Newspaper "News of Medicine and Pharmacy" Gastroenterology (348) 2010 (thematic issue)

The sour taste in the mouth is disturbing and unnerving. Unpleasant taste sensations in the mouth outside of food consumption are a sign of a large number of diseases.

There is such a gastronomic concept as aftertaste. And it is not always pleasant. This is a reaction to stimuli from the taste buds located on the tongue and the inner surface of the cheeks.

A sour taste in the mouth can be the result of using lemon, vinegar, and various marinades for cooking. During the period of not eating food, no foreign tastes should be felt in the oral cavity. If the aftertaste does not go away, or any additional symptoms appear, then the cause of this phenomenon should be identified.

Causes of discomfort

The taste in the mouth tells about the health of the whole body.

The reasons for the appearance of acid in the oral cavity can be both diseases of various organs and a joyful event - the onset of pregnancy.

Possible diseases that cause an unpleasant aftertaste:

• increased acidity of gastric juice;
• excess production of hydrochloric acid;
• disturbances in the gastrointestinal tract - pancreas, reflux disease;
• periodontal diseases;
• the presence of crowns or fillings made of different metals in the oral cavity - such combinations form a galvanic couple and a physical and chemical reaction of electrolysis takes place in the oral cavity;
• electrolyte imbalance;
• dehydration of the body;
• taking medications;
• impaired bile formation and liver pathology - as a result of eating fatty and heavy foods; pregnancy in the middle and late stages - the growing uterus compresses the stomach and hydrochloric acid refluxes into the esophagus and oral cavity.

All these processes are accompanied by additional symptoms. Therefore, if you regularly experience an unpleasant sensation in the oral cavity, you should undergo a comprehensive examination.

If at the same time there is pain in the epigastrium, nausea, and stool disorder, then you need to urgently contact a medical institution.

The following video will familiarize you with the causes of sour taste in the mouth:

How to cope with heartburn and indigestion during pregnancy?

1. Independent methods of treatment

   As already mentioned, most pregnant women experience heartburn and indigestion, but there are simple and useful tips that will help you experience these unpleasant sensations less often:

   Try to give up bad habits

   • Stop smoking and drinking alcohol - both of these can only contribute to the appearance of heartburn and stomach discomfort, not to mention the fact that this is simply contraindicated during pregnancy.

   Eat right

   Proper nutrition is an integral part of pregnancy. It is very important to maintain a balance of proteins, high-starch foods, vegetables and fruits. However, the best way to relieve heartburn is to avoid trigger foods. Spicy and fatty foods, caffeine, chocolate and tomatoes are the most common foods that most often cause heartburn.

Change your eating habits

• It is recommended to divide your daily diet into small portions and eat more often throughout the day. This way of eating will bring more benefits than three large meals. This will prevent overfilling and can ultimately prevent stomach acid from getting into your esophagus.
• If you experience heartburn and indigestion at night, you may be a late-night eater. If this is true, then gastric juice will continue to be produced even after you go to bed. To avoid this, it is better to eat 2-3 hours before bed: this time is just enough to digest the food.

Pregnancy doesn't mean you have to eat for two. Excess weight can cause you discomfort in the later stages. For women whose weight was normal before pregnancy, it is recommended to gain no more than 10-14 kg.3

Get plenty of rest

• Pregnancy is a blessing for expectant parents and the whole family, but sometimes you have to be nervous. Since stress can also cause heartburn and indigestion, try to regularly set aside time for yourself to relax. This way you can reduce the likelihood of the negative effects of stress.

Think about the body position you are in

• After eating, try to stand or sit for a while, do not lie down immediately after eating. Also try to avoid strenuous activity after eating, especially if it involves bending.
• Try to avoid putting additional pressure on the waist and abdominal area. In particular, do not wear compression belts. Don't forget about this when children or pets ask to sit on your lap.
• Get used to the correct sleeping position, which will allow you to avoid unpleasant sensations while you sleep. When you lie on your back, stomach acid is more likely to enter your esophagus. Some people find that raising the head of the bed can also help. Always pay attention to the position of your body - this is important both during pregnancy and in any other condition!

