Can IBS worsen during pregnancy in a 31-year-old woman?

Question

Hello doctor,

My 31-year-old daughter has been suffering from IBS for about six months now, and it is getting worse during her menstrual cycles. She gets severe cramping and diarrhea, especially the week before her period starts, which makes her miss work a lot. Tried eliminating gluten and dairy, but it does not seem to help much.

Her gastroenterologist put her on Dicyclomine, but it makes her dizzy, and she cannot take it during work hours. The worst part is she just got married three months ago, and they want to start trying for a baby, but she is worried the IBS symptoms will get worse during pregnancy. She also takes birth control pills, which might be making the hormonal connection worse.

Lost eight pounds in the past month because she is afraid to eat before leaving the house. Tried probiotics and fiber supplements, but they seem to make bloating worse. Her CBC and inflammatory markers came back normal, so doctors say it is definitely IBS and not something more serious.

Can pregnancy hormones make irritable bowel syndrome symptoms better or worse?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Symptoms of IBS (inflammatory bowel disease, a common, chronic functional gastrointestinal disorder causing recurrent abdominal pain, bloating, and altered bowel habits) can appear frequently, or they may occur during flare-ups. In other words, you do not always experience symptoms. Instead, symptoms may go away, and you will have normal bowel movements. At other times, symptoms return.

Signs and symptoms of IBS include abdominal pain or cramps, usually related to the urge to defecate; excess gas and bloating; diarrhea; constipation, or alternating between the two; mucus in your poop, which may look whitish; and feeling like you are unable to empty your bowels after pooping.

A dietitian can help you choose foods and modify eating and drinking habits to avoid symptom flare-ups. They may recommend that you increase fiber in your diet. Fiber-rich foods, including fruits, vegetables, grains, prunes, and nuts, can help if you are struggling with constipation. Introduce fiber slowly into your diet to give your gut time to adjust. Add supplemental fiber to your diet. Another option is to try fiber supplements, like Metamucil (Psyllium) or Citrucel (Methylcellulose).

Start taking the tablet. Flagyl 400 mg (Metronidazole) three times a day, tablet Novidat 500 mg (Ciprofloxacin) two times a day, and tablet Loperamide 10 mg two times a day.

Limit dairy products, like cheese and milk. Lactose intolerance is more common in people with IBS. If you cut back on dairy, make sure to eat nondairy foods rich in calcium, like broccoli, spinach, or salmon. Limit foods that can make you gassy. Foods like beans, brussels sprouts, and cabbage are notorious for causing gas, but carbonated sodas and even chewing gum can make you gassy. Reduce these foods to go easier on your gut.

Avoid gluten. People with IBS, even those without celiac disease (an autoimmune condition where the immune system reacts to gluten), tend to be more sensitive to gluten. If you opt for a gluten-free diet, work with your provider to ensure you are getting enough of the key vitamins and minerals, like fiber, iron, and calcium, often found in foods with gluten.

Try the low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet. This food plan reduces the amount of hard-to-digest carbohydrates you eat. It recommends alternatives that allow you to get the nutrients you need while going easier on your GI (gastrointestinal) tract.

Drink plenty of water. Drink at least eight eight-ounce glasses of water a day, which is two liters. Water keeps your GI tract lubricated and can help treat or prevent constipation. Keep a food diary. Your provider may recommend that you note the foods you eat to determine which foods trigger IBS flare-ups and then bring this to a nutritionist.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.