Table of Content

• Diarrhea in Pregnancy: Is this common?

• Diarrhea in pregnancy during third trimester

• Black stools during pregnancy: When should I be alarmed?

• Diarrhea and miscarriage

• Why is it important to tackle diarrhoea in pregnancy?

• What tests may be needed?

• How to treat diarrhea in pregnancy?

• When are the warning signs of diarrhea during pregnancy?

• Home Remedies for Diarrhoea in Pregnancy

• When to See a Doctor

• Take home message

• FAQ on Diarrhea in Pregnancy

Introduction

• Diarrhea can be defined as passing three or more loose, watery stools per day.

• In any individual, persistent passage of loose stools is dangerous as it can lead to dehydration and malnourishment if left untreated. Diarrhea during pregnancy should hence be considered doubly dangerous and should be corrected immediately.

• Difficulties linked with the digestive system, such as constipation and diarrhea, may often occur during pregnancy. It can be due to several factors.

Diarrhea in Pregnancy: Is this common?

Does pregnancy cause diarrhea?

Yes! As opposed to the common belief that diarrhea during pregnancy is rare, it’s actually quite common. Many pregnant women experience alterations in their bowel habits and frequency like diarrhea and constipation. But this commonness is not a reason to ignore having diarrhea when pregnant.

Let’s talk about the causes behind diarrhea during pregnancy.

Why is diarrhea common during pregnancy?

Diarrhea during pregnancy can be both due to pregnancy associated and non-pregnancy associated factors.

Pregnancy associated factors

 1. Diet changes

Most of the females tend to change their diets drastically once they get pregnant, usually to make an effort to eat healthier for the baby’s wellness. Sometimes, if unaccustomed to such a new diet, it can cause diarrhea when pregnant.

Also, sometimes pregnant women tend to eat junk food to satisfy their cravings, this could also cause diarrhea in pregnancy.

2. Sensitivities to some foods

This is one of the most common causes for diarrhea during pregnancy. Most of the women experience morning sickness during the early part of their pregnancy. During this time, they develop an aversion or a negative sensitivity to certain food items. So, food sensitivities can also contribute to having diarrhea during pregnancy.

3. Prenatal supplements

Pregnancy can be taxing even for the healthiest of females. Hence, obstetricians usually advise the use of vitamin and supplements during pregnancy. These could include iron supplements, folic acid, vitamin C etc. The use of these supplements can upset your tummy and cause diarrhea in pregnancy.

4. Hormonal factors

There are plenty of hormonal shifts occurring during pregnancy and they can alter bowel habits considerably. Changing hormone levels can affect the motility of the bowels, which can cause loose stools during pregnancy. For the same reason, constipation is also commonly noted in pregnancy.

5. The growing uterus

As pregnancy progresses, the rapidly enlarging uterus can start putting pressure on the bowel loops or can also irritate them. This could lead to constipation or diarrhea during pregnancy.

 Non-pregnancy associated causes

This could include all the causes of diarrhea seen in non-pregnant individuals like:

• Infectious diarrhea due to bacteria, viruses or parasites.

• Unhygienic food or water consumption leading to food poisoning.

• Side effects of medications.

• Chronic diarrhea as seen in Irritable bowel syndrome( IBS), lactose intolerance, inflammatory bowel diseases etc.

Diarrhea in pregnancy during third trimester

• It is common to experience bouts of diarrhea especially during the third trimester of pregnancy. This becomes more likely as the woman approaches her due date because the hormones are at their peak and the uterus has reached its maximum size as the body is getting prepped for delivering the baby. But remember, not every pregnant female may experience this.

• Diarrhea in pregnancy during the third trimester could be a probable sign that labor is approaching, but it’s no reason to be alarmed about the baby coming immediately or about premature birth. It’s just the body getting ready for delivery.

• However, any drastic alterations in bowel habits should immediately receive medical attention. The pregnant woman has to go in for weekly checkups during the last couple of months.