Treatment with medications

During pregnancy, expectant mothers are wary of taking medications. This is completely justified; no one wants to harm their unborn baby. However, there are medications that you can take during pregnancy without worrying about the baby's health. Despite this, always read the instructions before using a new drug and pay attention to special advice and side effects of drugs.

Antacids

Such drugs usually contain calcium carbonate, magnesium carbonate or aluminum hydroxide; they neutralize stomach acidity. They are used to treat mild attacks of heartburn and indigestion and are available in several forms, including liquid and chewable tablets.

alginates

"Gaviscon® Double Action" is a well-known drug related to alginates and has a neutralizing effect on excess gastric acid. Sodium alginate in its composition forms a protective barrier that prevents the contents of the stomach (including gastric juice) from entering the esophagus, due to which discomfort and pain disappear.

In addition, Gaviscon® Double Action contains calcium carbonate, which quickly neutralizes excess stomach acid. The result will be a reduction in discomfort in the stomach area. Gaviscon® provides long-term relief from heartburn and indigestion4 and has a longer-lasting effect on acid reflux than simple antacids.5,6

Gaviscon® Double Action can be used during pregnancy. The possibility of its use is explained by the fact that the drug is not absorbed into the blood.

If you are taking antacids or alginates (eg Gaviscon® Double Action), remember not to exceed the recommended dose. Follow the instructions carefully.

Acid and sweet

Acidity in the mouth is not a very pleasant sensation

A pure taste sensation is rare. Since there are receptors in the oral cavity for determining and analyzing various combinations.

In a pathological process, acid may predominate, but in most cases other flavors are also present. This provides additional information to find the cause of the unpleasant sensation.

Sweet and sour taste is caused by the following conditions:

1. increased blood glucose levels due to stress, physical exertion;
2. state of depression;
3. excessive consumption of sweets;
4. disruption of the gastrointestinal tract;
5. liver pathologies;
6. toxic effects of pesticides, gaseous chemicals;
7. smoking cessation period;
8. diabetes with a slight increase in blood glucose levels, a latent form of the disease;
9. pathologies of the maxillofacial system, which are accompanied by purulent processes - gum disease, caries, periostitis, gumboils and abscesses.

Before contacting a doctor, you should analyze the factors that contribute to the appearance of a sour taste in the mouth.

The main causes of an unpleasant taste in the mouth during pregnancy

Why might pregnant women have an unpleasant taste in their mouth—bitter or sour? Experts say that there may be several reasons for this phenomenon, so to understand what causes this unusual taste, you need to pay attention to other symptoms. A sour taste may be a sign of hormonal imbalance, lack of vitamins or diseases of the digestive system.

Physiological and hormonal changes in the body

During pregnancy, significant hormonal and physiological changes occur in a woman's body. In the early stages, many suffer from toxicosis, which manifests itself in the form of nausea, heartburn, and vomiting. In this case, a sour or bitter taste periodically appears in the oral cavity, especially in the morning.

In the second and third trimesters, the reason for the appearance of a sour or bitter taste is not toxicosis, but the growing uterus. Starting from the middle of the term, the uterus begins to increase in size, displacing neighboring organs. It puts pressure on the liver, gall bladder and stomach. As a result, the woman experiences belching and heartburn, which is accompanied by a bitter and sour taste.

Another reason for a strange taste in the morning is high progesterone levels. This hormone has the property of relaxing muscles to reduce the tone of the uterus. At the same time as the myometrium, the esophageal sphincter also relaxes slightly, causing stomach acid to be released into the esophagus.

Various diseases

During pregnancy, many chronic diseases become aggravated. If a woman has previously had problems with the gastrointestinal tract, they can manifest themselves in the form of bitterness and acidity. If you feel unpleasant symptoms, the expectant mother should immediately consult a gastroenterologist for advice.

The table provides a list of diseases that cause an unpleasant taste in the mouth.

