IBS and Pregnancy: All The Info You Need

Pregnancy isn’t always glamorous.

Sure, there are the cute bumpies and the compliments about glowing and all the rest of it.

But we mamas-to-be know that there can be some pretty uncomfortable and awkward aspects of pregnancy, too, like those annoying gastro-intestinal symptoms that many of us seem destined to get at some point during these long nine months.

But what if gastric problems are already part of your daily life because you have Irritable Bowel Syndrome (IBS)?

How does IBS affect pregnancy? And is there a chance that the condition could affect your little peanut?

(Just for reassurance, the answer there is almost certainly no).

In this article, we’ll unpack everything we know about IBS in pregnancy and, if you’re struggling with IBS, tips to help ease it as your bump grows.

Let’s dive in.

In this article: 📝

What is IBS?

IBS is a condition that affects around 10-15% of the population, and more women have it than men.

It’s thought that IBS happens when the connection between the brain and the sensitive muscles in the gut is disrupted.

It seems to affect people differently, but generally, when these muscles don’t receive the right signals, it can cause uncomfortable symptoms such as food sensitivity, constipation, diarrhea, painful cramping, and bloating.

Most people who have it experience “flare-ups”—when their symptoms are worse—and then times when they’re more manageable.

Even though these flare-ups come and go, however, lots of people who have IBS say that the symptoms have a significant impact on their work, social lives, and mental health, something you may well recognize if you suffer from the condition.

Can having IBS affect pregnancy?

Unfortunately, scientists don’t exactly know how pregnancy and IBS interact with each other.

As with a lot of medical issues, studies on pregnant women specifically are few and far between.

There are good reasons for this, but the gap in the medical knowledge can be frustrating because most mamas-to-be with IBS report that pregnancy can completely change the way they experience the condition.

For some women, IBS symptoms actually improve during pregnancy.

For others, being pregnant makes their IBS flare-ups worse, and for others, the “triggers” (foods and activities that bring the symptoms on) are different.

What are the risks of IBS during pregnancy?

The main risks of severe IBS while pregnant are:

1. Dehydration 🌵

Diarrhea can dehydrate you very quickly, and this is not ideal for you or your little peanut.

In rare cases, it can also lead to premature labor or a higher risk of small for gestational age (SGA) infants.

So if you do go through a bad flare-up, keep an eye out for the signs of dehydration, make sure you give yourself enough fluids, and get medical help if you need it.

2. Medications 💊

While IBS itself isn’t dangerous for your baby, a lot of the medications used to treat the symptoms aren’t recommended during pregnancy.

That being said, serious symptoms often get managed by balancing your needs during pregnancy with the possible risks.

Our best advice here is to talk to your doctor during your first prenatal appointments.

They may be able to recommend treatments to help you individually and help you figure out a strategy for managing your IBS during your pregnancy which keeps your little one happy and you comfortable too.

Can pregnancy cause IBS?

It's complicated.

Pregnancy causes changes in hormones and the autonomic nervous system, which then can cause a change in the gut-brain axis.

And this can very much lead to IBS

And while there is a big overlap between pregnancy symptoms and IBS symptoms, technically IBS can be triggered during pregnancy.

Can pregnancy make IBS symptoms worse?

Unfortunately, for some mamas-to-be, yes.

As we mentioned before, pregnancy can wreak havoc with your digestive system, especially during the first trimester and the third trimester.

At the beginning of pregnancy, it’s common for your hormones to slow your digestive system right down, which leads to bloating, gas, and constipation.

And a lot of women also experience some abdominal cramping in early pregnancy.

When you reach the third trimester, the amount of space that your not-so-little baby is taking up can make it harder to go again.

And then, right before your baby is ready to make their grand entrance, it’s fairly common to have diarrhea as your body prepares itself for labor.

Remember when we said that pregnancy wasn’t glamorous? Yeah. We weren’t kidding.

Are there risks to the baby if you have IBS while pregnant?

There doesn’t seem to be any correlation between how bad a woman’s IBS symptoms are while pregnant and how healthy her baby is.

Still, one 2012 study did find an association between IBS and an increased risk of miscarriage or ectopic pregnancy.

Equally, another 2021 study found an increased risk of ectopic pregnancy in women with IBS and Crohn's disease.

