GPAtlas🧭 When to suspect
Suspect gastro-oesophageal reflux disease (GORD) in any pregnant woman describing:
• Heartburn (a retrosternal burning sensation)
• Acid regurgitation into the throat or mouth
• Epigastric discomfort
It is one of the commonest complaints of pregnancy, affecting up to 80% of women and tending to worsen through the third trimester.
Two things drive it:
• Progesterone relaxes the lower oesophageal sphincter (LOS) – the muscular valve that normally keeps stomach contents down
• The growing uterus raises intra-abdominal pressure and slows gastric emptying
Symptoms are therefore typically worse after meals, on lying flat, and at night.
Your two jobs:
• Control the symptoms with a safe, stepped approach
• Never mistake the epigastric pain of pre-eclampsia for simple indigestion – the point that matters most. New upper-abdominal pain in the second half of pregnancy must prompt a blood pressure and urine check before it is labelled reflux.
Source: NICE NG201 · NICE NG133
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