Digestive System

Question 1

What are the physiological changes in pregnancy of the digestive system?

Answer 1

• RESULTED FROM HIGH LEVELS OF PROGESTERONE
• in smooth muscles
• sphincters are out of place
• changes to GI motility
• may be in part be responsible for common symptoms of constipation, nausea and vomiting,

Question 2

What outcomes occur with changes to GI motility?

Answer 2

• decreased gastric peristalsis
• decreased oesophageal pressure
• delayed gastric emptying

Question 3

What is hyperemesis gravidarum?

Answer 3

• due to high levels of HcG
• nausea and vomiting, in addition, there may be excessive saliva.
• nausea and vomition affect at least 50% however HG affects 0.1-1% of pregnancies.
• need to be admitted to hospital
• onset is in the first trimester

Question 4

Why is constipation common?

Answer 4

• up to 40% women have constipation during pregnancy
• due to decreases colonic motility
• poor fluid and food intake as most women feel nauseous and vomiting.
• oral iron supplements

Question 5

Why is heartburn common in pregnancy?

Answer 5

Decreased lower oesophageal pressure, decreased gastric peristalsis and delayed gastric emptying, all make reflux more likely - splashes into the oesophagus.
60% of women have heartburn during pregnancy

Question 6

How common is appendicitis in pregnancy?

Answer 6

It usually presents in the first two trimesters with an incidence of about 1 in 3500
Abdominal pain, rebound tenderness, nausea and vomiting.

Question 7

What is gallbladder disease and how common is it?

Answer 7

Symptomless gallstones are detected in between 2.5% and 11% of pregnant women
The prevalence of acute cholecystitis in pregnancy is about 0.1%
Pain is present in the right upper quadrant or epigastrium, and it may radiate through to the back and tip of the scapula- upwards pain

Question 8

What are the physiological changes in labour of the digestive system?

Answer 8

Increase in intra-abdominal pressure during labour leads to a slowdown in gastric emptying
This means the acidity of the stomach contents rises
The use of narcotics for pain relief will further affect gastric emptying

Question 9

What are the physiological changes in postnatal of the digestive system?

Answer 9

Decrease in circulating levels of progesterone

Constipation

Question 10

What does meconium contain?

Answer 10

meconium → contains epithelial cells, waste products such as bile salts, fatty acids, mucus and amniotic fluid.