Generality
Diarrhea in pregnancy is one of the many gastrointestinal disorders that can occur during gestation.
In some cases, however, the appearance of this symptom may indicate a not yet diagnosed underlying pathological condition. For this reason, diarrhea in pregnancy should never be underestimated.
What is that
What is Diarrhea in Pregnancy?
Diarrhea in pregnancy - as well as diarrhea in general - is not considered as a disease, but rather as a symptom that can originate from causes of different nature. In detail, diarrhea during pregnancy can occur due to the natural changes taking place in the woman's body during pregnancy, or due to different types of illness (such as infectious diseases or inflammatory bowel diseases).
However, to be able to talk about a real diarrhea during pregnancy, it is necessary that the consistency of the stools is semi-liquid or liquid and that at least three shocks occur per day.
Incidence
Is Diarrhea in Pregnancy a Common Disorder?
Diarrhea in pregnancy can be considered as a relatively common disorder, as it is estimated to affect about 35% of pregnant women. However, the most common gastrointestinal disorders during gestation undoubtedly remain nausea and vomiting.
Causes
What are the Causes of Diarrhea in Pregnancy?
As mentioned, the factors that lead to the appearance of diarrhea in pregnancy can be multiple, of a physiological or behavioral nature (but in any case not connected to diseases), or of a pathological nature. Therefore, the main causes that can favor the onset of the symptom in question will be reported below.
Hormonal causes
The hormonal change that naturally occurs within the woman's body during pregnancy could favor the appearance of various gastrointestinal symptoms. In truth - in addition to nausea and vomiting - the alteration of hormone levels usually leads more commonly to the appearance of constipation. However, although rarely, hormonal changes could also favor the appearance of the opposite disorder, namely diarrhea in pregnancy.
Food Causes
During gestation, especially in the early periods, it is not uncommon for future mothers to make several changes in their diet, both on the advice of the gynecologist (see: Diet in Pregnancy), and to satisfy the so-called cravings. These dietary changes may not be well tolerated by the digestive system and could therefore favor the appearance of diarrhea in pregnancy.
Furthermore, it is not rare that, during this particular period of life, future mothers can become hypersensitive to foods that, instead, before gestation did not cause any kind of disorder. The appearance of this hypersensitivity could, therefore, give rise to diarrhea when these foods are taken.
Infectious diseases and food poisoning
Another common cause of diarrhea in pregnancy - as well as diarrhea in any other individual - is represented by infectious diseases and food poisoning.
Unfortunately, the contraction of infections and food poisoning can prove to be much more dangerous during gestation, due to the possible negative effects on the fetus or on the same pregnancy. For this reason, it is good to observe adequate hygiene rules and take appropriate precautions (for more information, see: Infections in Pregnancy).
However, among the pathogens that can give rise to infections (even very serious) characterized by diarrhea during pregnancy, we recall:
- Viruses responsible for the so-called intestinal influences (among which we find the so-called rotavirus );
- Bacteria belonging to the genus Shigella ;
- Bacteria belonging to the genus Salmonella ;
- Staphylococci ;
- Escherichia coli ;
- Entamoeba histolytica (it is a parasite that can cause a very serious maternal infection during pregnancy, especially when it is late diagnosed. It is characterized by the appearance of bloody diarrhea, anemia and fever. In the most serious cases, the cardiovascular collapse).
Pre-existing pathologies
If the expectant mother suffers from pathologies that affect the intestine even before the beginning of pregnancy, the same gestation can contribute to accentuate the symptoms, also favoring the appearance of diarrhea. Among the aforementioned diseases, we mention irritable bowel syndrome and Crohn's disease .
Other Causes
Diarrhea in pregnancy could also be a side effect resulting from an iron supplementation (for more information, see: Iron in Pregnancy). In such a situation, it is good to consult the gynecologist who will assess how best to proceed.
Did you know that ...
At the end of the gestation period, diarrhea could be one of the symptoms of impending labor (for more information: Symptoms of Labor).
Associated symptoms
What symptoms can occur in association with diarrhea in pregnancy?
