Altered lower esophageal sphincter function during early pregnancy

Area of Science:

• Gastroenterology
• Obstetrics and Gynecology
• Physiology

Background:

• The lower esophageal sphincter (LES) prevents gastroesophageal reflux.
• Pregnancy involves significant hormonal changes that may affect gastrointestinal function.

Purpose of the Study:

• To investigate lower esophageal sphincter (LES) function during early pregnancy.
• To determine if basal LES pressure and LES responses to stimulation are altered in early pregnancy.

Main Methods:

• Studied 8 pregnant women before and after abortion to assess resting LES pressures.
• Evaluated LES pressure responses to pentagastrin, edrophonium, methacholine, and a protein meal.
• Measured serum concentrations of estrogen, progesterone, and gastrin.

Main Results:

• Resting LES pressures were within normal limits both before and after abortion.
• LES pressure responses to pentagastrin, edrophonium, methacholine, and a protein meal were significantly reduced during early pregnancy.
• Elevated serum estrogen and progesterone levels were observed, while gastrin levels remained unchanged.

Conclusions:

• Basal LES pressure is normal in early pregnancy.
• Despite normal basal pressure, LES responses to hormonal, pharmacological, and physiological stimuli are diminished in early pregnancy.
• Altered LES function can be demonstrated in early pregnancy even without clinical symptoms of reflux.