Lack of vitamins and microelements

A sour or metallic taste in the mouth appears due to a lack of iron and vitamin C. A decrease in hemoglobin levels in the blood is a common occurrence during pregnancy, so doctors often prescribe vitamin complexes and iron-containing preparations to women.

Vitamin deficiency and lack of microelements are usually accompanied by poor health and chronic fatigue. Hair and nails become brittle, skin turns pale. Ulcers and wounds appear on the oral mucosa.

Acid and bitterness

A bitter taste indicates a disruption of the liver and bile ducts. It may appear occasionally, but may bother you regularly.

Possible causes of a bitter-sour aftertaste:

• significant errors in nutrition - the liver is simply not able to cope with so many fatty, heavy, spicy foods, alcoholic drinks;
• alcoholism - the liver suffers first;
• treatment with aggressive drugs - a long course of antibiotics, antihistamines, and other medications;
• those who like to smoke a cigarette at night.

If we consider bitterness in the oral cavity in terms of the intended diagnosis, then most often it is cholecystopancreatitis, erosion of the mucous membranes of the stomach and intestines, gastritis.

Newspaper "News of Medicine and Pharmacy" Gastroenterology (348) 2010 (thematic issue)

During pregnancy, a woman's stomach is especially vulnerable. Pregnancy is often accompanied by increased acid production, although it is possible that it may decrease. It is known that with increased stomach acidity, an increase in appetite is characteristic. However, it is not recommended to load the stomach with high acidity during pregnancy. During pregnancy, the stomach produces more hydrochloric acid not so much to increase appetite, but to increase the bactericidal properties of its contents.

An unpleasant feeling of slight heat or burning in the pit of the stomach, sour belching - all these symptoms are combined into one term “heartburn”. During pregnancy, heartburn is caused by hormonal and physical changes in a woman's body. It is observed in approximately 50% of women during pregnancy at any stage, but more often in the second and third trimesters, and is provoked by the consumption of abundant fatty, fried and spicy foods. Its occurrence is due to the reflux of acidic (much less often alkaline) gastric contents into the lower esophagus and its irritating effect. As is known, in pregnant women the tone of the lower esophageal sphincter is significantly weakened, which is the result of the action of progesterone, and an enlarged uterus by the 25th week contributes to an increase in intra-abdominal pressure, which prevents complete closure of the sphincter. Progesterone also reduces contractions of the esophagus and intestines, slowing digestion. The feeling of heartburn is accompanied by a feeling of melancholy and depressed mood.

Another symptom typical of stomach pathology is pain. The nature of pain in stomach diseases may indicate not only the disease, but also the presence of complications. Thus, the occurrence of burning pain in patients with gastritis or peptic ulcer may indicate the addition of solarium. Pregnant women with chronic gastritis with reduced gastric secretion usually experience a feeling of heaviness and fullness in the epigastric region. This feeling also appears with pyloric stenosis. In pregnant women with chronic gastritis with preserved secretion, the pain is often dull and aching. The intensity of pain in stomach diseases can vary. With chronic gastritis, pain in the epigastrium is usually low-intensity, and with gastric ulcer, and especially with duodenal ulcer, the pain is usually severe. With a perforated ulcer, the pain intensity is so high that pain shock is possible.

According to a number of authors, chronic duodenitis occurs in pregnant women much more often than is diagnosed, is observed in the first trimester of pregnancy or 4-5 weeks before birth and is characterized by cyclical exacerbations (spring - autumn). The clinical picture is dominated by pain; night and hunger pains are typical; eating reduces them. The goal of drug treatment for chronic duodenitis in pregnant women is to achieve remission of the disease. In the uncomplicated course of chronic gastritis or duodenitis, the patient’s condition is not significantly disturbed, and the disease does not have a noticeable effect on the course of pregnancy and its outcome. When vomiting during pregnancy occurs, treatment of gastritis or duodenitis should be combined with treatment of early toxicosis.

