 0.002 and p < 0.001, respectively) (Fig. 2). ...
... The prevalence of GERD increased in the third trimester, which may be attributed to a cumulative weight gain in that trimester, when the enlarged gravid uterus increases abdominal pressure and promotes reflux symptoms. Said finding is in accordance with several previous studies evaluating the evolution of GERD during pregnancy 8,9 . In contrast to our finding, the result of the study by Ramya et al. in India was that GERD prevalence decreased across the 3 trimesters 10 . ...
Introduction and aims:
The prevalence of gastroesophageal reflux disease (GERD) has been reported to be increasing in recent years. However, there have been few reports on the prevalence of GERD during pregnancy in the Asian population. The aim of our study was to evaluate the prevalence and characteristics of GERD in Vietnamese pregnant women.
Materials and methods:
This cross-sectional study was conducted at the antenatal clinic of the Nhan Dan Gia Dinh Hospital, Ho Chi Minh, Vietnam. Four hundred females, at various stages of pregnancy, were enrolled. GERD was diagnosed if there was troublesome heartburn and/or acid regurgitation, at least once a week, during the current pregnancy.
Results:
The overall prevalence of GERD in pregnancy was 38.5% (154/400). The prevalence of GERD in the third trimester was significantly higher than that in the second trimester (46.8% vs. 30.7%, P=0.008) and tended to be higher than its prevalence in the first trimester (46.8% vs. 35.4%, P=0.051). In the pregnant women with GERD, the frequency of regurgitation was significantly higher than that of heartburn (92.9% vs. 30.5%, P<0.001). Those typical symptoms were more prevalent in the daytime, compared with nighttime.
Conclusion:
Our study showed that GERD was prevalent during pregnancy in Vietnam. In the pregnant women with GERD, regurgitation was much more common than heartburn, and those typical reflux symptoms occurred more frequently in the daytime, compared with nighttime.
... El estudio prospectivo de La prevalencia de ERGE aumentó en el tercer trimestre, lo cual cabe atribuir al incremento acumulativo de peso en dicho trimestre, cuando el útero grávido de mayor tamaño aumenta la presión abdominal y promueve los síntomas de reflujo. Dicho hallazgo concuerda con varios estudios previos que evaluaron la evolución de ERGE durante el embarazo 8,9 . A diferencia de nuestro hallazgo, el resultado del estudio de Ramya et al. en la India fue de que la prevalencia de la ERGE disminuyó a lo largo de los 3 trimestres 10 . ...
Resumen
Introducción y objetivos
La prevalencia de la enfermedad por reflujo gastroesofágico (ERGE) ha aumentado en los últimos años. Sin embargo, hay pocos informes sobre el predominio de esta afección durante el embarazo en la población asiática. Nuestro objetivo fue evaluar la prevalencia y las características de la ERGE entre las mujeres embarazadas vietnamitas.
Material y métodos
Este estudio transversal se llevó a cabo en el Hospital Nhan Dan Gia Din, en Vietnam. Se incluyó a 400 mujeres embarazadas en distintas fases del embarazo. La manera de diagnosticar la ERGE fue la observación de presencia de pirosis molesta o regurgitación ácida al menos una vez a la semana durante el embarazo.
Resultados
La prevalencia de ERGE en el embarazo fue del 38,5% (154/400). Esa prevalencia en el tercer trimestre fue mayor que en el segundo trimestre (46,8 frente a 30,7%; p = 0,008) y tendió a ser mayor que en el primer trimestre (46,8 frente a 35,4%; p = 0,051). La frecuencia de regurgitación fue mayor que la de pirosis (92,9 vs. 30,5%; p < 0,001). Estos síntomas típicos se manifestaron con mayor frecuencia durante el día que durante la noche.
Conclusiones
Nuestro estudio demostró que la ERGE era prevalente en el embarazo en Vietnam. Entre las mujeres embarazadas con ERGE, la regurgitación era mucho más común que la pirosis y estos síntomas típicos de reflujo ocurrían con más frecuencia durante el día que durante la noche.
