Liquid stools in pregnant women

Loose stools in pregnant women are a common pathology that can develop as a physiological condition, and can also be a sign of a disease that requires serious treatment. Changes in the consistency and color of feces should always attract attention, as this can be a serious pathology. Statistics show that problems with the gastrointestinal tract in women during pregnancy come to the fore in the first trimester and in the third trimester of pregnancy take second place. It is necessary to promptly diagnose any changes in the health of a pregnant woman that pose a threat to the future baby.

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Causes loose stools in pregnant women

Pregnancy is a special period in a woman's life, when all organs and systems work differently. At this point, the body is rebuilt to provide another circle of blood circulation, and this can affect all organs. This is due to the formation and functioning of the placenta as a place for the development of the child. During the period of placenta formation, there is no clear boundary that would allow separating all processes, so a woman may be bothered by various problems in the form of early toxicosis, which lasts throughout the first trimester of pregnancy and corresponds to the period of placenta formation. It is in the first trimester that a woman is bothered by problems with the gastrointestinal tract in the form of lack of appetite, nausea, vomiting, constipation or diarrhea. At the same time, very often there is a change in the nature and color of feces, which occurs under the influence of hormones and normally does not require any action. But it is necessary to distinguish such a normal condition from pathological symptoms and differentiate, first of all, the causes of the development of this condition.

First, we need to define the concept of loose stools – this is stool that is characterized by three or more episodes of loose stools during the day.

The reasons for the development of loose stools in pregnant women can be divided into those that are normal and those that require careful diagnosis.

Often, the appearance of loose stools due to the consumption of certain foods is considered normal. During pregnancy, a huge amount of hormones, hormone-like substances and biologically active substances are released that can enhance not only intestinal peristalsis, but also increase the sensitivity of the nervous apparatus of the mucous membrane to the action of certain foods. At the same time, foods that a woman previously consumed without any problems can irritate the mucous membrane and increase motility or secretion with manifestations of loose stools. Such foods can be dairy products, salty foods, oatmeal, prunes, plums, beets, watermelon. All these products can cause loose stools in pregnant women. Therefore, it is necessary first of all to analyze the diet of a pregnant woman and make a correction; if the consistency of feces becomes normal, then the problem is solved and there is no need to worry. Especially if such a change in stool is not accompanied by any other symptoms from the gastrointestinal tract and intoxication manifestations.

Very often, loose stools during pregnancy occur after taking medications. Such medications can cause both increased motility, and some components can be osmotically active substances and stimulate a hyperkinetic type of diarrhea. Most often, this occurs in the case of taking vitamins and multivitamin complexes.

There is another reason for diarrhea when taking medications - this is the development of dysbacteriosis in the case of antibiotic therapy. If a woman takes an antibiotic for some reason, then very often a violation of the symbiosis of normal microflora develops. This also occurs due to the state of relative immunosuppression that a pregnant woman has, which inhibits the normal flora and increases the activity of opportunistic intestinal flora. In this case, loose stools are very often observed as a manifestation of this condition.

The reasons that can often lead to loose stools during pregnancy and which must be taken into account and help sought are infectious diseases of the intestines of an inflammatory nature. In this case, the pathogen can be either a bacterium or a virus. Among the most common causes of bacterial diarrhea are intestinal yersiniosis, salmonellosis, dysentery, pseudotuberculosis, escherichiosis. Among viruses, diarrhea caused by enteroviruses of different types, as well as rotavirus infection, are more common. These diarrhea have distinctive features, but they are united by the symptom of loose stools, which during pregnancy can become a dangerous condition due to dehydration.

Therefore, it is very important to promptly diagnose infectious causes of loose stools in pregnant women and begin treatment promptly to prevent complications.

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Pathogenesis

The pathogenesis of the development of loose stools in pregnant women in the case of eating food products is that some products simply increase intestinal peristalsis by contracting the smooth muscle fibers of the intestine. Some products or medications act in a different way: they have components that stimulate the secretion of secretion into the intestinal cavity and thus, due to swelling, there is an increased excretion of these products.