The literature describes isolated information about the course of pregnancy against the background of Ménétrier's disease. Analysis of literature data does not allow us to draw conclusions about the etiology of the disease, although the role of cytomegalovirus is assumed. Along with the complaints characteristic of chronic gastritis, pregnant women experience lethargy and possible swelling of the lower extremities. It was noted that in the second half of pregnancy the disease is severe, but it is not a contraindication for pregnancy. During pregnancy, the diagnosis is established on the basis of gastroscopy, in which the gastric mucosa is pale gray, swollen, easily vulnerable, eroded, with the presence of hemorrhages. Treatment is symptomatic, since, according to most researchers, gastrectomy outside pregnancy is indicated.

Peptic ulcer disease in pregnant women is quite common, but the exact incidence is difficult to estimate, since diagnosing peptic ulcer disease during pregnancy is difficult. The chance of encountering this disease in pregnant women has increased significantly, although in the vast majority of cases pregnancy softens the clinical course of peptic ulcer disease. The reason for the favorable course of peptic ulcer disease in pregnant women has not been fully studied. Some researchers believe that this is the result of altered secretory (decreased production of hydrochloric acid and increased mucus production) and motor functions of the stomach in the direction of reducing it and increasing blood supply. It has been established that during pregnancy, in 40% of cases, remission of gastric and duodenal ulcers occurs due to the high level of progesterone in the body, which stimulates the production of mucus, which is a protective mechanism of the gastric mucosa. Perhaps the overproduction of sex hormones, namely estrogens, plays a role. It has been established that estrogens perform a protective function, increase the intensity of regenerative processes, and improve blood supply to the gastroduodenal area. For most women, the disease does not affect the process of bearing and giving birth to a child. However, exacerbation of peptic ulcer disease during pregnancy, although unlikely, is still possible (in 10% of cases). Most pregnant women associate it with excessive anxiety, fear of the upcoming birth and its outcome, probably because pregnancy itself is stressful for a woman. The main symptoms of a peptic ulcer are: pain in the epigastric region (under the stomach), belching of air, food, nausea, sometimes vomiting, constipation, flatulence, weight loss. Peptic ulcer disease is dangerous due to its complications, one of which is gastrointestinal bleeding, which sharply increases the risk of fetal death. Massive bleeding during pregnancy is an indication for emergency surgery.

Stomach cancer is quite rare in pregnant women. The authors note that for stomach cancer in pregnant women, the first symptoms appear at 15–16 weeks of pregnancy. Pain in the epigastric region, lack of appetite, nausea, vomiting are noted, melena is possible, but the symptoms are unclear and the clinical picture is blurred. The diagnosis is established on the basis of fibrogastroscopy with biopsy. Treatment is only surgical, since conservative treatment is not effective. According to most authors, the prognosis for the mother and fetus is unfavorable.

Gastric resection is one of the most common operations for gastric disease. It is known that pregnant women with a resected stomach are more likely to develop digestive system disorders, which is explained by the depletion of compensatory capabilities in this category of women. However, the issue of the influence of pregnancy on the health of women with a resected stomach and on the course of pregnancy itself in this category of women has not yet been sufficiently studied and is poorly covered in the literature.

Pregnancy imposes significant restrictions on the choice of diagnostic methods and on determining treatment tactics. X-ray examination of the stomach is not recommended for pregnant women, therefore the only diagnostic method for stomach pathology is esophagogastroduodenoscopy, although its implementation can be difficult.

Since therapy aimed at destroying Helicobacter pylori is not carried out during pregnancy, diagnosis of this infection is carried out after childbirth (a breath test is performed if necessary). Antacids are recommended for use during exacerbations of peptic ulcer disease in pregnant women. Antacids containing aluminum, calcium, or magnesium are considered safe and effective in treating heartburn during pregnancy. However, magnesium-containing antacids should be avoided during the third trimester of pregnancy because they may trigger preterm labor. In addition, antacids containing sodium bicarbonate should be avoided to avoid the occurrence of metabolic alkalosis. In addition, it is possible to prescribe enveloping and astringent agents of plant origin - decoctions of chamomile, St. John's wort.

