Basal management of gastrointestinal diseases in pregnant women
1 Wojskowa Specjalistyczna Przychodnia Lekarska w Radomiu. Kierownik: lek. med. Andrzej Cholewiński
2 Klinika Gastroenterologii, Centralny Szpital Kliniczny MON WIM w Warszawie. Kierownik Kliniki: prof. dr hab. n. med. Jerzy Gil
Adres do korespondencji: lek. med. Ewa Tylec‑Osóbka, ul. Sempołowskiej 7/22, 26‑600 Radom, e‑mail: tylewka@interia.pl
Praca finansowana ze środków własnych
PEDIATR MED RODZ Vol 8 Numer 4, p. 315-323
ABSTRACT
Pregnancy is a physiologic state, however pregnant women often require diagnosis and treatment of serious gastrointestinal tract disorders (GI) which are some of the most frequent complaints during pregnancy. Some women have GI disorders that are unique to pregnancy. Other pregnant patients present with chronic GI disorders that require special consideration during this period. Understanding the presentation and prevalence of various GI disorders is necessary to optimize care for these patients. Pregnancy has little effect on gastrointestinal secretion or absorption, but it has a major effect on gastrointestinal motility. Pregnancy‑related changes in motility are present throughout the gastrointestinal tract and are related to increased levels of female sex hormones. In addition, the enlarging uterus displaces bowel, which can affect the presentation of common omplaints such us constipation. Knowledge of the gastrointestinal adaptation to pregnancy is necessary for accurate interpretation of laboratory tests, as well as imaging studies in the gravid patient. Endoscopy is rarely required during pregnancy. The potential risks of endoscopy during pregnancy include foetal hypoxia due to sedative drugs and exposure to radiation. There is no evidence that endoscopy precipitates premature labour, and studies in this area have concluded that endoscopy during pregnancy is generally safe. There should be a strong indication for the procedure, which should be deferred whenever possible to the second trimester. Procedures should be performed without any sedation, or with the lowest dose of sedative medication. Radiation exposure should be kept to a minimum. Support should be obtained from specialists in obstetrics and anaesthesia. 
Keywords: pregnancy, gastrointestinal tract diseases, liver diseases, endoscopy, treatment