What is gastritis during pregnancy?
Gastritis is inflammation of the lining of the stomach. Often, it is diagnosed and managed as gastroenteritis, which includes not only the stomach but the intestines as well. The main two causes of gastritis are infection with the bacterial species Helicobacter pylori, which causes ulcers, and the use of a class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). Gastritis also can be caused by irritation with various agents, such as alcohol, and by chronic vomiting, plus there are medications other than NSAIDs that can irritate the stomach lining. However, H. pylori and NSAIDs are the most significant causes for healthy young people, such as pregnant women. On the other hand, for gastroenteritis, there is a range of infectious causes, both bacterial and viral. The typical stomach flu, for instance, is viral gastroenteritis.
How common is gastritis during pregnancy?
Gastritis is fairly common during pregnancy because an estimated 50 percent of the human population is infected with H. pylori and because very large numbers of women are reported to take NSAIDs during pregnancy even though they are known to pose risks to the embryo/fetus when used at certain points in pregnancy. Developing countries have much higher rates of H. pylori infection compared with developed countries. Most infections begin in childhood, and risk is highest in those areas with poor hygiene practices. In European countries, Australia, and Japan, H. pylori infects about 20-30 percent of pregnant women, while rates up to 80 percent or more have been reported in Egypt and Gambia, and 50-70 percent in Turkey. Not everybody who is infected experiences symptoms, but pregnancy increases your susceptibility to becoming infected in the first place.
How is gastritis during pregnancy diagnosed?
Gastritis is diagnosed primarily with a procedure called upper endoscopy in which a gastroenterologist can view and sample the inside of your stomach. Addition investigations will include blood tests to check for anemia and tests for blood in your stool.
Does gastritis cause problems during pregnancy?
Yes. Symptoms that you can suffer due to gastritis include abdominal pain, bloating, lack of appetite, nausea, vomiting (possibly with blood), hiccups, a burning sensation at night and between meals, and black, tarry stools, due to the presence of occult blood. Anemia from blood loss can make you feel tired and strain your heart, and the condition can develop into a gastric ulcer, which over the long term, can develop into stomach cancer. There may be an association between H. pylori and a rare pregnancy complication called hyperemesis gravidarum (HG), which features extreme nausea and vomiting, much worse than usual nausea and vomiting of pregnancy.
Does gastritis cause problems for the baby?
If your gastritis is due to H. pylori infection, this possibly may increase the risk of insufficient fetal growth, congenital malformations, and even fetal death. However, these concerns have not been backed up sufficiently with studies. If you develop gastric bleeding that leads to anemia, and if it is severe enough, this may increase risks of preterm labor and birth, low birth weight, and possibly sudden infant death. As for gastritis due to NSAID use, there is concern that NSAIDs in early pregnancy may increase the risk of spontaneous abortion (miscarriage). Later in pregnancy (after 30 weeks gestation), NSAID use can cause premature closing of the ductus arteriosus (a blood vessel that is needed during fetal life to keep fetal tissues supplied with oxygen) and oligohydramnios (too little amniotic fluid).
What to consider about taking medications when you are pregnant or breastfeeding:
- The risks to yourself and your baby if you do not treat the gastritis
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat gastritis during pregnancy?
H. pylori infection is treated with a combination of drugs that are usually called triple therapy (if three drugs are used). Sometimes four drugs are used, in which case it is called quadruple therapy. These medications include whats called a proton pump inhibitor, which reduces acid production in the stomach. They also include one or two antibiotics, such as clarithromycin or metronidazole, and a bismuth-containing drug, such as bismuth biskalcitrate. Additionally, proton pump inhibitors can be used to promote healing of the stomach lining in other gastritis conditions, including gastritis due to medications, such as NSAIDs. There has been some concern that clarithromycin might increase the risk of spontaneous abortion (miscarriage) early in pregnancy, but it is generally considered relatively safe, as is metronidazole. Most proton pump inhibitors are considered pregnancy safe, as are certain bismuth drugs.
Who should NOT stop taking medication for gastritis during pregnancy?
If you have an infectious condition, such as H. Pylori, as the cause of your gastritis, you should complete the full course of your medication treatment to eradicate the infection.
What should I know about choosing a medication for my gastritis during pregnancy?
It is important to stay in communication with your health care provider as the release of new studies over time can change the outlook on the role of specific medications during pregnancy.
You may find Pregistrys expert reports about the medications to treat this condition here. Additional information can also be found in the sources listed below.
What should I know about taking a medication for my gastritis when I am breastfeeding?
Proton pump inhibitors appear to be safe during breastfeeding, as are most bismuth drugs, clarithromycin, metronidazole, and most of the other antibiotics that often are used against H. pylori.
What alternative therapies besides medications can I use to treat my gastritis during pregnancy?
If it is determined that your gastritis is due to NSAID use, in some cases, simply stopping the medication may be enough to allow the stomach lining to heal, although a proton pump inhibitor may help. In the case of H. pylori infection, medications are needed to eradicate the infection and to help the stomach lining to heal.
What can I do for myself and my baby when I have gastritis during pregnancy?
It is very important to follow the instructions of your physician.
Resources for gastritis in pregnancy:
For more information about gastritis during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or contact the following organizations:
- Mayo Clinic. Gastritis.
- US Center for Disease Control and Prevention. Helicobacter pylori and Peptic Ulcer Disease
General information
It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.
For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.
It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.
If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.
If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.
Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.