H2-blockers of histamine receptors are also undesirable for pregnant women. However, it has been established that ranitidine is the only histamine H2 receptor antagonist that has been well studied during pregnancy. In a double-blind, placebo-controlled study, JD Larson et al. (1997) proved that ranitidine, taken several times a day by pregnant patients with heartburn (if antacids are ineffective), reduced its severity. No adverse effects on the fetus have been reported. A study on the safety of ranitidine by JE Richter (2003) showed that pregnant women who took it from the first trimester throughout pregnancy gave birth to healthy children. Taking proton pump inhibitors for acid-dependent conditions by pregnant women is undesirable and is possible only if antacids are ineffective. More recently (May 2010), new evidence has emerged showing an increased risk of hip, wrist and spine fractures with long-term or high-dose use of proton pump inhibitors, as well as a more than doubling of the risk of having a baby with heart defects. Only when the threat to the mother's health outweighs the potential risk to the fetus is it possible to prescribe short-term courses of proton pump inhibitors. Recently, evidence has emerged that lansoprazole and pantoprazole are priority representatives of this class of drugs, since their relative safety in pregnant women has been studied. Due to the fact that the range of medications for acid-dependent gastric conditions during pregnancy is limited, dietary measures play an important role. In addition, it is recommended to limit physical activity, semi-bed rest, split meals, and strict adherence to diet No. 1 during the period of exacerbation of the disease.

Metal

The reason may be unhealthy teeth or gums.

A metallic taste in the mouth can be caused by metal crowns or fragments of dentures. In this case, you should discuss with your dentist the issue of replacing them. When making a diagnosis, exclude:

1. diseases of the periodontium and maxillofacial system with obvious signs of a purulent process;
2. bleeding from the gums;
3. poisoning with salts of heavy metals - such taste sensations are caused by mercury, zinc, arsenic, copper;
4. diabetes mellitus in the stage of decompensation with a slight change in blood sugar levels;
5. Iron-deficiency anemia;
6. chronic bleeding due to stomach ulcers;
7. hormonal disorders;
8. taking certain medications. The appearance of such sensations is facilitated by drugs from the NSAID group and anticonvulsants. When the drug is discontinued, the metallic taste disappears on its own.

Prevention measures

Is it possible to prevent the strange taste from occurring? Some tips for prevention:

1. Changing your diet. During pregnancy, a woman needs to monitor her food intake. Minimize the content of fatty, fried and smoked foods in the menu. It is better to make small portions, but eat them at intervals of 2-3 hours. It is recommended to drink a sufficient amount of fluid (in the early stages - at least 1.5 liters, in the later stages - at least 1 liter).
2. Regular visits to the dentist. The cause of unpleasant odor and taste in the mouth may be diseases of the teeth and gums. You should rinse and brush your teeth after every meal.
3. Rejection of bad habits. Smoking and alcohol are strictly contraindicated for pregnant women.

If bitterness and acidity in the mouth are accompanied by other symptoms (burning, heartburn, abdominal pain, nausea), you should immediately consult a doctor. Such symptoms can be a sign of many diseases.

Acid and milk

Sour taste is common during pregnancy

This is a rare sensation, since in normal conditions it is caused only by the consumption of fermented milk products. When such an aftertaste appears, one can assume:

1. chronic stress;
2. infection with intestinal parasites;
3. various diseases of the gastrointestinal tract.

Outside of food intake, a sour milk taste in the mouth appears along with additional symptoms. This is a reason to contact a medical institution as soon as possible.

Early signs of pregnancy

For women with a regular monthly menstrual cycle, the earliest and most reliable sign of pregnancy is a missed period. However, there are other early signs of pregnancy that you should also pay attention to.

During pregnancy, a distinction is made between obstetric and embryonic periods.

Gynecologists count the obstetric period from the first day of the last menstruation, due to a simpler calculation, since the exact date of ovulation and conception is difficult to determine.

How do the first symptoms of pregnancy appear:

Each woman is individual, which means the first signs of pregnancy are not always identical. In this connection, it is difficult to notice the first symptoms, which may occur even before the delay.

The complete absence of early symptoms of pregnancy in the first weeks is very rare, and this is due to the increased level of sensitivity of the woman’s body to hCG (a hormone produced by the embryo in the first 14 days of its development).

