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Pregnant women are susceptible to nausea, vomiting, gastroesophageal reflux, constipation, and diarrhea at rates similar to or higher than the general population.
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Many of the pregnancy-induced gastrointestinal (GI) disorders result from the normal hormonal and structural changes associated with pregnancy.
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Although a vast majority of GI complaints are caused by normal pregnancy-related changes, other pathologic conditions and causes should be considered.
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When symptomatic remission cannot be
Gastrointestinal Diseases in Pregnancy: Nausea, Vomiting, Hyperemesis Gravidarum, Gastroesophageal Reflux Disease, Constipation, and Diarrhea
Section snippets
Key points
Nausea, vomiting, and hyperemesis gravidarum
A majority of pregnant women experience nausea and vomiting during pregnancy.1 The prevalence of nausea in this group is between 50% and 80% and for vomiting 50%.2 These are the most common medical conditions during gestation, usually beginning between weeks 4 and 6, peaking at approximately weeks 8 to 12, and often ceasing by week 20.3
Hyperemesis gravidarum (HG) is a severe and persistent form of nausea and vomiting.2 Fortunately, it only affects approximately 1.2% of pregnant women.3
Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) typically manifests as heartburn and is reported by 40% to 85% of pregnant women.18 Pregnancy may be the first time a woman experiences GERD or it may exacerbate preexisting reflux disease.19 Box 2 lists the common symptoms of GERD, which typically begin in the later portion of the first trimester or early portion of the second trimester. When present, GERD usually lasts throughout gestation and may get progressively worse in the later months but typically
Constipation
Constipation is the second most common GI complaint in pregnancy.21 After modifying the duration of symptoms (1 month instead of 3 months), Bradley and colleagues22 used many elements of the Rome III Diagnositic Criteria for Functional Constipation to define constipation as the presence of at least 2 of the following 6 symptoms during at least 25% of defecations: having fewer than 3 bowel movements per week, straining, hard or lumpy stools, sensation of anorectal blockade/obstruction, sensation
Diarrhea
Compared with other GI disorders in pregnancy, there is significantly less literature on diarrhea in pregnancy. There are no recent studies documenting the prevalence of diarrhea in pregnancy, and GI motility has not been evaluated in pregnant women who report diarrhea.24, 25 Previous studies from the 1970s reported an increased frequency of bowel movements in 34% of pregnant women.27 Diarrhea that develops at or near term may be a precursor to labor.21
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Cited by (81)
Effects of auriculotherapy on nausea and vomiting in pregnant women: A randomized clinical trial
2024, Complementary Therapies in Clinical PracticeAssociation of the Verbal Rating Scale-Measured Dysmenorrhea with Nausea and Vomiting in Pregnancy: A Retrospective Cohort Study
2024, Journal of Obstetrics and Gynaecology CanadaEfficacy of Cassia fistula Syrup on Constipation in Pregnant Women: an Open-Label Controlled Randomised Clinical Trial
2023, Journal of Herbal MedicinePredicting postpartum depressive symptoms by evaluating self-report autonomic nervous system reactivity during pregnancy
2023, Journal of Psychosomatic Research
Disclosure: Research support, Takeda Pharmaceuticals; Advisory Board, Synergy Pharmaceuticals.