Diarrhea and miscarriage

Many expecting mothers worry that diarrhea may harm the baby or increase the chances of miscarriage. It is a fair concern because the accompanying abdominal cramping may feel similar to the symptoms of impending pregnancy loss. The gastrointestinal system is entirely different from the reproductive system, and there is nothing much to worry about diarrhea during pregnancy.

 The hormones are at play during pregnancy and could impact your bowel movements. The body also uses fluids differently, which is why it’s common for expectant mothers to suffer from diarrhea. In most cases, it gets better on its own. But remember diarrhea could cause fluid loss and lead to dehydration, which can harm the pregnancy. So it is necessary to stay hydrated but avoid sugary and energy booster drinks as they could worsen the condition. 

Avoid over-the-counter medications as they are not safe during pregnancy. Contact your doctor immediately if diarrhea continues for more days along with fever, it could mean you have an infection, and proper treatment is necessary. Moreover, seek medical help if you often find blood in stools, feel contractions, and don't feel the baby move as much as you did before.

Black stools during pregnancy: When should I be alarmed?

A small proportion of pregnant females complain of change in stool color during pregnancy. Rarely, they complain of passing dark or black stool during pregnancy. This can be due to several reasons, both trivial and serious.

Some of the reasons behind passing dark or black stool during pregnancy are:

•  Food items : certain foods could alter the stool’s color like beetroot, spinach etc.

• Oral iron supplements taken could lead to passing black stools in pregnancy.

• Certain antibiotics taken for unrelated causes could also change the color of the stools.

• Antacids.

Even though the above causes do not sound scary, the woman may always be terrified of seeing dark stools. Some really alarming causes of passing black stool during pregnancy include:

• It could because of hemorrhoids or piles, which are common during pregnancy.

• Upper gastrointestinal tract bleeds due to factors like bleeding ulcers, peptic ulcers, mucosal tears etc. could manifest as dark, black tarry stools during pregnancy.

All of these causes are important and should be evaluated immediately by the treating doctor because, if it’s blood loss, it could cause anemia in the pregnant mother.

Why is it important to tackle diarrhoea in pregnancy?

Even though diarrhoea in pregnancy can be a common occurrence, it should be corrected immediately because it could lead to multiple complications in both the mother and the baby.

In the mother, some complications due to diarrhea during pregnancy are:

• Dehydration.

• Weakness.

• Weight loss.

• Abdominal cramps mimicking cramps of miscarriage.

But remember! Diarrhea is NOT a typical cause or symptom of miscarriage!

Some complications in the baby are:

• Growth of the baby could be affected due to loss of nutrients in the mother, leading to SGA infants ( Small for Gestational Age, where the baby is born at a lower weight compared to other babies at the same gestational age and geography) or LBW ( Low birth weight)

Infant mortality rate in India. Graph of infant mortality rate 2009-2019 (60-80% contributed by SGA)

• Increased risk for indirect infant mortality, because worldwide, SGA has been shown to contribute to about 60-80% of infant mortality.

What tests may be needed?

Whenever a woman presents with diarrhea in pregnancy, the treating doctor may:

• Ask a detailed history regarding the nature, frequency and severity of the complaints.

• Question about your dietary habits and general lifestyle.

• Collect your travel history.

• Ask you regarding the medications or supplements you are taking.

• -Thoroughly examine you for any signs of dehydration and then.

• Perform the routine examination of the mother and the foetus that is done during every antenatal visit.

After the above steps, if deemed necessary, your doctor may order some diagnostic tests like:

• Stool examination.

• Routine blood examinations, especially to rule out anemia.

• Routine ultrasound examinations to evaluate the fetus.

How to treat diarrhea in pregnancy?

If you get diarrhea when pregnant, first, do not panic. Try to remember if you have changed your dietary habits or are taking vitamin or mineral supplements or other medications. Usually most of the altered bowel habits get corrected on their own or by simpl precautionary steps. However, if the complaints persist for more than a couple of days, it’s absolutely necessary to visit a hospital.

