Gastrointestinal changes in pregnancy

Stomach and intestines are displaced upwards

Progesterone relaxes smooth muscles and inhibits the contractile response of the GIT to acetylcholine and gastrin

Lower oesophageal sphincter (LOS)

LOS becomes incompetent due to

• LOS tone progressively decreases
• Change in the angle of gastro-oesophageal junction

Stomach

Gastric motility is reduced

Delayed gastric emptying at 12-14 weeks of gestation

Further gastric emptying delay during labour due to pain and anxiety

Acid production

Gastrin production increases progressively throughout pregnancy
* Produced by the placenta

Gastric acid production increased during the 3rd trimester

Intestine

Reduced plasma concentration of motilin
--> Reduced motility of small and large intestines

Gallbladder

Reduced release of CCK (due to progesterone)
--> Reduced contractility of the gallbladder

Liver

Histological changes in liver
* Mild fatty changes
* Mild glycogen depletion
* Lymphocytic infiltration

Others

Increase in serum alkaline phosphatase and serum cholesterol