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Gastrointestinal (GI) issues are some of the most common complaints during pregnancy. Some women may experience GI issues that develop after becoming pregnant. Gastrointestinal problems affect the gastrointestinal tract, primarily the esophagus, stomach, small intestine, large intestine and rectum, but can also affect other organs of digestion, including the liver, gallbladder, and pancreas. Some women may have chronic GI disorders prior to pregnancy that can worsen and require special consideration during pregnancy.
Some of the most common gastrointestinal issues women experience during pregnancy are nausea and vomiting, hyperemesis gravidarum, gastroesophageal reflux disease, gallstones, diarrhea, and constipation. Some women may have been diagnosed prior to pregnancy with GI disorders such as Crohn’s disease or ulcerative colitis. It is also possible to have had these underlying conditions but they had been undiagnosed until pregnancy made them more apparent.
Because there is a wide range of gastrointestinal issues, the symptoms vary. Some of the most common gastrointestinal problems and their symptoms include the following.
Nausea occurs in 91 percent of pregnant women in the first trimester, usually in the first 6 to 8 weeks, and can often be accompanied by vomiting. In mild cases, it is referred to as morning sickness. However, it can become severe and require treatment to manage.
Hyperemesis gravidarum is characterized by uncontrollable and severe nausea and vomiting that leads to fluid and electrolyte imbalance. Symptoms of hyperemesis gravidarum can include:
Hyperemesis gravidarum occurs early in the first trimester of pregnancy, typically around weeks 4 to 10. Symptoms usually resolve by weeks 18 to 20. However, if your symptoms are severe, call your doctor. Many of the symptoms of hyperemesis gravidarum can adversely affect your pregnancy and health, and may require treatment.
Gastroesophageal reflux disease (GERD) is common in pregnancy, typically during the first or second trimester. It affects the lower esophageal sphincter, the muscle between the esophagus and stomach, and causes heartburn or acid indigestion. Symptoms can include:
While GERD is not often a severe disorder and can be managed through lifestyle modification, if you experience it during your first pregnancy, it often recurs in later pregnancies.
Pregnancy is associated with an increased risk of gallstone formation. The risk for developing gallstones is highest in the second or third trimester and during the postpartum period. Gallstones occur when substances in bile, which is released into the intestines to aid in digestion, becomes too concentrated and forms a hard stone. Gallstones themselves may cause no signs or symptoms. However, if they become lodged in a bile duct or cause a blockage, they can cause noticeable symptoms, which include:
Gallstones can cause serious complications. Call you doctor immediately if you experience any of the following symptoms:
Diarrhea is a common condition during pregnancy that causes loose or watery stools. It is most commonly caused by viruses or bacteria, but can also be caused by certain medications. Symptoms associated with diarrhea can include:
While diarrhea is common and generally not serious, you should call your doctor if you experience any of the following symptoms along with diarrhea:
This could be a sign of a more serious condition. If you experience diarrhea, make sure you are staying hydrated. Diarrhea can cause dehydration, which can lead to other health complications.
Constipation is having infrequent bowel movement, difficulty having bowel movements, or having hard to pass bowel movements. It is generally described as having fewer than three bowel movements a week. As your baby grows, pressure from the enlarging uterus on the rectum and lower part of the intestine may cause constipation. It may be worsened by high levels of progesterone, which can slow the muscle contractions in the intestine. Some of the symptoms of constipation include:
While constipation is common and generally not serious, you should call your doctor if you experience any of the following symptoms:
Constipation can also cause hemorrhoids -- which are swollen veins in or around the anus. Straining to have a bowel movement or passing hard stool can cause these veins to swell. However, pregnancy alone can cause hemorrhoids to develop, as a growing baby can put pressure on the lower rectum. Symptoms of hemorrhoids include:
There are several different types of colitis, a condition that causes an inflammation of the bowel. Different types include:
The symptoms can vary depending on the type. However, some common symptoms of colitis include:
IBS affects the large intestine and causes the colon muscle to contract more often than normal. Symptoms of IBS can include:
These conditions are often diagnosed prior to becoming pregnant and may worsen during pregnancy. They can cause difficulty in becoming pregnant or cause complications during pregnancy. Speak with your doctor if you have these conditions and are pregnant or thinking about becoming pregnant. They can help you take measures and considerations to ensure a healthy pregnancy.
While many gastrointestinal issues are very common, you may not have experienced any before becoming pregnant. Because they vary, the causes can vary as well. Some common causes or risk factors of gastrointestinal conditions during pregnancy can include:
Gastrointestinal issues are common during pregnancy and, for the most part, do not cause a serious health risk. However, if you experience any symptoms, you should inform your doctor. He or she will be able to help you manage your symptoms, monitor you for worsening symptoms and determine if additional treatment is required. Different gastrointestinal issues respond to different treatments, so your doctor will be able to suggest the best option for you.
Making changes at home can also help you manage your symptoms. Some of these changes include:
Eat a healthy diet: Changing what, how often, and how much you eat can help manage or relieve your GI symptoms. Depending on your issue, you may need to increase the amount of fiber in your diet, avoid sugary, processed foods, or limit the amount of caffeine and dairy in your intake. Ask to speak with a registered dietitian to determine an individualized healthy eating plan that would most benefit you.
Drink lots of fluids: Increase the amount of fluids you take in, including water, fruit juice and clear soups. Getting lots of fluids can help your digestion and keep your GI tract moving regularly. Certain GI issues can also cause you to become dehydrated, so taking in fluids is very important to avoid any additional health issues cause by dehydration.
Exercise: Regular exercise boosts blood circulation and brings more oxygen to organs, including the bowels, to help them move efficiently and smoothly. Aim for at least two and a half hours a week of moderate exercise, or 30 minutes a day, 5 days a week. Speak with your doctor to find the best workouts that would be safe and appropriate for you.
Medication: If your GI symptoms are severe, persistent, or unmanageable with lifestyle modification, your doctor may prescribe medication, which may include antacids, digestive enzymes, antidiarrheals, GI stimulants, and antiemetics, among others. Your doctor will prescribe you the safest medication at the most appropriate dosage.
Even if you experience only mild symptoms of gastrointestinal issues, it is important to inform your doctor. He or she can recommend the best methods to manage those symptoms and can then monitor you throughout your pregnancy for worsening symptoms.
If your symptoms are severe, become severe, and are persistent or prolonged, call your doctor right away. You should call your doctor and seek immediate medical care if you experience: