Review of recent evidence on the management of heartburn in pregnant and breastfeeding women

Figures

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  Fig. 1. Diagram of alginate raft structure formation following ingestion of an alginate-containing formulation. Alginates react with the stomach acid to form a gel-like substance with neutral pH (A). Sodium bicarbonate contained in the formulation releases carbon dioxide gas, which becomes trapped in the gel. The trapped carbon dioxide gas allows the gel to float to the surface of the stomach content (B), effectively forming a raft structure (C) which acts as a barrier over the gastric acid pocket, and blocks against upward reflux. Adapted from Bor et al. [79]

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  Fig. 2. Preferred treatment algorithm for GERD during pregnancy, according to current evidence. Mild GERD is usually remedied by non-pharmaceutical interventions (step 1). In all patients, if symptoms persist after step 1, patients may proceed to step 2, and so on. Once symptoms are resolved, advise patients to continue non-pharmaceutical intervention. Adapted from Ali and Egan [24]. GERD gastroesophageal reflux disease, OGD oesophagogastroduodenoscopy, P-CAB potassium-competitive acid blockers

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  Fig. 3. Preferred treatment algorithm for GERD during lactation, according to current evidence. Mild GERD is usually remedied by non-pharmaceutical interventions (step 1). In all patients, if symptoms persist after step 1, patients may proceed to step 2, and so on. Once symptoms are resolved, advise patients to continue non-pharmaceutical intervention. Adapted from Ali and Egan [24]. GERD gastroesophageal reflux disease, OGD oesophagogastroduodenoscopy