Treatment of Bacterial Esophagitis with Erosive Esophagitis in Pregnant or Lactating Females

When bacterial esophagitis occurs alongside erosive esophagitis in a pregnant or lactating patient, medication selection requires particular care. Both mucosal healing and the safety profile for mother and fetus or nursing infant must guide the clinical decision.

Clinical Scenario

This protocol applies to pregnant or lactating females presenting with bacterial esophagitis and concurrent erosive esophagitis. Pregnancy and lactation are primary determinants of which therapeutic options are appropriate in this setting.

Treatment Approach (Partial Overview)

Management in this setting involves mucosal-protecting or acid-suppressing agents with established safety records in pregnancy, selected and used in active consultation with the obstetrician. Certain newer classes of acid-suppressing therapy are not recommended during pregnancy or lactation.

The complete agent selection criteria, sequencing, and clinical decision algorithm are available in the full protocol below.

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References

DOI: 10.14218/JTG.2025.00006

H2RAs and PPIs are probably safe for pregnant and lactating females.
Sucralfate is a mucosal-protecting agent effective in healing low-grade EE and is recommended for pregnant women with GERD.
In the management of pregnant patients with EE, sucralfate, H2RAs, and PPIs can be used in consultation with the obstetrician.

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