Diarrhea in early pregnancy

Pregnancy is a special period in the life of every woman, it is not only a moral and emotional restructuring of the body, but also a hormonal one. It affects metabolism and can lead to various functional disorders. The increase in the size of the uterus affects the work of the intestines, since they are anatomically located close to each other, there is pressure on the intestinal loop, its displacement. Many women complain of constipation during this period. But can there be diarrhea in the early stages of pregnancy? How to determine whether this is a natural condition due to bearing a child or a sign of a serious pathological process that cannot be missed so as not to bring trouble to yourself and the future child?

Epidemiology

According to statistics, more than half of all pregnant women suffer from toxicosis. No other classifications of its specific symptoms have been found, but it must be assumed that some of these women also experienced diarrhea in the early stages of pregnancy.

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Causes diarrhea in early pregnancy

The causes of diarrhea during early pregnancy can be both physiological and pathological. The first is characterized by a short-term course and stops with adaptation to new conditions. Pathological diarrhea can be provoked by the following reasons:

• food poisoning;
• food incompatibility;
• reaction to taking vitamin complexes and individual microelements that are prescribed at the beginning of pregnancy;
• irritable bowel syndrome;
• intestinal infections;
• pancreatitis;
• gastrointestinal tract dysfunction.

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Risk factors

Risk factors for diarrhea in early pregnancy include emotional stress caused by worry about the unborn child, the use of laxatives in case of constipation, and the presence of worms.

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Pathogenesis

The pathogenesis of physiological diarrhea is associated with changes in a woman's hormonal background, the "behavior" of hormones, and the body's attempt to throw out a body that is still foreign to it. The mechanism of development of diarrhea associated with a pathological condition is due to 4 reasons: intestinal secretion, disruption of food transit, increased osmotic pressure in the intestine, and its inflammation. Each type of disease has its own pathogenesis:

• secretory diarrhea - increased secretion of water and electrolytes, decreased intestinal absorption;
• exudative - inflammation of the intestinal wall;
• osmolar - a violation of the digestion and absorption of food;
• hyper- and hypokinetic - acceleration or deceleration of the rate of movement of chyme - the contents of the intestine.

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Symptoms diarrhea in early pregnancy

The first signs that something has changed in a woman's sensations and condition may be bloating, gas accumulation, flatulence, heaviness, dull pain in the abdomen. Even without knowing about pregnancy, symptoms such as diarrhea and vomiting, or diarrhea and nausea, can give a woman a hint about what has happened. In the early stages of pregnancy, symptoms of diarrhea, if they do not cause great discomfort, are not systemic, are an acceptable manifestation, for which there is a definition of "toxicosis". Early toxicosis is not a disease, but a special condition of a woman - a reaction to smells, a strong desire to eat something specific and only this, or no appetite at all, decreased blood pressure. Thus, toxicosis and diarrhea during early pregnancy are not an abnormal phenomenon, but an effort of the body to adapt to new realities.

Temperature and diarrhea in early pregnancy

What should alert a woman and make her see a doctor? An alarming signal of the presence of pathology in the early stages of pregnancy is:

• severe diarrhea;
• fever and diarrhea;
• unnatural color of feces.

Most often, fever during diarrhea is caused by a viral, bacterial or parasitic infection. If the diarrhea is severe and the temperature is high, this indicates acute diarrhea - dangerous for both the health of the pregnant woman and the fetus.

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Black diarrhea during early pregnancy

Black diarrhea is not always a sign of illness. Some foods (blueberries, currants, liver), activated carbon, iron-containing drugs can change the color of feces to dark. But if a pregnant woman has been diagnosed with peptic ulcer disease, this is a reason to sound the alarm. Internal bleeding, when it gets into the intestines, colors the feces black. In addition, the woman's skin becomes pale, weakness appears, and chills hit.

