PREGNANCY REFLUX

A 32-year-old woman in her third trimester of pregnancy was referred to a gastroenterologist by her obstetrician due to persistent gastroesophageal reflux disease (GERD) symptoms. She had been experiencing frequent heartburn, regurgitation, and difficulty swallowing for the past month despite making dietary changes and taking antacids. Upon investigation, the upper endoscopy revealed erosive esophagitis with multiple ulcerations and friability in the distal oesophagus. She was diagnosed with severe GERD and given a Los Angeles classification score of Grade C as shown in figure 03. In addition, a GERD questionnaire was administered, and her GERD symptom score was 20, indicating significant impairment in her quality of life.

The gastroenterologist initially prescribed her a high dose of proton-pump inhibitors (PPIs) to control her symptoms and promote healing of the oesophagal mucosa. However, after four weeks of treatment, her symptoms persisted, and she reported slight improvement.

She was then switched to sodium alginate. After two weeks of treatment with sodium alginate, the GERD symptom score decreased to 6, indicating a significant improvement in her symptoms and quality of life. In addition, a follow-up endoscopy showed marked improvement in her oesophagal mucosa, with no visible ulcerations or friability. She continued taking sodium alginate for the remainder of her pregnancy and gave birth to a healthy baby boy without complications.