Gastrointestinal Changes in Pregnancy

Pregnancy changes gastrointestinal function through hormonal and mechanical effects. Smooth-muscle relaxation and altered motility contribute to nausea, reflux and constipation, while the enlarging uterus increases pressure on the stomach and bowel later in pregnancy. Heartburn usually reflects reflux rather than excess gastric-acid production. Slower intestinal transit and greater water absorption can harden stool; reduced fluid intake, reduced activity and oral iron may add to constipation. Gingival swelling and bleeding and increased salivation can also occur. Careful oral hygiene, small sips of water and individualized symptom measures may improve comfort. These findings are common adaptations, but the label “common in pregnancy” must not be used to dismiss severe, new or progressive symptoms. The clinical pattern matters: onset in relation to gestation, ability to drink and eat, hydration, weight trend, pain location, associated fever or bleeding, neurological findings, pruritus and hypertensive features distinguish expected discomfort from illness. The RN first identifies physiologic instability, gathers focused assessment data, begins ordered supportive care and immediately notifies the responsible physician or nurse practitioner when instability or a red flag is present. Diagnosis, medication selection and...