... Hormonal changes can weaken the lower esophageal sphincter and slow gastrointestinal transit, which, in combination with increased intra-abdominal pressure due to the growing fetus, results in esophageal regurgitation and subsequent GERD symptoms. 26 Certain genres of singing, such as western classical singing, may employ respiratory techniques that further increase intra-abdominal pressures, raising the question of the effect of singing during pregnancy on GERD symptoms. While our data is not robust enough to form any firm conclusions, the prevalence of GERD within our survey closely aligned with population prevalence estimates in recent literature, suggesting that singing did not have a significant effect on the prevalence of GERD during pregnancy. ...
Pregnancy has profound effects on a variety of body systems by way of hormonal and physical changes. Many of these changes directly affect body systems involved in singing. Assumptions exist about what can happen to a person's voice during pregnancy, but these assumptions are based on theoretical predictions leaving little knowledge of the lived experiences of voice changes during pregnancy. An anonymous mixed-method survey was given to 321 professional singers to gain insights on the lived experiences of pregnant singers. This investigation explored what people were told about the effects of pregnancy on the voice in comparison to what they actually experienced. Results show that about half of the respondents' experience matched what they were told for respiration. For phonation and vocal quality less than 25% respondent's experience matched what they were told. In addition, most of the information respondents received came from friends, colleagues, and teachers compared to medical professionals suggesting a need for more interdisciplinary education to best prepare vocalists who are contemplating becoming pregnant.
... Gastroesophageal reflux disease (GERD) is one the most common medical complaints in pregnant women. Its prevalence has been reported to reach as high as 80% in certain populations [1][2][3]. The prevalence of GERD is also increased as pregnancy progresses from the first to third trimester [4,5]. ...
... Regurgitation, acid taste in mouth and heartburn are among the most common GERD symptoms, with heartburn and regurgitation causing the most significant negative impact [1,2,6,7]. Heartburn during pregnancy may be caused by hormonal changes which affects normal gastric motility, increased intra-abdominal pressure from the growing uterus, slower gastrointestinal transit time or weight gain as pregnancy progresses, leading to acid reflux [8][9][10][11][12][13][14]. Heartburn and acid reflux have also been shown to be associated with severity of nausea and vomiting during pregnancy [15]. ...
Gastroesophageal reflux disease (GERD) is one the most common medical complaints in pregnant women. Some women continue to experience GERD symptoms after delivery. Effective management of GERD symptoms is important to improve productivity and quality of life. Management of heartburn in pregnant and breastfeeding women involves lifestyle modifications, dietary modifications, non-pharmaceutical remedies and pharmaceutical drugs. For most patients, lifestyle/dietary modifications are helpful in reducing GERD symptoms. For patients who require a more intense intervention, various types of pharmaceutical drugs are available. However, the suitability of each treatment for use during pregnancy and lactation must be taken into consideration. This article explores the reported efficacy and safety of these treatment options in pregnant and breastfeeding women. Recommended treatment algorithm in pregnant and breastfeeding women have been developed.
... We identified one case-control study, conducted in India, that evaluated the prevalence of GERD in pregnant women attending the antenatal services at various stages of pregnancy, in order to identify risk factors. 42 One hundred and eighty-two symptomatic women, with heartburn and/or acid regurgitation for at least 1 week (cases) and 218 asymptomatic women (controls) were compared. Diet was evaluated with a 7-day FFQ. ...
While interest in vegetarian nutrition has been steadily increasing, some aspects have not yet been consistently investigated. A topic requiring evidence-based confirmation is the adoption of a vegetarian diet during pregnancy and lactation. Maternal diet is correlated not only with the fetus’ and infant’s health, but it appears relevant for that of the mother as well. Not only is an adequate delivery of nutrients to the fetus and infant mandatory, but the increased physiological needs of the maternal body require an adequate supply of nutrients and can represent harmful stress events that may lead to well-defined pathological conditions. In this review, we aim to systematically investigate the state-of-the-art of vegetarian diets during pregnancy and lactation, focusing on maternal nutritional status and pregnancy outcomes. Data are scarce, often inconsistent and not homogeneous for many of the topics we considered, mainly because only a few studies were performed in developed countries, whereas other studies derived from developing countries, where vegetarianism can be a proxy indicator of malnutrition. For this reason, we did not find sufficient data to provide evidence-based information and recommendations. To date, the available literature does not clearly support a negative impact on the mother’s health and pregnancy outcomes, but, analogously with the findings in the vegetarian adult population, the improvement of the quality of the studies might facilitate finding more information on the possible positive impact of well-planned vegetarian diets in pregnancy and lactation. More epidemiological and interventional studies are warranted, in order to address the question as to whether vegetarian nutrition represents an advantage for the mother or poses nutritional issues that need further attention.
