Abdominal bloating in pregnancy: is there a cause for concern?

From the very beginning, this condition presents women with many surprises: morning sickness, changes in tastes and mood, as well as digestive problems.

Frequent bloating during pregnancy causes serious concern for many expectant mothers. We suggest looking into this issue, because it is indeed a deviation from the generally accepted physiological norm. Excessive gas formation in the intestines is called flatulence and as a symptom has a code according to ICD 10: category R14 in the 18th grade.

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Causes of Bloating During Pregnancy

It is important to keep in mind that the pathogenesis of flatulence during pregnancy differs significantly from bloating associated with dyspepsia or gastrointestinal diseases. However, if before pregnancy a woman had an inflamed intestine, problems with the stomach or gall bladder, a deficiency of digestive enzymes or intestinal dysbacteriosis was diagnosed, this will only complicate the situation.

There is little point in considering constipation or bloating in the early days of pregnancy, as many women only find out about their condition when these early days are long gone.

Quite often, bloating during early pregnancy is caused by stress, in which high levels of adrenaline have a negative effect on intestinal peristalsis.

But the key causes of bloating during pregnancy are rooted in the changes that occur in the body under the influence of hormones that are intensively produced during this period. First of all, this is the sex hormone progesterone, synthesized with increased intensity in the ovaries of a pregnant woman. At the level of the autonomic nervous system, it helps to reduce the tone of the muscles of the pregnant uterus, and at the same time - the muscular walls of the intestine. Because the autonomic nervous system regulates both the tone of the uterus and the motility of the large intestine with the same nerve fibers that form nerve plexuses in the pelvic area: uterovaginal, sigmoid colon (located behind the uterus) and rectum. Without going into these anatomical and physiological details of the abdominal cavity and pelvic organs, in everyday life, bloating is considered a sign of pregnancy.

Another "surprise" of pregnancy is the more active functioning of the pancreas and increased secretion of enzymes necessary for the most complete digestion of food. And changes in the work of the intestines are expressed not only in its slowdown, but also in a more thorough breakdown of food organics, as a result of which gases are formed. As a result, the expectant mother will inevitably feel bloating in the 1st trimester. Most women (for the above reasons) suffer from constipation, which also leads to flatulence.

Pregnant women often change their eating habits, for example, they eat more sweets, or continue to eat spicy and fatty foods, or start to consume too much food. And everyone tries to enrich their diet with vitamins and eat more vegetables and fruits. The intestines react to all this by increasing gas formation. And progesterone, the level of which begins to increase due to the placenta joining its synthesis (at the end of the 1st trimester), continues to do its job. So bloating in the 2nd trimester is almost guaranteed.

As the term increases, the fetus grows, and the growing uterus begins to press on everything that is in the abdominal cavity and pelvis. It is clear that the intestines also get it. So do not be surprised when you feel bloating in the 3rd trimester of pregnancy.

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Symptoms and Diagnosis of Bloating During Pregnancy

Obviously, there is no need to describe in detail everything that happens with increased intestinal gas formation. However, let us recall that its first signs are manifested by a feeling of discomfort and fullness in the upper abdominal cavity (it is often said that the stomach is bloated). This is followed by symptoms such as rumbling in the stomach and frequent gas release from the rectum (flatulence). There may also be belching, headache, spastic abdominal pain of a bursting nature or colic caused by excess pressure of accumulated gases, as well as reflex pain in the heart area.

Possible consequences of gestational flatulence include a feeling of weakness, lethargy, poor appetite and sleep, and complications - in the absence of adequate preventive measures - can be expressed in a short-term increase in the tone of the uterine muscles.

Diagnosis of abdominal distension during pregnancy is based on complaints of pregnant women, taking into account the presence or absence of gastrointestinal diseases in their anamnesis, as well as complete information about their daily diet. Tests (stool analysis) may be needed if the pregnant woman complains of pain in the umbilical area, and the doctor suspects helminthiasis, which can also cause abdominal distension.

Differential diagnostics is performed in case of complaints of frequent pain in the heart area. Then instrumental diagnostics is used – electrocardiography (ECG) is performed.

Treatment for bloating during pregnancy

Medicines prescribed to patients with excessive intestinal gas formation - enterosorbents Sorbex, Karbolong and Polyphepan, intestinal motility stimulant Motilium - cannot be used in pregnant women.

The treatment of bloating during pregnancy with these drugs, which some doctors suggest, must take into account the fact that they have not been clinically tested in mammals, and there is simply not enough information about their safety and effectiveness in pregnant women.

But there is an opinion that it is possible to use the antifoaming drug Espumisan (Simethicone, Imodium, Disflatil, Pepfiz, Flatin, Meteospasmil, Maalox, Bobotik) during pregnancy - based on the surfactant polydimethylsiloxane (siloxane polymer) and hydrated silicon dioxide (E551). Although the instructions indicate that these drugs have not had clinical studies on their use in the treatment of pregnant women. But, since the drug is not adsorbed in the gastrointestinal tract, then (we quote) "no negative impact on the fetus is expected." And according to the FDA, the most common side effects of simethicone are gastrointestinal symptoms, including diarrhea, belching, nausea and vomiting.

Homeopathy is also contraindicated during pregnancy. Therefore, folk treatment remains, that is, treatment with herbs with a carminative effect.

These medicinal plants include chamomile (flowers), dill and fennel (fruits, i.e. seeds), caraway and coriander (fruits). They are used to prepare an otar or infusion (a teaspoon per glass of boiling water), which is infused for about an hour and drunk throughout the day. Keep in mind that dill can lower blood pressure. Experienced herbalists and phytotherapists advise against getting carried away with chamomile tea during pregnancy due to the potential threat of bleeding. And if the carminative mixture purchased at the pharmacy contains oregano, then pregnant women should not drink it.

You can find a recipe for a parsley root infusion, which is recommended for bloating. But pregnant women are also strictly prohibited from drinking this potion: parsley is known as a strong abortive agent.

Diet for bloating during pregnancy

Eat right: small portions, but at least 5-6 times a day. And stay away from any products that can aggravate the problem.

Only a diet for bloating during pregnancy, that is, eating the right foods, can reduce the manifestations of gestational flatulence as much as possible. And since there are more of them than “wrong” ones, it is easier to remember the foods that cause bloating during pregnancy. This “black list” includes: animal fats; rye bread and fresh white bread, as well as yeast dough pastries; semolina, millet, pearl barley, oatmeal and corn grits; milk and ice cream; legumes (including peanuts); any cabbage; spinach, radish and horseradish; onions (raw); grapes (raisins), pears, apricots, sweet apples. Carbonated sweet drinks and any mineral water with gas are also completely excluded.

Obstetricians and nutritionists claim that the best prevention of bloating is a balanced diet, consumption of fermented milk products and sufficient amounts of water, an active lifestyle (in the absence of contraindications) and a positive attitude without unnecessary worries.

According to statistics, three out of four pregnant women experience intestinal problems. However, bloating during pregnancy is not a disease and does not pose a threat to either the mother or the unborn child, but simply causes temporary discomfort.

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