What to know about diarrhea during pregnancy
Persistent diarrhea can lead to dehydration and malnutrition. During pregnancy, this can harm the woman and the fetus, and pregnant women with severe or lasting diarrhea should seek immediate medical attention.
In this article, we discuss whether diarrhea is normal during pregnancy and the possible causes. We also describe when to see a doctor, home treatments, and medications.
Is it normal?
Experiencing diarrhea during pregnancy is normal.
Diarrhea is a very common condition that can affect anyone, including women who are pregnant. According to the American College of Gastroenterology (ACG), there is no up-to-date research about the prevalence of diarrhea in pregnant women.
During pregnancy, diarrhea may arise from hormonal or physical changes. However, it can also be unrelated to pregnancy and result from an infection or underlying bowel disorder.
One change that can cause diarrhea is a rise in prostaglandin levels. Prostaglandins, such as oxytocin, help stimulate contractions in the uterus but can also increase movement along the digestive tract.
If stool passes too quickly through the bowels, it can result in diarrhea. Increased prostaglandin levels can also cause diarrhea during the menstrual cycle.
Synthetic prostaglandins, such as a medication called misoprostol (Cytotec), can have diarrhea as a side effect. This is because misoprostol can cause stool to absorb more water and electrolytes from the stomach, contributing to diarrhea.
Doctors commonly use misoprostol to induce labor.
Bowel infections are a common cause of diarrhea. In addition to loose, watery stools, people with infectious diarrhea may also experience the following symptoms:
- bloody stools
- nausea and vomiting
- fever and chills
- dizziness or lightheadedness
Some organisms that can cause infectious diarrhea:
- bacteria, such as Escherichia coli or any in the Campylobacter, Salmonella, or Shigella genera
- viruses, including norovirus and rotavirus
- parasites, such as Giardia lamblia and Cryptosporidium enteritis
A person can become infected with these harmful organisms by consuming contaminated food or water. Infectious diarrhea can be a risk when traveling to developing countries.
Some bowel disorders can cause joint problems.
Chronic diarrhea can be a symptom of an underlying bowel disorder, such as:
- inflammatory bowel diseases, including Crohn's disease and ulcerative colitis
- irritable bowel syndrome
- celiac disease
- small intestinal bacterial overgrowth
The conditions above can also cause a wide range of other symptoms. For instance:
- abdominal pain and cramping
- gas and bloating
- weight loss
- nausea and vomiting
- skin and joint problems
If diarrhea accompanies other symptoms, see a doctor for an evaluation.
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Diarrhea during pregnancy can also result from these issues:
- food intolerances or allergies
- dietary changes
- stress or anxiety
- certain medications
- eating foods that contain sugar alcohol, such as sorbitol, xylitol, or mannitol
When to see a doctor
Diarrhea can lead to severe dehydration and malnutrition, which can be harmful to the woman and fetus.
A pregnant woman should receive immediate medical care if she experiences any of the following symptoms:
- stools that contain blood or pus
- diarrhea that lasts longer than 48 hours
- six or more loose stools in a 24-hour period
- a fever of 102°F (39°C) or higher
- frequent vomiting
- severe pain in the rectum or abdomen
- symptoms of dehydration, such as dark urine, thirst, dry mouth, feeling lightheaded, or urinating less frequently
Eating bananas and toast can help prevent electrolyte loss.
A person can prevent dehydration by drinking plenty of water. It is also important to drink liquids containing electrolytes, such as:
- broths and clear soups
- sports drinks
- fruit juices
- caffeine-free sodas
For pregnant women with severe hydration, a doctor may suggest an oral rehydration solution.
Many doctors also recommend a bland diet to help restore electrolytes lost from diarrhea. Examples of bland foods:
- plain potatoes
- Saltine crackers
Also, avoid foods that can make diarrhea worse, such as dairy products, anything high in fat or sugar, and drinks containing caffeine.
During pregnancy, it is important to talk to the doctor before taking any new medication. Some can be harmful, while the safety of others is not yet clear.
According to the ACG, a prospective, case-controlled study found no association between taking loperamide (Imodium) during the first trimester of pregnancy and major fetal abnormalities. Imodium is an effective OTC medication for treating short-term diarrhea.
However, the ACG do not recommend taking the antidiarrheal medications diphenoxylate-atropine (Lomotil) or bismuth subsalicylate (Pepto-Bismol) during pregnancy.
They report findings indicating that Lomotil can harm the fetus in the second and third trimesters. Pepto-Bismol may increase the risk of low birth weight, neonatal hemorrhage, and perinatal mortality.
Diarrhea is a common condition that can affect anyone, including women who are pregnant. Hormonal changes, bowel infections, and underlying bowel disorders can all cause diarrhea during pregnancy.
If diarrhea lasts for more than 48 hours, speak to a doctor. Seek immediate medical care for symptoms such as fever, dehydration, bloody stools, or frequent vomiting.
Also, it is important to speak to a doctor before taking any medications for diarrhea. Drinking plenty of water and clear broths or soups can help prevent dehydration.