Gastrointestinal Issues During Pregnancy

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:

• Uncontrollable vomiting
• Severe and persistent nausea
• Weight loss
• Malnutrition
• Electrolyte imbalance
• Food aversions
• Decrease in urination
• Dehydration
• Headaches
• Confusion
• Fainting
• Jaundice
• Extreme fatigue
• Low blood pressure
• Rapid heart rate

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:

• Burning in the chest or throat
• Chest pain
• Regurgitation of food or acid
• Bitter or acidic taste in the mouth
• Difficulty swallowing
• Dry cough
• Hoarseness or sore throat
• Sensation of a lump in your throat

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:

• Sudden and intensifying pain in the upper right portion of your abdomen
• Sudden and intensifying pain in the center of your abdomen, below your breastbone
• Back pain between your shoulder blades
• Pain in your right shoulder
• Persistent pain in any of the above areas that lasts for 30 minutes or longer
• Nausea or vomiting
• Other digestive problems, including bloating, indigestion, heartburn, and gas

Gallstones can cause serious complications. Call you doctor immediately if you experience any of the following symptoms:

• Abdominal pain so intense that you can't sit still or find a comfortable position
• Jaundice, or the yellowing of your skin and the whites of your eyes
• High fever with chills

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:

• Abdominal cramps or pain
• Bloating
• Nausea
• Urgent need to have a bowel movement

While diarrhea is common and generally not serious, you should call your doctor if you experience any of the following symptoms along with diarrhea:

• Blood or mucus in your stool
• Weight loss
• Fever

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:

• Having lumpy, small or hard stools
• Straining to have bowel movements
• Feeling as if  a blockage is preventing bowel movements
• Feeling as if you can't completely empty the bowel
• Bloating in the stomach, or stomach pain

While constipation is common and generally not serious, you should call your doctor if you experience any of the following symptoms:

• Blood in your stool
• Weight loss
• Severe pain with bowel movements
• Constipation that lasts more than 2 weeks

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:

• Bleeding during bowel movements, with bright red blood on your toilet tissue or in the toilet
• Itching or irritation at the opening of the rectum
• Pain or discomfort
• Swelling around the anus
• A lump near the anus, which may be sensitive or painful

There are several different types of colitis, a condition that causes an inflammation of the bowel. Different types include:

• Infectious colitis
• Ulcerative colitis
• Crohn's disease
• Ischemic colitis
• Radiation colitis

The symptoms can vary depending on the type. However, some common symptoms of colitis include:

• Diarrhea, with or without blood in the stool
• Rectal bleeding
• Abdominal cramps
• Urgent and frequent need to empty the bowels

IBS affects the large intestine and causes the colon muscle to contract more often than normal. Symptoms of IBS can include:

• Abdominal pain and cramps
• Excess gas
• Bloating
• Change in bowel habits such as harder, looser, or more urgent stools than normal
• Alternating constipation and diarrhea

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.