BACKGROUND Gestational reflux is common, affecting up to 80% of pregnant women. Most symptoms will abate during lactation. During both of these periods, interventions used to relieve symptoms focus on a "step-up" methodology with progressive intensification of treatment. This begins with lifestyle modifications. AIM To provide guidance in the treatment of reflux in pregnancy and lactation, as well as briefly summarising the pathogenesis, clinical presentation and diagnostic workup. METHODS A comprehensive search, using online databases PubMed and MEDLINE, along with relevant manuscripts published in English between 1966 and 2019 was used. All abstracts were screened, potentially relevant articles were researched, and bibliographies were reviewed. RESULTS Only a small percentage of relevant drugs are contraindicated for use in pregnancy or while breastfeeding. However, not all drug agents have been extensively evaluated in pregnant women or during the breastfeeding period. Antacids, alginates, and sucralfate are the first-line therapeutic agents. If symptoms persist, any of the H2 RAs can be used except for nizatidine (due to foetal teratogenicity or harm in animal studies). PPIs are reserved for women with intractable symptoms or complicated GERD; all are FDA category B drugs, except for omeprazole, which is a category C drug. CONCLUSIONS The management of heartburn during pregnancy and lactation begins with lifestyle modifications. In situations where disease severity increases, medical providers must discuss risks and benefits of these medicines with the patient in detail.

中文翻译：

---

评论文章：妊娠和哺乳期胃灼热的处理。

背景技术妊娠期返流是常见的，影响多达80％的孕妇。哺乳期间大多数症状会减轻。在这两个时期中，用于缓解症状的干预措施都集中在逐步进行治疗的“逐步”方法上。这始于生活方式的改变。目的为指导妊娠和哺乳期反流的治疗提供指导，并简要概述其发病机理，临床表现和诊断检查。方法使用在线数据库PubMed和MEDLINE以及1966年至2019年之间以英语出版的相关手稿进行全面搜索。筛选所有摘要，研究可能相关的文章，并对书目进行审查。结果在妊娠或哺乳期间禁忌使用相关药物的比例很小。但是，并非所有药物都已在孕妇或母乳喂养期间得到广泛评估。抗酸剂，藻酸盐和硫糖铝是一线治疗剂。如果症状持续，则可以使用除尼扎替丁以外的任何H2 RA（由于胎儿致畸性或动物研究中的危害）。PPI保留给症状难治或GERD复杂的女性使用；除奥美拉唑（C类药物）外，所有药物均为FDA B类药物。结论妊娠和哺乳期烧心的治疗始于改变生活方式。在疾病严重程度增加的情况下，医疗提供者必须与患者详细讨论这些药物的风险和益处。