5 common pregnancy-related GI issues and when to call the doctor
September 10, 2025
Gastrointestinal (GI) issues are common during pregnancy. As your pregnancy develops, you’ll have less available real estate in your abdomen for your intestines, stomach, and esophagus to function. Additionally, hormonal changes can affect digestion and other GI activities.
Most GI symptoms resolve quickly during pregnancy and can be treated with over-the-counter remedies at home. However, you should be aware of what is and isn’t normal – and when to call the doctor – to avoid potential complications.
Remember, when in doubt, call your prenatal care provider. Our doctors, nurses, and certified nurse-midwives are very familiar with the changes that happen in pregnancy, and we're happy to answer any type of question you may have.
Here are five of the most common GI-related symptoms of pregnancy.
1. Nausea and vomiting
During the first 16 weeks of pregnancy, it’s normal to have some mild to moderate nausea and vomiting – the infamous period of morning sickness. In fact, for many women, nausea is one of the earliest symptoms of pregnancy.
If you have severe symptoms, a doctor can recommend medication to reduce dehydration and discomfort. For mild symptoms, or if you prefer not to take medication, many women can manage symptoms with dietary changes or vitamin therapy under a doctor’s care:
- Eat small, frequent meals throughout the day to avoid becoming hungry, which can make nausea and vomiting worse.
- Water can help, as well as popsicles or citrus fruits for hydration and easy calories. If you become dehydrated, you may need to be admitted to the hospital for IV fluids.
- Taking vitamin B6, 10 to 25 milligrams every six to eight hours or as prescribed, can also help.
If you still feel nauseated, talk with your doctor about more advanced options. After 16 weeks of pregnancy, vomiting typically is not pregnancy-related and might be due to a bug or infection. In rare cases, vomiting can be caused by more serious medical concerns, such as hepatitis, pancreatitis, or ulcers.
2. Heartburn
Heartburn, or gastroesophageal reflux, is common in the general population, and up to 80% of pregnant patients have it at some point during pregnancy.
The sphincter between your esophagus and stomach relaxes due to the hormones that are produced during pregnancy. At the same time, the growing uterus puts increased pressure on the stomach. The combination is a perfect storm for heartburn.
To prevent heartburn:
- Eat smaller, more frequent meals
- Sit upright after meals
- Don’t eat too late at night
- Eat enough fiber
- Wear loose-waisted clothing
- Avoid trigger foods such as greasy, spicy, and acidic foods such as chocolate
Many over-the-counter treatments are proven safe in pregnancy through clinical research. From chalky tablets and liquids to proton pump inhibitors such as lansoprazole (Prevacid) or omeprazole (Prilosec) and antagonist medications such as cimetidine (Tagamet) or famotidine (Pepcid), there are several treatments for pregnancy-related acid reflux.
Having heartburn more than twice a week or symptoms that don’t improve after two weeks of treatment can be a sign of gastroesophageal reflux disease (GERD). Left untreated, this severe type of heartburn can lead to ulcers in the esophagus, narrowing of the tissue, and development of Barrett’s esophagus, a precancerous condition. About 20% of U.S. adults have GERD.
If the pain is severe, persistent, or accompanied by trouble swallowing, talk with a doctor about more advanced diagnosis and treatment options. Although rare, epigastric pain in the ribs or upper abdomen can be a sign of fatty liver disease or preeclampsia, a serious blood pressure disease that can arise suddenly during pregnancy.
3. Diarrhea
Let’s face it – diarrhea is the worst. When it lasts just a few days, diarrhea typically is related to an infection (usually gastroenteritis) or eating something that upsets your stomach. Common causes of diarrhea include:
- Viral or bacterial infections
- Certain medications, such as antibiotics
- Digestive conditions, such as irritable bowel syndrome (IBS)
- Trigger foods such as eating or drinking dairy, caffeine, and additives or artificial sweeteners
For mild diarrhea, drinking salt-containing fluids (such as sports drinks) and eating sodium-rich foods (such as broth) can help with water retention. Check in with your doctor to determine the best treatment option to reduce dehydration and duration of illness.
Diarrhea that develops without an identifiable trigger or in combination with low back pain and increased vaginal discharge or mucus can be symptoms of preterm labor. Call your doctor immediately if you have this combination of symptoms.
4. Constipation
Pregnancy hormones affect the lower GI tract, effectively slowing down the transit of stool through the bowels. This slow-motion process allows more water to be absorbed in the stools, which makes them harder to pass. Certain prenatal vitamins and iron therapy also can contribute to constipation. Later in pregnancy, pressure from the growing uterus can also make it harder to pass stools, which increases the risk of hemorrhoids.
Drinking more fluids and eating more fiber is effective in reducing and preventing constipation. Stool softeners are safe to use as well, and some iron supplements contain them. More severe constipation might require a mild laxative.
Can we talk about the first post-birth bowel movement?
For a lot of women, this is scarier than giving birth. Everything is sore, and your digestive tract is sluggish. I won’t sugarcoat – your first Number Two after delivery likely won’t be a pleasant experience. But you can make it a little easier by taking stool softeners as directed by your doctor during pregnancy and after delivery. This will reduce how much you strain, which can reduce your risk of developing hemorrhoids.
5. Hemorrhoids
Hemorrhoids are very common in pregnancy and postpartum – sometimes it is the biggest complaint after delivery. Hemorrhoids are dilated veins around the anus caused by a range of factors, including pressure from the expanding uterus, straining during bowel movements, and not eating enough fiber.
Symptoms of hemorrhoids can include:
- Raised, inflamed tissue around the anus
- Painful bowel movements
- Rectal bleeding or bloody stools
- Itching in and around the anus
- Anal soreness while sitting or moving
In severe cases, a blood clot can form inside the hemorrhoid that causes severe pain and may require surgery to drain it. However, most hemorrhoids can be treated with ice packs and over-the-counter creams, gentle steroids, or Proctofoam HC (hydrocortisone/pramoxine) rectal foam. Taking stool softeners can help minimize straining on the toilet; the more you strain, the worse hemorrhoids will get.
When to see a doctor
Some symptoms such as nausea and vomiting are very common in pregnancy and may be among the first signs of pregnancy. Call your doctor if you have concerning symptoms such as these:
- Unable to keep down fluids, especially water
- Persistent or worsening GI symptoms
- Vaginal or rectal bleeding
- Bloody stools
- Abdominal pain or cramping
- Dizziness or lightheadedness
- Dark or too little urine
Most women will have GI symptoms at some point during pregnancy, and safe, gentle remedies are available. You know your own body best. If your symptoms are serious or if you are concerned, talk with your doctor. It’s better to be safe, and we’re here to help your pregnancy (and GI tract) flow smoothly.
To talk with an expert about gastrointestinal problems in pregnancy, make an appointment by calling 214-645-3838 or request an appointment online.
