II. Evaluation

  1. Avoid diagnostic testing in pregnancy

III. Management: First Line Agents

  1. First: Antacids (may interfere with iron absorption)
    1. Aluminum hydroxide - Magnesium Hydroxide (Maalox)
    2. Calcium Carbonate (Tums)
  2. Next: Gastric mucosa protection or skip to H2 Blocker
    1. Sucralfate 1 gram PO tid
  3. Next: H2 Blocking Agents (Avoid Axid or Nizatidine)
    1. Cimetidine (Tagamet) 400 mg PO bid or qhs
    2. Ranitidine (Zantac) 150 mg PO bid
      1. Less known about Ranitidine in pregnancy

IV. Management: Refractory cases

  1. Metoclopramide (Reglan)
  2. Avoid Proton Pump Inhibitors (e.g. Prilosec)
    1. Class C Medication
    2. Unknown longterm safety

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