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During both of these periods, interventions used to relieve symptoms focus on a \u201cstep\u2010up\u201d methodology with progressive intensification of treatment. This begins with lifestyle modifications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To provide guidance in the treatment of reflux in pregnancy and lactation, as well as briefly summarising the pathogenesis, clinical presentation and diagnostic workup.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A comprehensive search, using online databases PubMed and MEDLINE, along with relevant manuscripts published in English between 1966 and 2019 was used. All abstracts were screened, potentially relevant articles were researched, and bibliographies were reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only a small percentage of relevant drugs are contraindicated for use in pregnancy or while breastfeeding. However, not all drug agents have been extensively evaluated in pregnant women or during the breastfeeding period. Antacids, alginates, and sucralfate are the first\u2010line therapeutic agents. If symptoms persist, any of the H<jats:sub>2<\/jats:sub>RAs can be used except for nizatidine (due to foetal teratogenicity or harm in animal studies). PPIs are reserved for women with intractable symptoms or complicated GERD; all are FDA category B drugs, except for omeprazole, which is a category C drug.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The management of heartburn during pregnancy and lactation begins with lifestyle modifications. In situations where disease severity increases, medical providers must discuss risks and benefits of these medicines with the patient in detail.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.15611","type":"journal-article","created":{"date-parts":[[2020,1,17]],"date-time":"2020-01-17T08:14:58Z","timestamp":1579248898000},"page":"421-434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":47,"title":["Review article: the management of heartburn during pregnancy and lactation"],"prefix":"10.1111","volume":"51","author":[{"given":"Camille S.","family":"Th\u00e9lin","sequence":"first","affiliation":[{"name":"Division of Digestive Diseases &amp; Nutrition Department of Medicine Morsani College of Medicine University of South Florida Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5841-8491","authenticated-orcid":false,"given":"Joel E.","family":"Richter","sequence":"additional","affiliation":[{"name":"Joy Culverhouse Center for Swallowing Disorders Division of Digestive Diseases &amp; Nutrition Department of Medicine Morsani College of Medicine University of South Florida Tampa FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,1,17]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8553(02)00065-1"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2007.05.006"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(78)90698-4"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02654.x"},{"key":"e_1_2_12_6_1","first-page":"668","article-title":"Heartburn of pregnancy","volume":"72","author":"VanThiel DH","year":"1977","journal-title":"Gastroenterology"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1992.tb13873.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(67)90122-6"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2012.02.029"},{"key":"e_1_2_12_10_1","first-page":"CD011379","article-title":"Interventions for heartburn in pregnancy","volume":"9","author":"Phupong V","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/aim.2009.000497"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-199819040-00007"},{"key":"e_1_2_12_13_1","first-page":"225","volume-title":"Danforth\u2019s Obstetrics and Gynecology","author":"Niebyl JR","year":"1994"},{"key":"e_1_2_12_14_1","first-page":"912","article-title":"The committee on FDA\u2010related matters for the American College of Gastroenterology. 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