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Your Pregnancy Matters

4 common pregnancy-related GI issues, and when to call the doctor

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Mild gastrointestinal issues are common during pregnancy, but if you’re concerned, call your doctor.

Gastrointestinal (GI) issues are common during pregnancy. As your baby grows, 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 functions.

Most GI symptoms pass relatively quickly during pregnancy and can be treated with over-the-counter remedies at home. However, to avoid potential complications, women should be aware of what’s normal and when to call the doctor when it comes to GI health during pregnancy.

1. Nausea and vomiting

During the first 16 weeks of pregnancy, we expect 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, you can usually manage symptoms with dietary changes or vitamin therapy under the care of your doctor. 

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. If you experience nausea or vomiting past the first trimester of pregnancy, don’t assume it’s pregnancy-related, and don’t let your doctor assume so, either, without checking for underlying causes.

2. Heartburn

Heartburn, or gastroesophageal reflux, affects three of five people in the general population. By the time women reach the third trimester, as many as half will experience heartburn at one point or another. During pregnancy, the muscle between the esophagus and stomach relaxes due to hormonal changes related to pregnancy. At the same time, the growing uterus puts increased pressure on the stomach. The combination is a perfect storm for heartburn.

Eating smaller, more frequent meals can help stave off heartburn. Standard treatments – antacids, proton pump inhibitors (Prevacid), or H2 blockers (Tagamet or Pepcid)  – are generally safe during pregnancy.

However, if you experience pain below the ribs in your upper abdomen, call your doctor. Although rare, epigastric pain 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. 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 experience 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 hard 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 actually contain them. More severe constipation might require a mild laxative. Talk to your doctor about additional treatments if you experience abdominal pain, bloody stools, or painful hemorrhoids.

Most women will experience GI concerns at some point during pregnancy. If your symptoms are serious or if you are concerned, talk to your doctor. It’s better to be safe, and we’re here to help your pregnancy – and GI tract – flow smoothly.

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