Gastroesophageal reflux disease during pregnancy

Gastroesophageal reflux disease (GERD) with heartburn and acid regurgitation is exceedingly common in pregnancy. The pathophysiology involves primarily a decrease in lower esophageal sphincter pressure. Most, if not all, of these patients are managed by obstetricians, but gastroenterologists may be consulted in difficult-to-treat cases. Because of the concern about the use of systemic medications during pregnancy and lactation, it is important for gastroenterologists to understand the pathogenesis, natural history and diagnostic and therapeutic options available for treating GERD during pregnancy.