General notes
Please run ALL medications and supplements you are taking past your OBGYN.
Most herbs and supplements have not been studied under scientific conditions much so advice will vary. It is sensible to take the precaution of taking anything that you or your doctor are not totally sure about only when necessary.
Also, make sure you check the other ingredients on any supplements you are taking and run them by your OBGYN cat's claw for instance is found in some digestive enzyme pills and this is not recommended during pregnancy.
What To Expect
TTC: Prenatal vitamins contain a lot of iron which can make C worse. If you are prone to C, talk to your OBGYN and they can give you one either without iron or with a mild stool softener in it to offset this effect.
1st Trimester: It can take some weeks for the effects of the hormones to be felt on your IBS, but most people then find their IBS symptoms either ease or disappear. This is likely to be the worst time for morning (or all day!) sickness. Luckily the nutritional needs of the fetus at this stage are very low so eat whatever makes you feel best, whether it's 'What To Eat When You Can't Eat Anything' diet, sweet foods or salty foods. The usual advice of never letting your stomach getting empty, snacking on fat-free saltines and drinking ginger tea can also help. If you're having a really bad time, talk to your doc about meds that can help for example, Diclectin (a combination of Vitamin B12 & an antihistamine).
2nd Trimester: IBS symptoms may increase during the hormonal changes between trimesters.
3rd Trimester: Again, IBS symptoms may increase during the hormonal changes between trimesters. C is likely to become an increasing problem, particularly as you get to the 8th month, but if it is a major issue for you, your doctor is likely to be able to prescribe you something to help. Also, try increasing your IF intake more than usual, drink lots and lots of water and get as much exercise as you can.
Post-natal: IBS sometimes starts after the birth. However, IBS is known to sometimes disappear for a while after the birth and then come back, or even to ease long-term.
Supplements, Medications and Alternative Therapies (in alphabetical order)
Acetaminophen see Tylenol.
Anti-depressants have not really been studied enough, but the general consensus seems to be that Prozac and Zoloft have been most studied and are probably the safest to take whilst pregnant. However, use of SSRIs (selective serotonin reuptake inhibitors) and serotonin norepinephrine reuptake inhibitors in the 3rd trimester has been shown to increase the risk of new babies suffereing from neonatal behavioral syndrome, or withdrawal syndrome (symptoms of which include jitteriness, irritability and respiratory problems).
Bentyl (Dicyclomine) is considered safe throughout pregnancy. However, it is excreted into breast milk and there have been reports of apnea (cessation of breathing) when dicyclomine has been given to children, so it should probably not be used by nursing mothers.
Codeine is generally avoided in pregnant and nursing women.
Colace (docusate) should be used during pregnancy only when your doctor thinks it is clearly needed, but can be used when the benefits outweigh the potential risks. It has not been studied in nursing mothers.
Dicyclomine see Bentyl.
Digestive enzymes talk to your doctors about these as some will want you to stay off enzymes to be on the safe side.
Donnatal: effects on foetuses and nursing babies are unknown so it should only be prescribed when the expected benefits outweigh the potential risks, and then used with caution.
Fennel is considered safe in small amounts during pregnancy, as long as only the seeds or fruit are used (the tea is made from the seeds). The pure oil is toxic in moderate doses and can cause miscarriage so must never be ingested. Fennel tea may actually help milk production in nursing mothers!
Ginger is considered safe and can be great for morning sickness. For ginger tea: slice a few slices of ginger the size of a quarter and steep in a mug of boiling water. Drink several cups a day.
Hyoscyamine should be used only when clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug may be excreted into breast milk. Consult your doctor before breast-feeding.
Hypnosis is safe during pregnancy: you can even have hypnosis to help with the birth!
Immodium (loperamide) has not been adequately studied in pregnant women (although studies in animals receiving very high doses of loperamide suggest no important, detrimental effects on the fetus). Physicians may use loperamide during pregnancy if its benefits are deemed to outweigh the potential but unknown risks. It is not known if loperamide is secreted in breast milk.
Immodium Advanced (simethicone & loperamide) see Immodium and Simethicone.
Lansoprazole see Prevacid.
Levsin see Hyoscyamine.
Lomotil (diphenoxylate and atropine) has not been adequately studied in pregnant women, so it should be used during pregnancy only when clearly needed. Diphenoxylic acid, a metabolite of diphenoxylate (that is, diphenoxylate that has been changed chemically by the body) is excreted into breast milk, as is atropine. Although there have not been problems reported in the infants of women who breast-feed, the benefits to the mother should be weighed against the potential risks to the nursing infant.
Loperamide see Immodium.
Miralax should be used only when needed, but is considered safe enough to be used if your doctor thinks it is necessary and under full doctor supervision. It is not known whether it passes into breast milk, so consult your doctors before using it whilst breast feeding.
Paracetamol see Tylenol.
Peppermint is helpful but don't use too much as it relaxes uterine muscles as well as the GI ones so in high doses it can increase the risk of miscarriage. It can also increase the occurrence of heartburn, which is a common problem in pregnancy anyway. Talk to your OBGYN about taking it during pregnancy for complete peace of mind. It may also decrease milk production in nursing mothers the tea has traditionally been used for that purpose.
Prevacid (lansoprazole) has not been adequately studied in either pregnant or nursing women.
SFSs are safe for use during pregnancy and nursing. Acacia is particularly useful as it is tasteless and can be combined into many foods and drinks helpful when a lot of things are making you gag anyway!
Simethicone is safe during pregnancy and for use by nursing mothers.
Slippery Elm is usually considered safe, but should ideally only be taken as taken and not regularly as adequate studies have not been done. Talk to your doctors before taking this during pregnancy.
Tegaserod see Zelnorm.
Tylenol (acetaminophen/Paracetamol) is safe throughout pregnancy. It is excreted in breast milk in small quantities. However, acetaminophen use by the nursing mother appears to be safe (source www.medicinenet.org).
Yoga is safe although some poses are to be avoided. There are prenatal yoga classes, CDs and DVDs available.
Zelnorm (tegaserod): there are no adequate studies of Zelnorm in pregnant women (although studies found it caused no ill effects in pregnant rats and rabbits). Therefore, physicians must weight the potential benefit of giving Zelnorm during pregnancy against the unknown risk and some physicians will not prescribe it to pregnant women. Zelnorm is secreted into the breast milk of nursing rats. Very high doses of Zelnorm in mice cause tumors. Due to the demonstration of these tumors and the lack of safety data in children, physicians must weigh the potential benefit of giving Zelnorm to nursing women against the unknown risk to the infant.
Edited by Linz (10/24/05 02:37 PM)
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Pregnancy & IBS (edited again 10-24-05)
