Causes of Diarrhea in Pregnancy

Causes of diarrhea in pregnant women are pretty much the same as in other populations and so is the treatment (1). Some women experience diarrhea, nausea or vomiting just before the labor starts (2).

FOODS TO AVOID in Pregnancy

Pregnant women should avoid risk of food poisoning:

  • Salads in restaurants
  • Fast food
  • Soft cheeses
  • Refrigerated smoked seafood

SAFE DIAGNOSTIC in Pregnancy

The following investigations to find a cause of diarrhea during pregnancy are generally safe:

  • Stool tests
  • Rectal examination
  • Abdominal ultrasound
  • MRI of abdomen
  • Upper endoscopy
  • ERCP (Endoscopic Retrograde Cholangio Pancreatography) – when therapeutic intervention is expected
  • Flexible sigmoidoscopy

Colonoscopy should be reserved for intestinal bleeding and other urgent situations.

NON-SAFE DIAGNOSTIC in Pregnancy

The following diagnostic should be avoided in pregnancy:

  • X-ray and CT of any kind
  • HIDA scan

SAFE DRUGS in Pregnancy

The following anti-diarrheal drugs are generally safe to use in pregnacy:

  • Loperamide
  • Antibiotics: penicillin, cephalosporins, erythromycin, metronidazole (Flagyl)
  • Rehydration solutions (e.g. Pedialyte, Gatorade)
  • Anti-inflammatory drugs for Crohn’s disease or ulcerative colitis
  • Local anesthetic Lidocaine and sedative Meperidine.

NON-SAFE DRUGS and PROCEDURES in Pregnancy:

  • Bismuth salicylate (Pepto-Bismol) was connected with decreased birth weight and neonatal hemorrhage (3);
  • Cholestyramine
  • Antibiotics streptomycin, quinolones, and tetracycline
  • Inducing vomiting

References:

  1. Pregnancy and diarrhea  (acg.gi.org)
  2. Diarrhea before childbirth  (childbirth.org) 
  3. Pepto Bismol increases risk of neonatal hemorrhage  (drugs.com)

Further Reading :
  • Colonoscopy – Preparation, Procedure, Pictures, Risks, Cost
  • Stomach Disorders – Available Tests and Investigations