Infectious diarrhea also has several pathogenetic mechanisms for the development of loose stools. Some bacteria penetrate the intestinal wall, destroy its structures, and cause an intense inflammatory process, which is accompanied by all the symptoms of inflammation - swelling occurs, the barrier function of the intestine is disrupted, and secretion increases, which contributes to the formation of loose stools. Some viruses and bacteria act like secretory diarrhea - they increase the level of substances that draw water to themselves and, increasing the volume of fluid in the intestinal cavity, they cause diarrhea.

It is important to clearly understand when loose stools in pregnant women signal danger, and when they are simply a manifestation of dietary peculiarities.

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Symptoms loose stools in pregnant women

Various symptoms from the digestive system of a pregnant woman may indicate certain pathologies. The nature of the stool, its consistency, color, quantity - all this is an indicator of the work of the stomach, intestines, liver and pancreas. Therefore, loose stools in pregnant women can be one of the symptoms of the disease. It is also necessary to distinguish the time of diarrhea. Loose stools in pregnant women in the early stages can develop with early gestosis. In this case, diarrhea occurs together with nausea, vomiting and is one of the normal manifestations that does not require special etiological treatment. Loose stools in pregnant women in the later stages is a more dangerous symptom, since it makes you think about a possible infectious cause.

If loose stools in pregnant women are a manifestation of an intestinal infection, then in this case the symptoms of changes in stool will be accompanied by other clinical signs. In this case, there will be abdominal pain of a spasmodic or constant nature, symptoms of intoxication in the form of an increase in body temperature, chills, headache, nausea and vomiting are also possible. All these clinical signs indicate an intestinal infection, which requires urgent complex treatment using antibacterial agents. At the same time, loose stools have their own characteristics depending on the pathogen - they can have different characteristics in the form of mushy, watery, mucous, and can also have a different color - from green to black. All these features are diagnostic signs of certain infections.

Intestinal infection is often accompanied by manifestations of intoxication and dehydration. At the same time, dry skin and mucous membranes develop, intoxication manifestations in the form of increased body temperature, exhaustion, dizziness, fatigue, headache. All these symptoms require careful attention and diagnosis due to their possible infectious nature.

Complications and consequences

The main complications that can occur with diarrhea in a pregnant woman are not only the impact on her condition, but also the impact on the child. Any toxins in the woman's body are potentially dangerous for the child, since they penetrate the blood, from where they get to the child. The main complications of loose stools, which are most common, are severe dehydration. In this case, the blood supply to all organs is disrupted due to thickening of the blood, including the placenta, which is accompanied by oxygen starvation of the child.

Complications of loose stools are possible if they are caused by an intestinal infection. In this case, intestinal bleeding, prolapse of the anus, intestinal obstruction, and intussusception may develop. These consequences are rare due to timely and adequate diagnostics.

Diagnostics loose stools in pregnant women

Diagnosis of loose stools in pregnant women should be perceived from the very beginning as a serious phenomenon requiring the exclusion of acute intestinal infection.

It is very important to find out all the details and carefully collect anamnesis, then this is the key to a possible diagnosis. When a pregnant woman comes to the doctor, it is necessary to clarify the pregnancy period, the presence of gestosis, anamnestic data on diseases of the digestive system. If diarrhea is early in pregnancy and is accompanied by nausea and vomiting, then this may be a manifestation of early gestosis. It is necessary to detail the complaints and find out how many times loose stools were observed, whether there was a change in color, its consistency, as well as the presence of nausea, heartburn, vomiting, abdominal pain. It is necessary to find out the details of the pregnant woman's diet and the intake of drugs that could affect the nature of the stool. Sometimes only at this stage can you find out the cause of loose stools and no additional diagnostic methods are required. But if there is any suspicion of an intestinal infection, then additional research methods must be carried out.

The tests that must be taken without fail during pregnancy are general clinical tests - a general blood and urine test, a biochemical blood test, and a stool test. The stool test must be carried out with a bacterial examination and determination of sensitivity to antibiotics. If it is not possible to identify the type of pathogen, then the accurate diagnostic method is the polymerase chain reaction. This method allows you to identify the DNA of bacteria or viruses. Which also allows you to accurately establish a diagnosis.