While the exact reason isn't clear, both studies stress the importance of prenatal care for people with IBS and cautious monitoring throughout pregnancy.

What helps IBS when pregnant?

The problem with treating IBS during pregnancy is that you can never be completely sure whether the symptoms are down to your pregnancy or an IBS flare-up.

Thankfully though, a lot of the advice for treating gastric symptoms is the same.

For both people with IBS and mamas-to-be, the two big pieces of advice are:

1. Eat smaller, more regular meals 🥙

Instead of eating three big meals every day, eating five smaller ones can help to keep your digestive system working as it should and can reduce bloating and nausea in early pregnancy.

You might also find in later pregnancy that smaller meals more frequently are the most comfortable way to go anyway.

2. Try to reduce stress and anxiety levels 🧘‍♀️

Stress can very much make IBS symptoms worse.

And this is because they often come from the connection between the brain and the gut.

Some of the major ways stress can mess with your gut include changes to how fast food can move through it, slowing down healing in your gut lining, and making your gut wall more leaky (leading to inflammation).

And then there's the increase in how much you feel stomach upsets.

Not to mention changes in the balance of good bacteria in your intestines.

Fun.

But there are ways to lower your stress while pregnant, including:

• Getting a good night’s sleep 💤
• Doing some gentle exercise on most days each week 🏊‍♀️
• Having a massage (or whatever else self-care looks like to you)
• Journaling to process your worries 📓
• Talking to your support network or a counselor
  If there’s one particular symptom that’s really getting you down, you can try some of these tips as well:

3. Treatment for bloating

If you feel like someone could pop your stomach like a balloon, drinking peppermint tea after meals and eating extra probiotics (such as those found in natural yogurt and fermented foods) can make a big difference.

A lot of over-the-counter remedies for indigestion and trapped wind are also safe to take in pregnancy, with your doctor or pharmacist’s advice.

4. Treatment for constipation

If things are feeling backed up, the best (and most immediate) thing you can do is hydrate.

It might also be worth switching your brand of prenatal vitamin since a high dose of iron can often cause constipation.

A common tip is to add more fiber to your diet, but with IBS, you should only do this gradually and in consultation with your doctor because certain forms of fiber can make your symptoms worse.

So make this a slow experiment, eating a little more soluble or insoluble fiber each day while tracking your symptoms.

5. Treatment for abdominal cramps

Here, the first thing to try is usually a warm compress, or a warm bath or shower.

Much like the solution for bloating, peppermint oil can provide temporary relief.

Research also indicates that some anti-cramping medications can help, specifically butylscopolamine, cimetropium, pinaverium and otilonium.

Still, it's best to consult your doctor before taking any medications.

6. Treatment for diarrhea

Possibly the least fun symptom of IBS and pregnancy.

The best thing you can do if you’re struggling with diarrhea is to stay hydrated and rest if you can.

It’s also worth asking your doctor for advice on which nutritional recommendations and diarrhea medications are safe during pregnancy.

Nutrition can help with diarrhea, so it's worth what non-pharmaceutical options or lifestyle changes are available to you.

Speaking of which...

Is a FODMAP diet for IBS safe while pregnant?

IBS sufferers are often recommended a low FODMAP diet.

This is basically a meal plan that steers clear of certain carbohydrates and sugars that typically trigger IBS symptoms (the acronym stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols — quite the mouthful).

Many mamas-to-be with IBS ask whether it’s safe to follow a FODMAP diet while pregnant.

FODMAP can make it a little harder to get your five-a-day and to make sure that your body is getting all the nutrients it needs to build a brand new person, but again, there isn’t a whole lot of research to say if it is definitely safe or not.

So this is definitely something you want to ask your doctor or nutritionist during those first few appointments.

If you were on FODMAP before pregnancy, it’s likely to be safe to continue.

A doctor is less likely to recommend that you start with any drastic dietary changes during pregnancy that your body wasn’t used to before, but you might be able to introduce aspects of a FODMAP diet slowly and in consultation with them and see if they help.

At the end of the day, IBS affects everyone differently, and this doesn’t change when we’re carrying little ones.

The best thing is to aim for solutions that work well and safely for you.

Still looking for advice or a sympathetic ear?

The moms in the Peanut Community have been there.