It is not unusual for women to experience gastrointestinal symptoms during pregnancy. Morning sickness, constipation and heartburn are common in pregnancy, and are thought to be the result of hormonal changes and taking vitamins and supplements, hormonal changes, as well as your baby pressing against your organs as food moves through your digestive system.
But for women with IBS, constipation, diarrhea, heartburn, gas and nausea can be more difficult to bear, as pregnancy could make these symptoms worse. And as your pregnancy progresses, you will need to be more aware of what you are eating and how you are feeling to minimize any gastrointestinal symptoms. By making the right choices, however, you can help to make your pregnancy with IBS more bearable and you decrease the risk of any health complications to you or your baby.
Little is known about how IBS affects pregnancy and if symptoms worsen or get better during pregnancy. Here is what is currently known.
The Research is mixed
Women with IBS could have a higher likelihood of miscarriage, ectopic pregnancy and other pregnancy complications, according to a study out of the University College Cork, Ireland and the Biostatics Group of the University of Manchester, United Kingdom.1 The data was as follows: among the 100,000 pregnant study participants, 26.5% had IBS prior to getting pregnant and of that percentage, 6.6% suffered a miscarriage, 0.74 had an ectopic pregnancy, 0.43% developed preeclampsia, and 0.22% were stillborn.1 The researchers proposed that the risks for miscarriage with IBS were “moderate,” while relatively small for ectopic pregnancy and other complications. They further noted that additional factors, such as smoking, depression, and further comorbidities, could have contributed to the increased miscarriage risk for women with IBS.
The European study is contradictory to some of the other research out there. Other research has indicated that some pregnant women with IBS see a decrease in symptoms, as reported by Drs. Olafur S. Palsson, and William E. Whitehead out of the UNC School of Medicine’s Center for Functional GI and Motility Disorders.2 The UNC doctors believe this reduction is a result of sex hormones increasing during pregnancy. Their research has also indicated that when hormone levels drop, women – whether they have IBS or not – will experience increased “stomach pain, diarrhea, nausea, and bloating,” which is what many women already experience during a monthly menstrual cycle.2
Other researchers believe that pregnancy-related factors, such as stress, anxiety, depression, constipation, and ovarian hormonal changes, are what worsen IBS symptoms. And as pregnancy progresses, these things can significantly intensify IBS symptoms.3
Managing IBS Symptoms During Pregnancy
While research does show that IBS may impact pregnancy, there are few studies out there to establish any solid findings. Further, there is no unanimity amongst the researchers as to what impact IBS has on pregnancy and whether all pregnant women with IBS will notice their symptoms either get worse or better. Nonetheless, the existing research does indicate a need for better prenatal care for pregnant women with IBS to manage symptoms and have better pregnancy and delivery outcomes.
If your IBS symptoms get out of control, you can put your pregnancy at risk. Prolonged diarrhea can lead to severe dehydration while severe constipation affects the muscles and tissues of your pelvis. Make sure you stay in touch with your OB/GYN, primary care doctor and gastroenterologist and let them know if your symptoms get better or worse throughout your pregnancy.
Khashan AS, Quigley EMM, McNamee R, McCarthy FP, Shanahan F, Kenny LC. Increased Risk of Miscarriage and Ectopic Pregnancy Among Women With Irritable Bowel Syndrome. Clinical Gastroenterology and Hepatology. http://www.cghjournal.org/article/s1542-3565(12)00217-0/abstract. Published 2012. Accessed July 9, 2016. Volume 10, Issue 8, 902 -909.
Palsson OS, Whitehead WE. IBS and Hormones. UNC Center for Functional GI & Motility Disorders. https://www.med.unc.edu/ibs/files/educational-gi-handouts/ibs and hormones.pdf. Accessed July 9, 2016.
Adibi N, Riahinejad S, Farhag M, et al. Irritable bowel syndrome symptoms during pregnancy trimesters. Journal of Research in Medical Sciences. http://jrms.mui.ac.ir/index.php/jrms/article/view/8181. Published March 2012. Accessed July 10, 2016.