Women of reproductive age represent a significant portion of patients with irritable bowel syndrome (IBS). There is evidence that the menstrual cycle influences IBS symptom. This suggests that ovarian hormones, which are elevated in pregnancy, may contribute to gastrointestinal (GI) symptoms. But, there are limited laboratory data to support this claim, and little is known about effective treatment strategies for pregnant women with IBS.
Fertility and IBS
First it is important to point out that to date there is no evidence that fertility is influenced by IBS. It is estimated that in the U.S. approximately 8–10% of couples are infertile. Whether women with IBS have fewer children than women without IBS is not known.
Do IBS symptoms worsen during pregnancy?
For several reasons, the data related to pregnancy and bowel function are extremely limited. Surveys of pregnant women indicate that GI symptoms are common with pregnancy. Upwards to a third of pregnant women experience increased constipation, particularly during the last trimester. Many women report increased heartburn and nausea in the first trimester, and another third of women report an increase in stool frequency during pregnancy. Changes in the ovarian hormones, which are elevated during pregnancy, and the physical pressure the growing baby places on the bowel wall, may both contribute to GI symptoms.
For many women, pregnancy is a time of heightened stress and this may exacerbate underlying anxiety and depression, which can lead to a vicious cycle of increasing GI symptoms and increasing stress. Again this is an area which remains poorly understood and in need of study.
Many women choose to avoid drug therapies during pregnancy, since most have never been tested in pregnant women. Concerns for fetal development and adverse maternal effects may limit use of drugs for pain, diarrhea, and constipation management. Similarly, women should avoid using herbal therapies for IBS symptoms because many remain untested. Talk to your doctor before using any medicine while pregnant.
Non-drug therapies for managing IBS symptoms during pregnancy include:
- understanding what to expect, and
- relaxation therapy.
Dietary changes can also be considered safe for pregnant women. This might include:
- additional fiber (e.g., fruits, vegetables, and grains) in those with inadequate fiber intake, and
- reduction of gas-producing foods (e.g., beans, cabbage, legumes, cauliflower, broccoli, lentils, and Brussels sprouts) to reduce abdominal discomfort.
Points to remember
There is no scientific evidence to suggest that women with IBS are more likely to be infertile, or that IBS symptoms are worse following delivery. During pregnancy there are changes in bowel function that may lead to increases in heartburn and constipation. Be certain to speak to your doctor about any concerning symptom during pregnancy and to discuss with your doctor the use of ANY medications or supplements before taking them.
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Adapted from IFFGD Publication #183 by Margaret Heitkemper, RN, PhD, Professor of Nursing and Medicine, University of Washington, Seattle, WA.
Last modified on September 16, 2014 at 08:43:50 AM