Coprogram is a method of microscopic examination of feces, which allows to establish the degree of dyspeptic disorders and the function of the pancreas. This study can provide data on the presence of leukocytes, erythrocytes, mucus, which allows to differentiate intestinal infection, hemorrhoids, bleeding. In the general blood test in the case of inflammatory intestinal infection, leukocytosis and a shift in the formula to the left in the case of bacterial intestinal infection will be determined.

In case of diarrhea and vomiting in early pregnancy, it is necessary to determine the level of acetone, which allows us to judge the degree of intoxication of the body, as well as determine the treatment tactics.

Instrumental diagnostics of loose stools in pregnant women includes mandatory ultrasound examination to determine the condition of the fetus, and also at a short term it is possible to visualize the intestines. If the pregnancy is in the third trimester, then it is necessary to conduct cardiotocography with registration of the main indicators of fetal vital activity to determine the degree of dehydration and how it affects the fetus.

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Differential diagnosis

Differential diagnostics of loose stools in pregnant women should be carried out primarily between intestinal infections and a normal phenomenon during pregnancy due to the use of products or medications. Intestinal infection or food toxicoinfection is accompanied not only by loose stools, but also by other symptoms from the gastrointestinal tract, as well as intoxication syndrome. In case of intestinal infection, there will be characteristic blood tests, coprograms, as well as the general condition.

In the case of loose stools, as a manifestation of dietary features, the general condition does not change. If loose stools in pregnant women are not accompanied by an increase in their frequency or do not affect the general condition, then this is a normal phenomenon caused by hormonal changes.

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Treatment loose stools in pregnant women

Intensive treatment of loose stools in pregnant women is necessary only if it is a pathological symptom and the etiology of the disease is confirmed. In the treatment, medications and non-medicinal means are used - folk methods and homeopathic remedies. It is very important to follow the regime and nature of nutrition in acute intestinal infection, especially if loose stools have other manifestations.

The regime of a pregnant woman should exclude excessive loads, but at the same time it is necessary to have minimal physical activity. If the etiology of intestinal infection is confirmed, then it is necessary to adhere to bed rest during the acute period.

It is very important to maintain an adequate drinking regime with control of the incoming and outgoing fluid. It is necessary to take into account pathological losses not only with loose stools, but also with vomiting, sweating and diuresis. Therefore, it is necessary to drink a lot of alkaline liquids in non-carbonated form. Mineral water is recommended - "Borjomi", "Luzhanskaya", "Polyana Kvasovaya" without gas. It is very important to control the degree of dehydration and the condition of the child and amniotic fluid.

Since the processes of normal digestion, absorption and evacuation functions are disrupted, it is necessary to adhere to a diet:

• The calorie content of food should be minimal, without complex saturated fats and with limited dietary fiber, as they stimulate the motility of the gastrointestinal tract.
• It is better to eat food boiled, warm, not hot and not cold, as this is an additional burden on the digestive tract. You can eat soups on water with any cereal except buckwheat, without fat, meat and fish.
• Sour, salty, smoked products - exclude completely. Potatoes can be boiled as mashed potatoes in water or baked potatoes in the shell.
• It is necessary to exclude "simple" carbohydrates - sweets, buns, cookies, candies. Fresh white bread should also be excluded, since it tends to form adhesions in the intestines. It is recommended to eat rolls, diet cookies, and rusks from a loaf.
• The diet needs to be supplemented with complex carbohydrates; the ideal option is oatmeal, which has an enveloping effect, as well as all porridges on water, except buckwheat.
• Dairy products should be excluded during the acute period, as they cause fermentation.
• It is necessary to exclude sweet fruits and fruit juices during the acute period of severe diarrhea.

These are the basic principles of dietary nutrition, which are a mandatory component of the complex treatment of loose stools in pregnant women.

In case of proven intestinal infection of bacterial etiology, complex treatment with antibiotic, probiotic and sorbent is mandatory. But drug treatment has its limitations, since many drugs are contraindicated during pregnancy. When prescribing antibiotics, preference should be given to those drugs that do not affect the fetus. At the same time, it is necessary to monitor the child's condition and be ready to take measures in case of complications.