And since this condition is not observed often, in most cases, it is still not difficult to notice the period of the first symptoms of pregnancy.

Among which a woman has:

1. Feeling sick or vomiting (usually called morning sickness, but can happen at any time of the day or night).
2. Metallic taste in the mouth.
3. Flatulence (bloating).
4. Dizziness.
5. Feeling tired (common during pregnancy).
6. Increased emotionality, depressed mood.
7. Chest pain (manifests in the early stages).

At the same time, you may notice other signs of pregnancy:

• Constipation;
• Increased vaginal discharge (without pain or irritation);
• Strange tastes, smells and cravings for foods that previously disgusted you;
• Or, conversely, in the early stages of pregnancy you may find that you no longer enjoy some foods and drinks that you previously enjoyed;
• Loss of interest in smoking;
• The breasts become larger and there are diseases, as before menstruation;
• Veins may become more visible and nipples may darken and stand out.

In the early stages of pregnancy, frequent urination may be a concern. And such symptoms are easily confused with cystitis. This is why treatment without consulting a doctor can be harmful.

So, if you crave new foods, lose interest in certain foods or drinks you used to enjoy, such as tea, coffee or fatty foods, have a more sensitive sense of smell than usual, such as the smell of food or cooking, you often go to the toilet - talk to your doctor.

If you're sick all the time and can't suppress anything, see a therapist.

You may have hyperemesis gravidarum, a serious condition during pregnancy that causes severe vomiting and requires treatment.

Can pregnancy occur during menstruation?

Pregnant women sometimes experience bleeding that feels like a very light period, with some spotting. This is called “implantation bleeding,” which women confuse with real menstruation. This condition does not require treatment and, especially, the prescription of hormonal drugs - progesterone!

According to leading gynecologists, discharge in the early stages of pregnancy is almost always possible. However, implantation bleeding stops a little earlier than menstruation.

And this happens due to the fact that the fertilized egg, trying to attach to the wall of the uterus, causes slight bleeding.

Therefore, we can say with confidence that pregnancy does not happen if you have your period. If normal menstruation occurs, it means that the egg was not fertilized.

Delayed menstruation without accompanying symptoms is also not the main criterion for pregnancy. Since the reason may lie in a woman’s hormonal imbalance, which is provoked by stress, nervous strain, heavy physical activity or gynecological pathologies.

It is always very important to listen to your health and visit a gynecologist in a timely manner - this will help not only not to miss the first signs of pregnancy, but also gynecological pathologies.

What to do if you notice the first symptoms of pregnancy?

If you find clear signs of pregnancy in the first two weeks, you need to consult a gynecologist.

If pregnancy is confirmed, you need to listen to the doctor’s recommendations, get rid of bad habits (if any) and adjust the correct diet.

And of course, don’t forget about planned visits to the gynecologist, which are prescribed by the doctor on an individual basis.

Planned appointments for ultrasound examinations, tests, monitoring are the responsibility of the gynecologist managing the pregnancy.

During pregnancy, three scheduled ultrasounds are prescribed - once in the first trimester, in the second and sometimes in the third.

Additional unscheduled ultrasound examinations of a pregnant woman may be performed according to individual indications. This should not scare you, as it is necessary for making timely decisions to avoid certain complications.

Comprehensive support for women during pregnancy, qualified organization and support of childbirth is the main specialization of the Irkutsk City Perinatal Center. Here, all young mothers receive full medical care with an individual approach from doctors.

Sour taste in pregnant women

The appearance of such an unpleasant aftertaste in a pregnant woman is facilitated by 2 metabolic processes associated with the process of bearing offspring.

You can thank for the acid in your mouth:

1. The hormone progesterone. This is a necessary condition for pregnancy. This substance helps relax muscle tissue, preventing the development of fetal rejection. Ideally, it should act only on the muscles of the uterus. But in reality, all smooth muscles relax, including the muscles of the stomach and esophagus.
2. The growing uterus puts pressure on the hollow organs. There is a reflux of stomach contents into the esophagus and oral cavity. The result is heartburn and an acidic taste in the mouth.