... A prospective longitudinal cohort study that compared pregnant and nonpregnant females reports significantly increased GERD symptoms [10]. Several mechanisms contribute to GERD symptoms in pregnancy, including decreased LES pressure, increased intra-abdominal pressure due to the enlarging uterus, and GI motility changes [11]. Increased circulating levels of progesterone and estrogen during pregnancy increases LES relaxation and allows reflux [12][13][14]. ...
Gastroesophageal reflux disease (GERD), a condition wherein there is reflux of stomach contents into the esophagus, causing heartburn and regurgitation with a sour and bitter taste in the mouth. It may or may not lead to mucosal injury. GERD symptoms can be troublesome and negatively impact the quality of life. Estrogen, the sex hormone in females, may play a role in the gender differences observed in GERD symptoms. This review article analyzes estrogen's mechanism in the causation of GERD symptoms and its complications. A better understanding of pathophysiology will help us guide early detection, treatment, and prevention of repeated reflux complications. We did a comprehensive PubMed database search and analyzed differences in GERD symptoms experienced by males and females and the role of estrogen in erosive and non-erosive GERD. GERD symptoms in association with hormonal replacement therapy (HRT) and pregnancy, the lower esophageal sphincter (LES) relaxant effects, and estrogens' protective effect on the esophagus from mucosal injury due to repeated reflux are discussed. Estrogen can cause GERD as an adverse effect and, at the same time, can be used to protect the mucosa from GERD induced injury and its complications like metaplasia and cancer. The mechanism is complex and requires further studies and trials. We recommend future researchers to look for possible estrogen use to treat erosive GERD and complication prevention.
... Furthermore, antacids which are not absorbed systemically or cause alkalosis or rebound hyperacidity, and those that do not hamper processes such as absorption and digestion because they are insoluble basic com¬pound and can be used either alone or in combination. [18,19] Recently, newer antacid formulations have been introduced which claim to have a better efficacy in terms of ANC. One of the antacid formulations included oxetacaine (oxethazaine), a local anaesthetic component, which offers fast and long-lasting relief from gastric pain of peptic ulcer disease or oesophagitis. ...
Background: Antacids are common over-the-counter medications for relief in common dyspeptic symptoms. However, antacid use has decreased with the availability powerful acid suppressant medications such as histamine H2 blockers, proton-pump inhibitors and prostaglandin analogues. Of late, a resurgence in the usage of antacids has been noted because of the improved profiles of newer antacid formulations, for example, the addition of pain-relieving component, oxetacaine (a local anaesthetic), anti-flatulent (alginate base compounds), in some antacid preparations. Aims and Objectives: The study investigated the efficacy (in terms of acid-neutralising capacity [ANC]) and cost-effectiveness of commercially available antacid formulations (both liquid and solid formulations). Materials and Methods: ANC was carried out using simple titrimetric methods and cost-effectiveness of antacid preparations was based on cost (in Saudi riyal) per milliequivalents of the acid neutralised. Results: ANC/gram was highest for antacid A1 (Moxal Plus solid) and lowest for antacid A3 (Fawar effervescent powder). The ANC/gram varied greatly among different antacid products and it ranged from 3.48 to 13.18. In general, solid antacids showed a high ANC/ gram compared to the liquid antacids. Furthermore, solid antacids were also found to be cost-effective compared to liquid dosage forms. In terms of efficacy, the newer antacid containing simethicone (A1) was found to be more cost-effective followed an antacid containing calcium carbonate (A2) and magnesium carbonate. Conclusion: In conclusion, mentioning ANC on antacid formulation labels may help to guide the choice of appropriate antacid, while cost-effectiveness study would govern the prescribing pattern of an antacid.
Keywords: Antacid, dyspepsia, H2 blockers, proton-pump inhibitors, simethicone
