Gastritis During Pregnancy

Prepared by Dr Lua Guan Way

Consultant Gastroenterologist and Hepatologist

Gleneagles Medini Hospital

Gastritis refers to a group of conditions that develop from the inflammation, irritation, or erosion of the protective lining of the stomach. It most commonly results from an infection by the same bacterium that triggers stomach ulcers.

Gastritis comes in either one of two forms, depending on the severity of the inflammation and the length of the incubation period.

Acute gastritis and chronic gastritis share similar symptoms, namely loss of appetite, recurrent nausea and vomiting, indigestion, and a feeling of bloating particularly after a meal. However, the pain stemming from acute gastritis occurs more suddenly but is temporary, while chronic gastritis causes duller and longer-lasting pain. Left unchecked, both can lead to ulcers or an increased risk of stomach cancer. Regardless, gastritis is not a huge worry with prompt and appropriate treatment.

Your stomach lining secretes mucus to protect against damage by corrosive digestive juices. Gastritis occurs due to the inflammation of this layer of tissue. The primary source of the condition is a bacterial infection of Helicobacter pylori (H. pylori), which can cause ulcers and in severe cases, stomach cancer. It is usually passed from person-to-person contact but may be transmitted via contaminated food or beverages as well.

Other risk factors can also engender gastritis, including:

• Alcohol, drug, and tobacco abuse
• Routine use of anti-inflammatory medication and pain relievers
• Extreme stress
• Chronic vomiting
• Old age as older adults are more prone to H.pylori infection and the stomach lining usually thins with age
• Autoimmune gastritis where the body attacks its own stomach lining
• The presence of other diseases such as Crohn's disease, HIV/AIDS, or parasitic infections

Women who already live with gastritis will suffer an aggravation of the disease during pregnancy. This is due to fluctuating hormone levels combined with the pressure that a growing foetus places on the body. In addition to the typical symptoms, expecting mothers may also experience heartburn, toxicosis accompanied by severe vomiting, stomach pain, flatulence, and diarrhoea.

Heartburn, vomiting, stomach pain, flatulence, and diarrhoea pose minor inconveniences during pregnancy but could indicate serious health issues depending on the severity and frequency. Use self-help measures and home remedies to relieve negligible irritation. Visit your specialist should the problems persist.

Antacids containing aluminium, calcium, and magnesium were not found to be teratogenic in animal studies and are recommended as first-line treatment of heartburn and acid reflux during pregnancy. Over-the-counter antacids such as Gaviscon may help you cope with occasional heartburn symptoms.

The doctor may also prescribe Histamine-2 blockers (such as ranitidine or cimetidine) or proton pump inhibitors (such as omeprazole) if your symptoms do not respond well to antacids. Although there is no evidence suggesting that these medications use is harmful during pregnancy, it is recommended that the drug only be used during pregnancy as needed, when no other options are available.

If you are experiencing nausea and vomiting (especially during the early trimester), your doctor may prescribe you certain antiemetic medication, such as Metoclopramide (brand name Maxolon) and Domperidone (brand name Motilium). However, some women with the more severe form of pregnancy sickness, Hyperemesis Gravidarum, may require further hospitalisation and investigation.

While a pregnant woman afflicted with gastritis may encounter exacerbated symptoms, there is no negative effect on the course of pregnancy and the development of the child.

No, it may be due to underlying pre-existing diseases, such as presence of Helicobacter pylori infection or peptic ulcer disease.

While it may be almost impossible to eliminate every gastrointestinal issue when you are pregnant, the following tips may help you feel a little better:

• Drink plenty of water
• Avoid gassy drinks such as soda and other carbonated drinks
• Avoid sugar substitutes such as sorbitol
• Keep a food diary to track foods that might be problematic for your digestive tract
• Eat high fibre foods
• Consider taking fibre supplements
• Exercise regularly to relieve constipation as physical activity may help speed up digestion
• Wear comfortable clothes such as loose-fitting maternal clothing
• Find ways to reduce stress, such as meditation, or taking a nice warm bath

Changes should be made to your dietary habits. Cut out foods that are spicy, fried, acidic, and high in fat content as these can cause gastritis flare-ups. Caffeinated drinks are also culprits, so swap your coffees and sodas with herbal teas and flavoured water.

Certain dishes like red meat, pork, and refined foods may not elicit immediate reaction but could exacerbate pain in the long-term. Instead of having three big meals, space out about four to six reduced portions throughout the day.

Your plate should consist of foods that are easy for your stomach to break down, for example low-fat dairy products, soup, porridge, as well as steamed or boiled lean meat and fish. Wash it all down with a fresh juice made out of fruits and vegetables.

It is essential to see your doctor for gastrointestinal issues even if they do not seem serious when you are expecting. Besides being able to prescribe you treatment to alleviate the symptoms, your doctor will also be able to monitor your condition to ensure that you remain healthy throughout pregnancy.

• Severe pain or discomfort that interrupts your daily activities
• Blood in stools
• Constipation for more than a week
• Vomiting blood
• Extreme weight loss
• Pain or difficulty swallowing
• Frequent choking episodes
• Extreme tiredness or fatigue

Gastritis during pregnancy can be very uncomfortable. If you are an expecting mom experiencing gastrointestinal symptoms, do not hesitate to make an appointment with Gleneagles' Ob/Gyns or Gastroenterologists. Our team of doctors are well equipped to journey with you throughout your pregnancy and beyond.