DR M Asha Subbalakshmi, Head of the department of Interventional Gastroenterology and Liver Diseases at CARE Hospitals, Hi-tech city, tells us about digestive problems during pregnancy and how to tackle them. Problems in Pregnancy are not diseased it’s natural.
What kind of digestive problems do women face during pregnancy?
Hyperemesis Gravidarum (excess- Sive vomiting) is the most common one.
It may start within the first three months of the pregnancy and sometimes continue until the baby is delivered.
In addition, there is Gastroesophageal Reflux disease which affects the muscular sphincter between the esophagus and the stomach.
The problem may occur for the primary time as pregnancy begins or it’s going to be a pre-existing condition that could worsen during pregnancy.
Other digestive conditions include Acid Peptic disease during which there is excessive acid secretion. It is seen even during the non-pregnant state. However, pregnancy may exacerbate the issue due to hormonal changes.
At times, expecting mothers come with an emergency case — that of blood vomiting. This may occur when there is a tear in the lining of the junction of the stomach and esophagus or the food pipe or a bleeding ulcer in the stomach intestine where emergency endoscopy treatment is done to stop the bleeding.
Women also suffer from lower gastrointestinal problems like sudden onset of constipation, hemorrhoids, and anal fissures. Many pregnant women who get stressed during pregnancy suffer from inflammatory bowel disease. The problem is characterized by ulcers in the large and small intestines.
During pregnancy, the gallbladder becomes sluggish. The liquid that is stored in it can turn into stones and slip into the tube next to the gall bladder, called the bile duct that opens into the intestine. It leads to jaundice with fever and abdomen pain. It’s a rare and emergency case in which emergency ERCP is done to save both the baby and mother.
I have 20 years of experience in these procedures and even have written many publications on this.
There are some conditions during which the patient could develop hepatitis.
It could worsen and become a permanent condition if not treated on time, especially hepatitis E. Benign Recurrent Intrahepatic Cholestasis may be a condition which if shows up during the first pregnancy can also occur within the second pregnancy.
Why do these conditions appear?
As the baby grows, the baby’s weight increases, say it grows to 2.6 kg. The secretions also add weight. So a pregnant woman carries in her abdomen a weight close to 3.5 kg as she approaches term. This weight in the abdomen creates a sensation and causes pressure on the surrounding organs. As the uterus also increases in its height, it presses the stomach causing Acid Peptic disease or GERD. There are a lot of physical changes in the body just as there are hormonal changes.
Are these problems common across all pregnant women?
Hyperemesis Gravidarum and Gastroesophageal Reflux are common problems. Others are seen only in 20 percent of the cases and are due to a genetic component.
What advice would you give to expectant mothers?
Eat a balanced diet, on time. Exercise moderately and do expose yourself to the sun. Remember, pregnancy is not a disease; it’s a state of being which one must enjoy.
HOD Interventional Gastroenterology & Liver Diseases
CARE Hospitals Hitech City,
Old Mumbai Highway,