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Green diarrhea during early pregnancy

If green diarrhea cannot be associated with specific products or medications, vitamins that can give such a color, and other alarming symptoms appear (abdominal pain, high temperature, weakness, vomiting, watery stool), then a possible cause of the pathological condition may be dysbacteriosis - a violation of the intestinal microflora, an intestinal infection (dysentery, salmonellosis, escherichiosis).

Morning diarrhea in early pregnancy

Diarrhea in the morning in early pregnancy can be caused by iron preparations, such as sorbifer. They are prescribed for low hemoglobin and to prevent iron deficiency. But if loose stools no longer bother you during the day, then there is no need to worry. Loose stools in the morning are also possible due to the body's reaction to the formation of the placenta, since this affects the internal organs and leads to disturbances in the protein and carbon balance. After the adaptation period, everything will return to normal.

Complications and consequences

The consequences and complications of diarrhea in early pregnancy are not so harmless, even if they are not associated with serious pathology. The fact is that diarrhea leads to dehydration of the pregnant woman's body, and this has a detrimental effect on the woman's blood circulation, and therefore the placenta. The fetus will not receive the necessary substances for full development. In case of infection, the consequences are even more dangerous, since toxins easily overcome the placental barrier and can harm the child.

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Diagnostics diarrhea in early pregnancy

If diarrhea lasts more than three days, the consistency of feces has changed, the color is unnatural, other alarming symptoms have appeared, it is time to see a doctor. Diagnosis of diarrhea in early pregnancy consists of laboratory tests of feces, blood, and the use of instrumental methods. The degree of dehydration is also assessed; with a large loss of fluid, the skin becomes dry, tachycardia appears, and blood pressure decreases.

Deviation of indicators from normal in a blood test will give an idea of pathological changes in the pregnant woman's body. General and biochemical blood tests will show the value of liver enzymes and pancreas. Stool analysis is examined for the presence of helminth eggs, dysbacteriosis, intestinal infections, coprology is performed if pancreatitis is suspected.

Of the instrumental methods, taking into account the special situation of the woman, with the permission of the doctor, an ultrasound examination of the liver, gallbladder, spleen, and pancreas can be performed.

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Differential diagnosis

When conducting differential diagnostics, it is important to have a set of signs inherent in a specific infection, their development dynamics, the patient's medical history, the nature and volume of feces, the smell, color, frequency of stool, and the results of laboratory tests. Establishing the correct diagnosis is not an easy task, since there are many diseases with symptoms of diarrhea, and the superposition of manifestations of toxicosis complicates it. It is important to determine contacts with sick people, animals, to exclude acute conditions of the abdominal cavity that require surgical intervention, for example, appendicitis.

Treatment diarrhea in early pregnancy

Treatment of diarrhea during early pregnancy can only be prescribed by a doctor. Its main areas are fluid replenishment, dietary nutrition, drug treatment, and prevention. If, apart from loose stools, nothing significant happens to the woman’s health, you can limit yourself to drinking plenty of fluids (herbal teas, uzvars, non-carbonated mineral alkaline water), a gentle diet, including boiled rice, baked potatoes, lean varieties of boiled meat, etc. In case of more pronounced manifestations of diarrhea that cause concern to the pregnant woman, the doctor can prescribe sorbents, enveloping and astringent substances, enzyme preparations, and other medications, according to the diagnosis and not contraindicated during pregnancy.

Medicinal treatment of diarrhea during pregnancy

Medicines for diarrhea in early pregnancy:

Regidron is available in powders packaged in 18.9 g sachets. Restores intestinal alkaline balance. The solution is prepared as follows: pour one sachet of powder into a container, add a liter of boiling water, stir and bring to a warm state. Take in small sips after each bowel movement or vomiting attack. On average, you need to drink an amount equal to 10 ml of liquid per hour, multiplied by a kilogram of a person's weight. As a rule, it does not cause any side effects. Contraindicated for hypertensive patients, diabetics, and renal failure.

Among the sorbents approved for use by pregnant women are activated carbon, Polysorb, Smecta, and Sorbex.

