Gastroesophageal Reflux Disease (GERD) During Pregnancy

Gastroesophageal reflux disease (GERD) is very common during pregnancy; approximately 45%-80% of pregnant women have experienced GERD. GERD can have a negative impact on quality of life, particularly late in pregnancy.

The elevated progesterone hormone levels of pregnancy probably cause reflux by lowering the pressure in the lower esophageal sphincter. At the same time, the growing fetus increases the pressure in the abdomen. Both of these effects would be expected to increase reflux.

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Management of GERD in Pregnancy

Lifestyle modifications and pharmacologic management

Lifestyle modifications are the first line of management in pregnant women with GERD.

With regard to medications,

· Antacids or Sucralfate are safe in pregnancy, because they are not systemically absorbed.

· Histamine 2 (H2) blockers can be safely used in pregnancy.

· Many patients with GERD have intermittent symptoms, so they can use PPI therapy for symptom control as needed. If the patient’s heartburn is severe, the patient could be started on PPI therapy.

Lansoprazole & Dexlansoprazole is the preferred PPI in pregnancy.

Note: The outcome for pregnant patients with GERD is good. However, this condition tends to recur with subsequent pregnancies.

Highly Effective PPI in GERD

Dexlansoprazole Dual Delayed Release (DDR) has been shown to be highly efficacious in healing erosive esophagitis, controlling symptoms of patients with nonerosive reflux disease (NERD), GERD related sleep disturbances and bothersome regurgitation.

Dexlansoprazole has a dual delayed release (DDR) technology which was designed to prolong the plasma concentration time profile in order to improve symptoms control and esophageal mucosal healing, using once-daily dose.

Dexlansoprazole also can be taken regardless of meal times.