The symptomatology that accompanies diarrhea in pregnancy depends very much on the cause that gave rise to it, even if, in some cases, it could manifest as the only symptom.
However, abdominal pain and cramps are undoubtedly the symptoms most commonly associated with this condition.
Other symptoms that could appear in association with diarrhea in pregnancy, in particular when caused by pathological factors, are: tiredness and weakness, fever, presence of blood in the stool.
Complications of Diarrhea in Pregnancy
In addition to the potential damage caused by the possible contraction of infections, one of the most worrying complications in case of diarrhea in pregnancy is dehydration . Because of the continuous discharges, in fact, large quantities of liquids and mineral salts with negative consequences are lost. Typical symptoms that may suggest a possible dehydration consist of:
- Feeling thirsty;
- Muscle cramps;
- Decreased diuresis;
- Dark urine;
- Dryness of the skin and mucous membranes;
- Weakness.
In case of suspected dehydration resulting from a condition of diarrhea during pregnancy, medical intervention is essential.
Diagnosis
Importance of Diagnosis in the presence of Diarrhea in Pregnancy
Given the great variability of causes that can give rise to diarrhea in pregnancy, the diagnosis plays a fundamental role in order to identify in a timely manner the presence of any diseases that could complicate the pregnancy itself. In this regard, in addition to the evaluation of the symptoms reported by the patient, the doctor and / or the gynecologist could resort to a possible analysis of the faeces, both to search for the presence of possible pathogens, and to determine the presence of occult blood.
In order to make a correct diagnosis, the identification of the type of diarrhea that afflicts the patient can also be useful. For example:
- A diarrhea in pregnancy characterized by frequent discharges and watery stools, but in the absence of abdominal pain, could indicate an intestinal influence sustained by rotavirus. In such a case, the phenomenon should be self-limiting and regress within a few days.
- A bloody diarrhea, therefore characterized by the presence of blood in the faeces, can indicate the presence of infections sustained by Entamoeba histolytica, staphylococci or Eseroichia coli enterohemorrhagic serotype. In some cases, this type of diarrhea can lead to anemia.
- A diarrhea in pregnancy that is particularly intense and associated with fever and more or less intense abdominal pain, however, could be a sign of the presence of infections sustained by Salmonella spp, Shigella spp. or Escherichia coli .
Of course, what has been said so far is only given as an example, since the type of diarrhea, the clinical manifestations and the symptoms could vary from pregnant to pregnant.
Care
Care and Treatment of Diarrhea in Pregnancy
Clearly, the treatment of diarrhea in pregnancy is related to the treatment of the cause that triggered it.
If the symptom is induced by hormonal causes, it should be resolved relatively quickly; while in the case in which the diarrhea results from alimentary causes or from the intake of supplements, the gynecologist can intervene by making changes in the diet of the future mother and modifying or suspending the administration of the integrator due to the onset of the symptom in question.
Regarding the pathological causes, the intervention of the doctor or gynecologist is essential, since it is known that a pregnant woman cannot take the same drugs (even if over the counter) used to treat diarrhea under "normal" conditions.
In the presence of bacterial infectious diseases, it may be necessary to use specific antibiotic drugs which, however, can only be prescribed by the doctor. In the presence of infectious diseases of a viral nature (rotavirus), on the other hand, administration of antiviral drugs is not usually required, since infections of this type - in most cases - tend to be self-limiting.
However, if diarrhea during pregnancy persists, the doctor may prescribe the administration of specific drugs whose use is considered safe even at this stage of the woman's life. Among these, we remember the diosmectite (Diosmectal®), an active ingredient with an antidiarrheal action that is not absorbed by the intestinal mucosa and, for this reason, its use is also safe to counteract diarrhea during pregnancy.
Moreover, given the large amount of fluids that can be lost, in case of diarrhea during pregnancy it is essential to keep yourself well hydrated by drinking plenty of water or, if necessary, fruit juices. In the most severe cases, reintegration with saline solutions may be necessary, of course, only and exclusively after medical indication.
