Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Gastro-intestinal complaints and disorders are common in women of all ages, including women in their childbearing period and thus, often occur during pregnancy, while hepatic, biliary and pancreatic disorders are relatively uncommon but not rare during pregnancy. For example, about 3 per 100 women develop serum liver function test abnormalities and about 1 per 500 women develop potentially life threatening hepatic diseases, during pregnancy that endanger fetal viability. Hepatic, biliary and pancreatic disorders are often complex and these complaints and disorders, in addition to gastro-intestinal disorders present unique clinical challenge. First, the differential diagnosis is extensive. Aside from gastrointestinal disorders unrelated to pregnancy, their complaints may be caused by obstetric or gynecologic disorders related to pregnancy or other intra-abdominal diseases incidental to it. Moreover, some gastro-intestinal conditions, such as hyperemesis gravidarum are unique to pregnancy. Second, the clinical presentation and natural history of gastro-intestinal and hepatic disorders can be altered as in the case of appendicitis. Indeed, some disorders such as intrahepatic cholestasis are unique. Third, the diagnostic evaluation is altered and constrained by pregnancy. For example, radiologic tests and invasive examinations raise concern about their fetal safety. Fourth, the interests of both the mother and the fetus must be considered in therapeutic decisions. Usually these interests do not conflict, because what is good for the mother is generally good for the fetus. Sometimes, however, maternal therapy must be modified to substitute alternative but safer therapy because of concerns about drug teratogenicty. Rarely, the maternal and fetal interests are diametrically opposed, as in the use of chemotherapy for maternal cancer, a therapy that can be life-saving to the mother, but life-threatening to the fetus. These conflicts raise significant medical, legal and ethical issues .The obstetrician and gynecologist, as well as the hepatologist gastro-enterologist and surgeon, should be familiar with the medical and surgical gastro-intestinal conditions, hepatobiliary and pancreatic disorders that can present in pregnancy and how these conditions affect and are affected by pregnancy. In this article, we are going to revise hepatic, biliary, pancreatic and gastrointestinal symptoms and disorders during pregnancy, with a focus on aspects of these disorders unique to pregnancy.

Biography

Assem shaik is currently working in Ain Shams University, Egypt

Email: drassemshafik@gmail.com