In this case, taking an antacid is indicated at the discretion of the gynecologist. But first you should exclude diseases of the gastrointestinal tract. The drug of choice can be Gaviscon in any convenient form.

Acid-dependent diseases during pregnancy

Heartburn during pregnancy is a very common complaint. It is known that up to 80% of pregnant women experience symptoms characteristic of gastroesophageal reflux disease (GERD) (heartburn, dysphagia, belching and others), and the frequency of heartburn in the first trimester is 7.2%, in the second - 18.2%, in the third - 40%.

The main factors responsible for such a high prevalence of GERD during pregnancy include hormonal changes, such as hyperprogesteronemia (increased levels of the hormone progesterone) and hyperestrogenemia (increased levels of estrogen hormones), as well as increased intra-abdominal pressure due to the growth of the uterus and fetus.

The effect of gestational hormones in the first trimester of pregnancy is due to the fact that, without affecting the basal tone of the lower esophageal sphincter (LES), they reduce the increase in pressure of this sphincter in response to various physiological stimuli, including food intake. In the second and third trimesters of pregnancy, progesterone and estrogen reduce the basal tone of the LES to 50% of the initial level, the maximum reduction occurs at the 36th week of gestation. After successful delivery, the tone of the LES in women who did not suffer from GERD before pregnancy, as a rule, returns to normal - in connection with this, this condition is called “pregnant heartburn”.

Heartburn in pregnant women usually does not lead to the development of esophagitis, complications of GERD (strictures, ulcers, bleeding) and does not require serious drug treatment.

If a woman suffered from GERD before pregnancy, during gestation the complaints may worsen and require examination and drug treatment.

The diagnosis of GERD during pregnancy is established primarily on the basis of complaints, medical history and objective examination. X-ray examination in pregnant women - due to a possible damaging effect on the fetus - is not used; pH-metry and manometry can be used, but the need for its use is doubtful.

Esophagogastroduodenoscopy (EGD) is the method of choice for diagnosing GERD in pregnant women, but it should be used only for strict indications, such as a history of complications of GERD and the ineffectiveness of drug therapy.

Treatment of GERD in pregnant women should be based on changes in lifestyle and nutrition: avoiding a horizontal body position immediately after meals, sleeping with the head of the bed elevated (15 cm), avoiding physical activity that increases intra-abdominal pressure (including wearing corsets, tight belts, bandages). The last meal should take place no later than 3 hours before bedtime, you need to eat in small portions, and pay special attention to normalizing stool.

First-line drugs for the treatment of GERD in pregnant women include antacids and alginates. If these drugs are ineffective, it is permissible to prescribe prokinetics (metoclopramide), histamine H2 receptor blockers and (if strictly indicated) proton pump inhibitors (PPIs).

H2-histamine blockers are the most commonly prescribed group of drugs for pregnant women. They are classified as risk category B by the US Food and Drug Administration (FDA) (“drugs that have been taken by a limited number of pregnant women without evidence of an effect on the incidence of congenital anomalies or harm to the fetus”). Russian instructions allow only cimetidine and ranitidine with the caveat: use during pregnancy is possible only if the expected effect of therapy exceeds the potential risk to the fetus. Famotidine and nizatidine are contraindicated in the Russian Federation for pregnant women.

Despite the fact that the FDA also classifies most PPIs as risk category B, in Russia there are stricter restrictions on the use of this group of drugs in pregnant women. Thus, lansoprazole is contraindicated in the first trimester; in the second and third trimesters, its use is possible only if the expected benefit of therapy outweighs the potential risk to the fetus. The use of pantoprazole and esomeprazole is possible only under strict indications, when the benefit to the mother outweighs the potential risk to the fetus. Rabeprazole is contraindicated during pregnancy.

Pregnancy has a beneficial effect on the course of peptic ulcer disease: 75–80% of women experience remission of the disease, and it does not have a noticeable effect on its outcome. However, some patients may experience an exacerbation. Most often this is observed in the first trimester of pregnancy (14.8%) and the third trimester (10.2%), as well as 2–4 weeks before the due date or in the early postpartum period. Uncomplicated peptic ulcer disease does not have a negative effect on fetal development.