Following are some of the measures to be taken:

• Take plenty of oral fluids (water, fruit juices, etc.) to avoid dehydration.

• Consume hygienic food and drinking water.

• This is important! : Consult your doctor before starting on any over-the-counter anti-diarrheal drugs or before stopping any of the supplements or medications. Don’t even consume electrolyte drinks without consulting your doctor. If your doctor considers it necessary to stop a particular drug you’re already on, they may offer you a replacement.

• Wash your hands before and after using the restroom and before eating with soap and water.

• Try to avoid junk food, fast foods and spicy foods.

• Avoid using unhygienic restrooms.

What are the warning signs of diarrhea during pregnancy?

Even though having diarrhea when pregnant is quite common, it’s important to know certain warning signs which require immediate medical attention. These include:

• Fever.

• Dark yellowish urine.

• Reduced urine output.

• Dry sticky mouth.

• Thirst.

• Fatigue or weakness.

• Headache, blurring of vision.

• Dizziness or lightheadedness.

• Passing of blood in stools.

• Passage of tarry dark or black stool during pregnancy.

• Abdominal pain.

• Reduced fetal movements etc. are some of the major warning signs when you should rush to the hospital immediately in diarrhoea during pregnancy.

Home Remedies for Diarrhoea in Pregnancy

Combating diarrhoea during pregnancy might present some challenges. However, there are a few simple and effective home remedies that can assist in alleviating this uncomfortable condition. By incorporating these natural solutions into your daily routine you can find relief and maintain your well-being throughout your pregnancy. 

• Hydration: It is crucial to stay hydrated. Drinking plenty of fluids, including water, herbal teas, and clear broths. Will help replenish lost fluids and prevent dehydration. 

• Probiotics: Consuming probiotics found in yoghurt and fermented foods can play a significant role in promoting a healthy balance of gut bacteria and aiding digestion. These beneficial bacteria can also help alleviate the symptoms of diarrhoea. 

• BRAT diet: Incorporating the BRAT diet into your meals may prove beneficial. This diet comprises easily digestible foods such as bananas, rice, applesauce, and toast. These foods can help firm up your stool. 

• Avoid trigger foods: To manage diarrhoea effectively during pregnancy. It is important to identify trigger foods that may worsen the condition. Spicy or greasy foods, caffeine, and artificial sweeteners are examples of triggers that should be avoided. 

• Ginger: Moreover ginger has natural anti-inflammatory properties which make it useful in soothing the digestive system. You have the option of consuming ginger tea or adding ginger to your meals for relief. 

• Herbal remedies: Herbal remedies like chamomile or peppermint tea may have a calming effect on the digestive system. 

When to See a Doctor

While it is often possible to find relief from diarrhoea during pregnancy through home remedies there may be situations in which it is necessary to seek medical help. Being aware of your symptoms and knowing when to involve your healthcare provider is crucial for the health and safety of both you and your baby. 

Persistent diarrhoea: If diarrhoea continues for more than a day or two despite trying home remedies. It is advisable to consult your doctor. 

Dehydration: if you are experiencing signs of dehydration such as excessive thirst, dark urine, dizziness, or lightheadedness it is important to seek immediate medical attention. 

Severe symptoms: In cases where you are experiencing severe abdominal pain, fever, bloody stools, or persistent vomiting alongside diarrhoea it becomes essential to seek medical help. 

High-risk pregnancies: If you have a high-risk pregnancy or underlying medical conditions. Even mild symptoms should prompt you to consult your healthcare provider.

Take home message

Diarrhea is a common disease that can affect anyone, including women who are expecting a baby. Prevention is always better than cure, so ensure proper hygiene of the food you eat, the water you drink and the surroundings you move about.

A healthy mother ensures a healthy baby, so if encountered with diarrhea in pregnancy, do not panic, don’t self-medicate and visit a Gynecology Doctor.

Wishes for a happy, healthy and comfortable pregnancy!

Reference

• American Pregnancy Association