The diagnosis and treatment of gastrointestinal and hepatic disorders during pregnancy

Gastrointestinal and hepatic symptoms are common during pregnancy. Increased levels of female sex hormones partially or fully contribute to symptoms such as heartburn, nausea, vomiting and constipation. The spectrum of medical problems in pregnancy ranges from innocent symptoms to life-threatening diseases for mother and fetus. The therapeutic priority is to obtain control over symptoms by means of drugs not posing a danger to the development of the fetus. Most drugs for inflammatory bowel diseases can be used during pregnancy, but the benefits and risks of specific drugs should be carefully considered. Liver diseases can be coincidental or pregnancy-specific, such as intrahepatic cholestasis of pregnancy, liver injury secondary to eclampsia, HELLP syndrome and microvesicular liver steatosis. In severe pregnancy-specific liver diseases urgent induction of delivery is recommended. This review provides an overview of the spectrum of gastrointestinal and hepatic diseases occurring during pregnancy and discusses the best therapeutic options.