If a woman has had severe vomiting and diarrhea, it is necessary to replenish the water balance orally, which is an important stage of treatment pathogenetically, and in the case of intestinal bleeding, it will replenish the volume of circulating blood. It is also necessary to carry out infusion therapy in a volume that will replenish all pathological losses.

In case of proven infectious genesis of liquid feces, a necessary component of treatment is the prescription of antibiotics, but taking into account the possible negative impact on the fetus, it is necessary to select the type and dose. In pregnant women with liquid stool, intestinal antiseptics of the nitrofuran series, as well as antibiotics of the fluoroquinolone group, should not be prescribed, since they have a pronounced effect on the development of the fetus. Preference is given to antibiotics of the cephalosporin group, which are relatively safe due to the absence of proven harmful effects on the child. Therefore, in case of bacterial intestinal lesions in pregnant women, cephalosporins are the drug of choice.

Cefepime is a beta-lactam antibiotic from the 4th generation cephalosporin group, which has a pronounced bactericidal effect on gram-positive and gram-negative microorganisms, i.e. covers a huge range of microbes. It is produced in the form of a powder for injections of 1 gram. The drug is used in a dose of 1 gram per day, administered intramuscularly or intravenously at intervals of 12 hours. The course of treatment is 7-10 days.

Contraindications for use are allergic reactions to penicillins or other beta-lactam antibiotics.

No negative impact on the fetus during pregnancy has been identified. Side effects are possible from the gastrointestinal tract, allergic reactions, nervous system reactions in the form of headache, drowsiness, dizziness.

Antibacterial therapy of colitis during pregnancy should be carried out with strict monitoring of the condition of the mother and fetus. It is important to conduct antibiotic sensitivity before prescribing therapy and then be guided by the results obtained.

Today, there are a huge number of sorbents, but some of them are preferred because they can be taken during pregnancy. Loose stools of any genesis are accompanied by a violation of the excretory function of the intestine and the accumulation of a huge number of toxins and metabolic products, so the use of sorbents allows you to cleanse the intestines and restore normal flora.

Smecta is a natural sorbent that can adsorb viruses and bacteria, and also has a protective effect by stabilizing the mucous-bicarbonate barrier and increasing the amount of mucus. The drug reduces the symptoms of bloating and heartburn.

Available in 3 gram sachets.

The drug can be used during pregnancy and lactation, since it is not absorbed, but excreted unchanged. Side effects are rare, allergic reactions may be observed. The drug is contraindicated in case of intestinal obstruction and hypersensitivity to it. Precautions - it should be taken at least 2 hours apart from other drugs, since it reduces their absorption.

Dosage: 3 grams of the substance (one packet) must be diluted in half a glass of warm water and taken 3 times a day, the course is 5-7 days.

During treatment with antibiotics, and also taking into account the disruption of the normal intestinal biocenosis during diarrhea in pregnant women, it is necessary to prescribe probiotics as part of complex therapy.

Linex is a drug that contains lactic acid bacteria and bifidobacteria and helps to normalize the intestinal flora and, in addition, has an antidiarrheal effect. It is available in the form of capsules of 1 gram. The drug has no pronounced side effects, can be used during pregnancy due to. Dosage - 2 capsules 3 times a day after meals, the course of treatment for colitis is not less than three days.

Antispasmodic drugs are most often used as pain relievers, which can additionally reduce the tone of the uterus.

No-shpa (Drotaverine) is an antispasmodic drug widely used in surgery and gynecology. It is available in tablets in a dosage of 40 milligrams, as well as in ampoules in the same dose of 2 milliliters. Side effects of the drug are tachycardia, a feeling of a rush of heat to the face, increased sweating, dizziness, allergic reactions. No significant harm to the fetus is detected, since the drug does not penetrate the hematoplacental barrier. Contraindications for use are closed-case glaucoma, prostatic hyperplasia. The drug is used for colitis in pregnant women to relieve intestinal spasm during pain syndrome. Dosage is 40 mg per dose. It can be taken as a tablet, but it is better to inject in the same dose, no more than 3 times a day.

