Which agent is preferred for treating GERD in pregnant patients?

In the management of gastroesophageal reflux disease (GERD) during pregnancy, sucralfate is often preferred due to its safety profile and mechanism of action. Sucralfate acts as a mucosal protectant by forming a gel-like barrier over the gastric mucosa, which can help prevent the irritation caused by stomach acid. Since pregnant patients need to be cautious with medication use, sucralfate is advantageous because it remains localized in the stomach and does not have systemic effects, making it a more favorable option during pregnancy.

Other agents, while effective for GERD, may carry certain risks or are less preferred in this population. Proton pump inhibitors, although effective, are often avoided in the first trimester due to concerns about potential fetal risks. Histamine-2 receptor antagonists, while generally considered safe, do not provide the protective mucosal barrier that sucralfate does. Metoclopramide can increase gastrointestinal motility and may be used in certain situations, but it comes with its own set of potential side effects, such as sedation or extrapyramidal symptoms, which could be more concerning during pregnancy. Thus, the use of sucralfate aligns well with the goals of treating GERD in a pregnant patient safely and effectively