How to Manage IBS-D When You Are Pregnant

pregnant woman on examining table
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The management of diarrhea-predominant irritable bowel syndrome (IBS-D) is not easy under most circumstances, and is certainly complicated by pregnancy. You will need to work to find strategies that help to manage your symptoms without putting your baby at risk. Let's take a look at what is known about IBS-D and pregnancy and what you can do to keep yourself and your baby healthy.

IBS and Pregnancy

In general, woman who are pregnant tend to experience more IBS symptoms than woman who are not pregnant.

This is most likely because the hormones of pregnancy have an effect on the working of your digestive system. These effects include affecting the speed in which stool moves through your large intestine and how much water is absorbed from the stool as it makes its way through. There is not a lot known about the specifics of the relationship between IBS-D and pregnancy, but one small study found that IBS-D symptoms may worsen in the second and third trimesters.

Of greater concern are the results of a large study which found an increase in the risk of miscarriage and ectopic pregnancy in woman who have IBS. This study did not provide any information as to how this risk relates to IBS sub-type. A similar increased risk for miscarriage and ectopic pregnancy was also detected in woman who have IBS along with anxiety and depression. And not surprisingly, the risk was higher for woman who had IBS and smoked.

Luckily, there was no increased risk noted for having a stillborn baby.

Keep in mind that such studies point to correlation and not causation. It may not be your IBS-D that raises your risk, but rather some other unknown factor that raises the risk for the IBS and any possible problems with your pregnancy.

Although it is not yet known why there would be an increased risk for pregnancy problems, this study does highlight the need for proper medical attention and attention to self-care while you are pregnant. Here are some things you can do:

1. Work Closely with Your Doctor

It is essential to speak with your obstetrician before taking any medication to treat your IBS-D symptoms, including over-the-counter products. When it comes to the safety of prescription medications for diarrhea, your doctor is in the best position to advise you about the safety record of the various options. Some medications may be okay if used infrequently; others are best avoided. And although you may have reached for the Imodium regularly before you got pregnant as it is generally considered a safe product, it may not be such a great option for you now. There are mixed research results as to whether or not Imodium can cause problems for a developing fetus. As you can see, it is thus essential to work with your doctor to figure out which medications can be used safely while you are pregnant.

2. Eat Wisely

The safest way to try to manage your IBS-D symptoms while pregnant is through dietary modification. You will want to make sure to follow a well-rounded diet to ensure optimal nutrition for your developing baby. While doing so, keep in mind these basic guidelines:

  • Avoid eating a diet filled with unhealthy fats. This includes fried foods, greasy foods and fast foods as these foods can strengthen intestinal contractions contributing to abdominal pain and diarrhea episodes. Don't neglect taking in healthy fats, as these fats are important for your health and that of your growing baby. Examples of healthy fats include avocados, coconut oil, nuts and nut butters.
  • Avoid poorly digested sugars, such as lactose, fructose and sorbitol, if you tend to experience bloating along with diarrhea.
  • If you are experiencing excessive flatulence, minimize your intake of gassy foods.

3. Drink Plenty of Fluids

Remember that you are drinking for two. Maintaining adequate hydration is essential for your health and that of your baby. If you are experiencing chronic episodes of diarrhea, you are at risk for excess fluid loss and therefore a state of dehydration. You will know that you are taking in enough water if your urine is clear.

4. Use Stress Management Options

If you haven't already tried psychotherapy as a treatment for your IBS-D, your pregnancy may be just the thing to get you motivated. This may be particularly essential if you experience anxiety or depression alongside your IBS, as there is that research that identified these combos as increasing your risk for miscarriage and ectopic pregnancy.

Two types of therapy -- cognitive behavior therapy (CBT) and hypnotherapy -- have been shown to be effective in reducing IBS symptoms. The major advantage to these treatments is that you do not have to worry about any negative effects on your baby.

Other mind/body approaches offer additional options. Yoga may not only be of benefit for your IBS symptoms, but may also help to ease discomfort during labor and delivery.  Meditation is also a wonderful option for offsetting the effects of external stress on your body.


Adibi, N. et. al. "Irritable bowel syndrome symptoms during pregnancy trimesters" Journal of Research in Medical Sciences 2012 17:S171-S174.

Einarson, A., et. al. "Prospective, controlled, multicentre study of loperimide in pregnancy" Canadian Journal of Gastroenterology and Hepatology 2000 14: 185-187.

Hasler, W. "The irritable bowel syndrome during pregnancy" Gastroenterology Clinics of North America 2003 32:385-406.

Kallen, B., Nilsson, E. & Otterblad Olausson, P. “Maternal use of loperamide in early pregnancy and delivery outcome.” Acta Paediatrica 2008:541-545.

Khashan, A., et. al. "Increased Risk of Miscarriage and Ectopic Pregnancy Among Women With Irritable Bowel Syndrome" Clinical Gastroenterology and Hepatology 2012 10:902–909.

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