Diseases of the upper gastrointestinal tract in pregnancy: what should the gastroenterologist consider?

Diseases of the upper gastrointestinal (GI) tract are among the most common extragenital pathologies in pregnant women. Hormonal and physiological changes occurring during pregnancy can trigger or exacerbate conditions such as gastroesophageal reflux disease (GERD), functional dyspepsia, chronic gastritis, and peptic ulcer disease. The rational selection of pharmacotherapy requires careful consideration of drug safety for both the mother and the fetus. Objective. To summarize current evidence-based data on the diagnosis, natural history, and treatment of the most common upper GI diseases in pregnant women. Key points. This review discusses major gastroenterological disorders in pregnant women, including their pathogenesis, clinical manifestations, and diagnostic methods. Approaches to treatment are outlined in accordance with international and national guidelines, with a particular focus on pharmacotherapy and the FDA drug safety classification system. Algorithms for patient management are presented, emphasizing risk minimization for the fetus while ensuring effective treatment for the mother. Conclusion. Early diagnosis and appropriate treatment of gastroenterological disorders in pregnant women can reduce complications and improve patient quality of life. The management of such cases requires a multidisciplinary approach involving both a gastroenterologist and an obstetrician.