The frequency, symptoms, and complication rate of peptic ulcer disease
appear to decrease during pregnancy significantly. Clinicians, howeve
r, often have to treat dyspepsia or pyrosis of undetermined cause beca
use the frequency of pyrosis increases during pregnancy. Physicians ar
e reluctant to perform esophagogastroduodenoscopy (EGD) during pregnan
cy for pyrosis to reliably differentiate gastroesophageal reflux from
peptic ulcer disease. Dyspepsia or pyrosis during pregnancy first shou
ld be treated with dietary and lifestyle changes, together with antaci
ds or sucralfate. When symptoms persist, H-2 receptor-antagonists are
recommended. If symptoms continue and are severe despite these interve
ntions, the patient should be evaluated for possible EGD or proton pum
p inhibitor therapy during the second or third trimester.