It is better not to carry out vitamin therapy during the acute period of diarrhea.

Physiotherapy treatment is recommended only during the period of remission.

Surgical treatment of diarrhea is possible in extreme cases when complications such as intestinal bleeding, intussusception and obstruction occur. Such complications occur very rarely.

Folk remedies for loose stools in pregnant women

Traditional methods of treating diarrhea are widely used by expectant mothers due to the minimal harm to the child. There are many methods of treatment using both herbs and traditional and homeopathic preparations. The main effect of such treatment is the restoration of water-electrolyte balance, bactericidal effect and restorative.

The main methods of folk treatment:

• Propolis tincture reduces inflammation of the intestinal wall, promotes epithelial regeneration and has a bactericidal effect. To prepare the tincture, 10 grams of propolis should be boiled in boiled water for about 20 minutes, this solution should be infused for at least an hour, after which it is used internally by a tablespoon 2 times a day.
• The use of a natural remedy - mumiyo - is widely used in the treatment of diarrhea, especially during pregnancy. This substance has a pronounced anti-inflammatory, regenerating, analgesic effect. To prepare the remedy, you need to dissolve 100 milligrams of mumiyo in a tablespoon of water and take it orally 2 times a day for seven days. Such a solution can suppress normal intestinal microflora, so it is necessary to take probiotics.
• A starch tincture, which is prepared from one tablespoon of starch dissolved in a glass of warm water, helps to normalize the consistency of feces and is a good antidiarrheal agent.
• Herbal treatment also has its advantages, since herbal medicine, in addition to its local action, has a general calming effect, and it also replenishes the body after severe dehydration.
• An infusion of rose hips, which is boiled for five to ten minutes in hot water, replenishes the water balance and helps to normalize liver function, which enhances its antitoxic function.
• Chamomile infusion, which is prepared from three tablespoons of chamomile leaves, which are brewed in a liter of boiled water. Before taking, add a spoonful of honey and take as often as possible during the acute period, at least a liter per day.
• Raspberry leaves and raspberry juice are boiled in water and made into a sour compote, which is taken in any mode during the acute period for rehydration.

Homeopathic remedies:

• Nux vomica-Homaccord is a combined homeopathic preparation that has an anti-inflammatory effect on the intestinal mucosa. It is available in drops, the dosage is 10 drops per tablespoon of water 3 times a day. Side effects include allergic rash.
• Mucosa compositum is a homeopathic remedy that has a regenerative, antispasmodic, anti-inflammatory effect. The drug also has a mucolytic effect and can enhance intestinal motility. It is available in the form of an injection solution in a dose of 2.2 ml. Dosage - 2.2 ml intramuscularly or subcutaneously, in acute conditions once a day, and in chronic colitis once a week. It is not contraindicated in pregnancy, side effects may be in the form of allergic reactions.
• Traumeel S is a complex homeopathic remedy that is available in the form of tablets and injections. It has anti-inflammatory and regenerative effects. Dosage in the acute period is 1 ampoule of 2.2 ml per day, later or for chronic colitis, take 1 tablet 3 times a day.
• Viburcol is a homeopathic drug that has analgesic, anti-inflammatory, antispasmodic, and sedative effects. It is available in the form of rectal suppositories. Use one suppository 2-3 times a day. It can be taken during pregnancy, side effects are not common in the form of allergic reactions. There are no contraindications to the use of the drug.

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Prevention

Preventive measures are non-specific, which mainly include dietary recommendations for pregnant women. During pregnancy, it is necessary to carefully monitor your diet, which ensures normal caloric content of food and the completeness of food products with a balanced composition of microelements. It is necessary to limit products that cause fermentation and are strong stimulants of intestinal motility. You should not eat products of dubious quality, since during pregnancy the gastrointestinal tract works differently and you should not risk your health.

Loose stools during pregnancy can be a serious symptom and if it is combined with other manifestations from the gastrointestinal tract, then there is a high probability that this is an intestinal infection. In this case, you need to seek qualified help, especially considering the life and health of the unborn child.

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Forecast

The prognosis for recovery is favorable, and for life it is also favorable.