Polysorb — capsules containing 250 mg of granulated activated carbon. Binds toxic substances in the intestinal lumen and removes them. Taken between meals. The dose is 2-4 pieces three times a day. As a result of long-term treatment, intestinal motility and absorption by the walls are impaired. Not prescribed for erosions and ulcers of the digestive tract, individual intolerance.

If necessary, if the benefit to the mother outweighs the risk to the fetus, antibacterial drugs Ercefuril, Biseptol, Enterosedive are prescribed.

Ercefuril - capsules, suspension, has a bactericidal property. The recommended dose is one capsule or measuring spoon 4 times a day at equal intervals, regardless of food. The drug is well tolerated by patients, in some cases an allergy in the form of a rash was observed. Contraindicated for children under 1 month, in capsules - up to 7 years.

Enzyme preparations that help in the digestion of food: festal, pepsin, mezim, pancreatin.

Festal is a dragee that helps digest proteins, carbohydrates, and fats. Taken three times a day during or immediately after meals. Contraindicated in hepatitis and bile duct obstruction.

Bacterial preparations can be used to normalize intestinal flora (linex, enterol, bifiform, normaflor, acylact).

Bifiform - capsules, the required dose is 2 pieces per day. In case of increased sensitivity, they can cause allergies.

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Vitamins

With diarrhea, vitamins and microelements are poorly absorbed in the intestines, which causes their deficiency, which can turn into a problem for the mother and the future baby. Therefore, after restoring normal stool, it is necessary to saturate the body with foods rich in vitamin A (liver, eggs, fish, tomatoes, carrots), vitamins of group B (apples, cabbage, bran bread), C (currants, sweet peppers, citrus fruits, rose hips), D - building material for the formation of the child's skeleton (fish oil, sun rays) and other useful elements. Do not forget that all this should be prepared using gentle technologies, in chopped, boiled form.

Physiotherapeutic treatments usually used for diarrhea (micro enemas of medicinal herbs, acupuncture) are not prescribed during pregnancy.

Folk remedies

Traditional treatment mainly involves astringent and enveloping remedies for diarrhea. The most harmless for the expectant mother are the following:

• rice decoction - take 4 parts water for one part of well-washed grains, boil over low heat, strain when ready. The viscous jelly-like liquid is the remedy;
• potato starch - a teaspoon per half glass of warm water, mix thoroughly and drink;
• Soak rye bread in water for half an hour, drink the liquid in small sips.

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Herbal treatment

Herbal treatment of diarrhea during pregnancy should be carried out very carefully, because many medicinal plants can cause increased uterine tone and carry the risk of miscarriage, including plants containing tannins (sage, oak bark). Recommended astringent herbs include cinquefoil, St. John's wort, chamomile, blueberries, bird cherry, and burnet.

Homeopathy

Homeopathic remedies available in pharmacies and aimed at treating bowel disorders contain warnings in the instructions that the drugs have not been tested on pregnant women, and some of them contain ethanol. One of them is Enersel Plus V.M.

Enersel plus V.M. is an injection solution intended for the treatment of diarrhea of various etiologies in combination with other types of treatment. It is administered intramuscularly 4 times a day, at the same time, 4 ml at a time. No adverse reactions, contraindications, or cases of overdose have been found.

Among safe homeopathic preparations, chamomilla stands out; it is based on medicinal chamomile. The therapeutic effect begins to manifest itself from the 6th dilution, but is also used in the 12th and 18th dilution.

Prevention

Diarrhea caused by a change in the physiological state of a woman will pass on its own after a period of adaptation and restructuring of the body. To avoid other factors causing diarrhea, it is necessary to adhere to the following rules of prevention:

• always wash your hands after coming home from outside and before eating;
• monitor the expiration dates of food products;
• foods consumed raw should be washed well;
• keep the refrigerator and kitchen clean;
• adhere to the rules for heat treatment of food products;
• Do not combine difficult to combine dishes.

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Forecast

Since diarrhea entails a violation of the electrolyte composition of the blood, dehydration, this has a bad effect on bearing a child. However, if timely measures are taken, the prognosis is favorable.

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