Read the article to learn about bowel disease in pregnancy, its symptoms and causes, treatments, and how it may affect your baby.
Bowel problems are nothing new for millions of moms-to-be. But imagine what it feels like to enter into a pregnancy with a chronic bowel disease. The strains this condition brings to an expectant mother during the course of her pregnancy are diverse. The health of pregnant women with chronic bowel disease should be carefully monitored in order to achieve a healthy pregnancy and delivery.
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IBD and IBS
Similar initials are the only things inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) have in common.
Inflammatory bowel disease in pregnancy is a group of disorders that bring inflammation to the digestive tract (which include the small and large intestines, rectum and anus). Symptoms of IBD include diarrhea, constipation and abdominal pain (such as gassiness, bloating or a combination of the two). The exact reasons why IBD occurs in some people are unknown. However, certain factors such as infections, lifestyle and hormonal changes may cause the above symptoms to increase.
To learn about diarrhea during pregnancy : Diarrhea During Pregnancy
Some individuals diagnosed with IBD discover their immune systems react negatively to normal bacteria found in the intestines. This reaction causes the intestines to inflame. People who suffer from IBD experience different degrees of severity and length of symptoms with their condition. Some may experience only mild symptoms and then may go into a remission only to see their symptoms resurface. Others may suffer from severe attacks that only medication and/or surgery can relieve.
Ulcerative colitis and Crohn’s disease are two major types of IBD. They both tend to share the same symptoms, which include abdominal pain, diarrhea, constipation, loss of appetite, fever and weight loss. What separates Crohn’s from ulcerative colitis is that individuals who suffer from Crohn’s may develop tunnels or openings (known as “fistulas”) between parts of the intestine, bladder and/or vagina. Ulcerative colitis causes inflammation in the lining of the large intestine, causing the colon to empty often, which results in diarrhea.
Crohn’s disease often difficult diagnose because the symptoms of Crohn’s are similar to IBS and ulcerative colitis. Crohn’s disease, unlike ulcerative colitis, can be hereditary. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 20 percent of people diagnosed with Crohn’s disease have a blood relative with some form of IBD.
IBS affects the bowel (also known as the large intestine), and it causes cramping, diarrhea, constipation or a combination of both. What should be understood about IBS is that it is not categorized as a disease. Unlike inflammatory bowel disease, many doctors describe IBS as a function disorder, since it does not inflict any damage on the bowel upon an internal examination.
IBS can be quite painful for some women and for others, just a slight annoyance. Common causes of IBS are stress and/or intake of certain foods that can cause diarrhea and/or constipation, such as chocolate, alcohol, caffeine and carbonated drinks. Women who suffer from IBS tend to experience more symptoms during a menstrual cycle.
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Can I Have a Baby if I Have IBD?
The fertility rates for women with IBD or IBS are the same as those for healthy women. When a woman with IBD conceives a baby, most doctors believe the state of her condition at the time of conception is usually what will remain during the course of her pregnancy. Most obstetricians and gynecologists agree pregnancy does not increase the risk of a new attack of IBD.
“If the disease is quiet in early pregnancy, it is likely to remain so,” says Christy L., director of maternal fetal medicine at a medical center.
If you plan your pregnancy while your condition is in remission, you have a good chance for a healthy outcome for both you and your baby. “Do not try to become pregnant while your disease is active,” he says. “Attempt to conceive during a period of good health.”
If a woman should become pregnant while her disease is active, most doctors treat the condition aggressively. Many women fear their active condition may bring on an increased risk for miscarriage. This is not always the case, according to Leona S., research director for a inflammatory bowel disease center. If a woman becomes pregnant while her disease is in an active state, “the rates of a possible miscarriage are 9 percent with ulcerative colitis and 11 percent with Crohn’s disease,” she says.
She maintains these rates are similar to those in women who conceive a child without suffering from a chronic bowel condition. Usually, women who enter pregnancy with an active inflammatory bowel disease such as Crohn’s tend to undergo more sonograms during pregnancy. “Increased fetal surveillance, such as ultrasounds for growth and fetal monitoring, will likely be advised,” says Christy.
Also, check our article to learn about miscarriage and its symptoms : What are the Symptoms of Miscarriage?
What are the treatments?
Following a proper diet is essential for women with IBD to achieve healthy pregnancies. “Take a daily multivitamin and a folic acid supplement,” says Miguel C., chief of pediatric a children’s clinic.
Since certain foods can trigger an attack, changing or modifying a diet may help. Some pregnant women with IBD find it beneficial to seek advice from a registered dietician or nutritionist. They can look at the nutritional needs for both mother and baby.
Kristine Green, a dietitian at a nutrition counseling center in Los Angeles, Calif., has counseled several pregnant women with IBD. “We make sure the mother is receiving an adequate intake for all of her needs,” she says.
Genetics of IBD
“There is no genetic test that will tell us if your child will inherit IBD,” says Leona. However, there has been research that indicates certain forms of IBD, like Crohn’s, can be genetic.
Christy concludes that there appears to be a genetic predisposition for IBD. “The risk of a child born to a parent with this disease may be increased by a factor of 10 times to 20 times the baseline risk,” he says.
Miguel agrees. “There is an increased incidence of IBD in first order relatives, which means that you would be at a increased risk if your mother, father or a sibling developed IBD,” he says.
Vaginal Delivery With IBD
When the time comes for a pregnant woman with IBD/IBS to deliver her baby, there are several factors to consider, including her condition prior to delivery. “In general, we like to deliver these patients vaginally if possible,” says Christy.
With women who suffer from fistulas or scarred/short perineums, Christy believes that a Cesarean delivery may be advised, in order to avoid any further damage.
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The names of the people mentioned in the article have been changed for security reasons and to protect privacy.