Gastrointestinal disorders

This chapter focuses on cholelithiasis, pancreatitis, intrahepatic cholestasis of pregnancy (ICP), inflammatory bowel diseases (IBD), and appendicitis. Symptomatic cholelithiasis is a common non‐obstetric gastrointestinal condition encountered in pregnancy complicating 1‐3% of pregnancies. Pancreatitis is most commonly caused by cholelithiasis. The mainstay of treatment for biliary pancreatitis includes conservative management, laparoscopic cholecystectomy (LAC), or endoscopic retrograde cholangiopancreatography. The clinical manifestation of ICP is pruritus in the absence of rash. IBD in pregnancy consists of Crohn's disease and ulcerative colitis. Patient's with IBD can be reassured there does not appear to be an increased risk stillbirth or congenital anomalies. Pregnant women who present with abdominal pain, nausea/vomiting, and/or anorexia can be a diagnostic enigma as these symptoms are common to both pregnancy and non‐obstetric gastrointestinal conditions. However every clinician must have a high suspicion for appendicitis in any pregnant woman who presents with any or all of these symptoms, irrespective of the trimester of pregnancy.