Q&A: Updated ACG monograph provides guidance for GI care during pregnancy, postpartum
The ACG has published a supplement to The American Journal of Gastroenterology with updated recommendations for the management of gastrointestinal disorders in patients who are pregnant or in the postpartum period.
The supplement, “ACG Monograph on GI Diseases and Endoscopy in Pregnancy and Postpartum Period,” is in its third edition and was created with input from a multidisciplinary group of health care providers, including a maternal fetal specialist, an obstetrician and a pediatric pharmacist.
According to the introduction authored by supplement editors Shivangi T. Kothari, MD, FACG, assistant professor of medicine and associate director of endoscopy at University of Rochester Medical Center, and Vivek Kaul, MD, FACG, the Segal-Watson Professor of Medicine at University of Rochester Medical Center, a multidisciplinary team aimed to build upon ACG’s 2007 revised monograph to provide the “current best practice approaches and guideline-based recommendations in the treatment of various GI-liver disorders and endoscopy practice in the pregnancy and postpartum period.”
To learn more, Healio spoke with supplement editor Sunanda V. Kane, MD, MSPH, FACG, professor of medicine at Mayo Clinic, about key takeaways and value added to advancing patient care.
Healio: Why was this supplement created and what is its importance?
Kane: GI complaints are common during pregnancy. When those complaints turn into clinically relevant conditions, it is important to have up-to-date evidence on the safest and most effective therapies.
For women with gastrointestinal conditions who get pregnant, management of the disease during pregnancy can be scary for both mother and gastroenterologist. Having a resource that will help guide decision making is so important; this monograph is that resource.
Healio: What are the key takeaways of this monograph?
This monograph covers common complaints of pregnancy as well as management recommendations for the conditions that we as clinicians treat. Taking care of mom is paramount, otherwise the pregnancy is at risk for a bad outcome.
Healio: How will this monograph assist with patient care going forward?
It will provide data and resources for clinicians that they can share with non-GI colleagues and their patients.
Healio: What does the future hold for research in GI diseases and endoscopy during pregnancy and the postpartum period?
Kane: This monograph points out where there are still gaps in knowledge, as pregnancy is an exclusion from clinical trials. Continuing to work at the national level to follow women in the preconception period all the way to 1 year postpartum for common GI conditions is how we move the needle and provide the best care to our female patients. Understanding the role of medications in male fertility is also important for birth outcomes.
Healio: Why should physicians review this supplement?
Kane: The supplement is “from mouth to anus” and among its editors are non-gastroenterologists, a maternal fetal specialist, a practicing obstetrician/gynecologist and a pediatric pharmacist, all of whom know what they are talking about.
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