Treatment of peptic ulcer in pregnant women includes adherence to generally accepted “regime” measures and diet; taking non-absorbable antacids in usual therapeutic doses (1 sachet 3 times a day 1 hour after meals and adsorbents 1 sachet 3 times a day 1 hour after meals). If there is no effect, H2-blockers are prescribed (ranitidine 150/300 mg once at night); if they are insufficiently effective, as well as if complications develop, we can take PPIs (omeprazole 20–40 mg, lansoprazole 30–60 mg, pantoprazole 40 mg). mg, in the morning before the first meal). Bismuth preparations are contraindicated for pregnant women. Eradication therapy for H. pylori infection is not carried out in pregnant women.

What to do if you have high stomach acidity

09.10.2021

Increased stomach is a very unpleasant ailment that affects many people. In particular, its exacerbation or onset is provoked by poor nutrition. In this article we will talk about how to reduce high stomach , how to eat and what to avoid.

Causes of high acidity

One of the main reasons for increased stomach is poor nutrition. Stomach acidity can be caused by carbonated, sweetened drinks, smoked foods, various sauces, fried foods, some citrus fruits, chocolate, mint, alcohol, and smoking. Therefore, you should think about your diet if you feel that your acidity is starting to increase at least a little. Poor diet weakens the valve at the bottom of the esophagus , causing stomach acid levels to rise.

Increased stomach can also be caused by various diseases - diabetes , excess weight, stomach ulcers . These diseases also develop mainly due to an unbalanced diet. Frequent stress can also cause increased stomach .

Symptoms of high stomach acidity

With increased stomach , certain symptoms occur. There may be a burning sensation, pain, and acidity in the mouth . Sometimes it can even be a dry cough. Particular attention should be paid if you do not have a cold, but the cough constantly torments you, especially at night, when lying down.

If you experience even the slightest symptoms, it's important to take action because, over time, rising stomach acid can cause sores, worsen your mouth, and damage your teeth . Without changing anything in your daily routine and allowing the disease to grow, the condition only gets worse. It feels like something is constantly burning in my mouth And this is a very unpleasant and upsetting feeling. Some may not even fall asleep because of this.

Of course, there are medications that help reduce acidity or sometimes relieve symptoms. But the most important thing is to change your lifestyle, habits, diet , and give up bad habits.

What to do and what to eat if you have high stomach acidity?

To prevent acid from rising or not arising at all, this unpleasant sensation must first be started with a diet .

• Excessively fatty, spicy foods, unhealthy snacks, processed foods, and alcohol should be avoided.
• You should also not eat salted, smoked foods, canned food, chocolate or products made from it.
• Among vegetables, garlic, onions, radishes, cucumbers, and horseradish should be avoided. Avoid pepper.
• Acidity can also be caused by ice cream or cold drinks.
• Avoid fatty meats, fried meats, sour fruits and berries.
• You should also avoid coffee and all products containing caffeine.
• You can eat crackers, chicken, beef, lean pork, boiled or stewed fish, and omelet. Use pure unrefined olive oil for cooking.
• It is better to cook vegetables. You can eat boiled potatoes, pumpkin, carrots and beets. You can also include spinach, cucumbers, and salads in your diet. Fruits include avocado, watermelon, bananas, papaya, melon, and baked apples.
• You can eat different nuts - pistachios, pumpkin seeds, almonds, cashews, walnuts, pecans, sesame seeds.

Tightening the diet should take at least a month, and some other foods can be added gradually after improvement. The main thing is to take your time and monitor your well-being. You should try to introduce a diet and eat every 3 hours, but not much. If you are overweight, you should try to lose it, this will also help improve your well-being. Eat only while sitting, do not lie down after eating. In the evening, the last meal should be no later than three hours before bedtime.

Well, if you don't have such problems, try to avoid them and start eating right!

Published in Gastroentorology Premium Clinic