In general pregnancy is not associated with an increase in the inciden
ce of gastro-intestinal (GI) conditions, but it is associated with an
increase in the severity of these conditions. This is largely due to a
delay in making the diagnosis. Delay is caused by a combination of fa
ctors. These include mimicry of symptoms and signs with pregnancy-rela
ted conditions, a change in the usual clinical presentation, reluctanc
e to use radiological diagnostic aids and a higher threshold for perfo
rming invasive investigative procedures. However before resorting to i
nvasive investigations, it is imperative that appropriate non-invasive
investigations are performed and evaluated first. This is especially
relevant to liver conditions in pregnancy which can present with abdom
inal pain. Optimal management of GI conditions in pregnancy requires b
oth surgeons and obstetricians to be aware of the problems of diagnosi
s, communicate promptly and investigate without delay in order to make
a diagnosis and avert a GI crisis. This article discusses the clinica
l presentation, diagnosis and management of the common GI conditions o
ccurring in pregnancy.