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The Gastrointestinal Tract and the Liver in Pregnancy: Normal Functions and Diseases

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Medical Management of the Pregnant Patient

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Abstract

The gastrointestinal tract undergoes dramatic modifications during pregnancy. Heartburn, nausea, abdominal cramps, and altered bowel habits are the most common gastrointestinal symptoms of pregnant women. However, it may be a challenge to distinguish among functional symptoms and the onset of diseases that require immediate medical attention. The differential diagnosis must include diseases specific to pregnancy as hyperemesis gravidarum, intrahepatic cholestasis of pregnancy, acute fatty liver of pregnancy, and preeclampsia.

Another challenge for the physician is the treatment of pregnant women with underlying chronic illnesses. Significant advances were made in the recent years to ascertain the outcomes and the best therapy in pregnant women with inflammatory bowel disease. As a result, it is now recommended to continue the immunosuppressants and immunomodulators maximizing the mother’s health throughout gestation. The treatment of chronic liver disease has also changed in the last few years. Pregnancy in patients with advanced liver disease is no longer discouraged, but the patient needs to be followed closely by a team of experts given the high risk of complications for both the mother and fetus.

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Authors and Affiliations

  1. Center for Women’s Gastrointestinal Medicine, Women’s Medicine Collaborative, The Miriam Hospital, 146 West River Street, Providence, RI, 02904, USA

    Silvia Degli Esposti M.D.

  2. The Warren Alpert Medical School of Brown University, Providence, RI, USA

    Silvia Degli Esposti M.D.

  3. Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Judy Nee M.D.

  4. Harvard Medical School, Boston, MA, USA

    Judy Nee M.D.

  5. University of Wisconsin School of Medicine and Public Health, Medical Foundation Centennial Building, Rm 4224, 1685 Highland Avenue, 4th Floor, Madison, WI, 53705, USA

    Sumona Saha M.D.

Authors
  1. Silvia Degli Esposti M.D.
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  2. Judy Nee M.D.
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  3. Sumona Saha M.D.
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Corresponding authors

Correspondence to Silvia Degli Esposti M.D. or Katie Lester .

Editor information

Editors and Affiliations

  1. SVP Women’s Services and Clinical Integration, Lifespan Corporation, Professor and Vice Chair of Medicine Director of Obstetric Medicine, Alpert Medical School at Brown University, Providence, Rhode Island, USA

    Karen Rosene-Montella

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Esposti, S.D., Nee, J., Saha, S. (2015). The Gastrointestinal Tract and the Liver in Pregnancy: Normal Functions and Diseases. In: Rosene-Montella, K. (eds) Medical Management of the Pregnant Patient. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1244-1_5

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  • DOI: https://doi.org/10.1007/978-1-4614-1244-1_5

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