Diarrhea in pregnant women - what to do?

What are the different causes of diarrhea in pregnant women? How to treat it and especially how to avoid the main risk that is dehydration? The answers of Pr Philippe Deruelle, obstetrician-gynecologist and Manon Forthoffer, midwife.

Summary

An unwanted effect of iron supplementation

Diarrhea: what if it was appendicitis?

The usual causes: gastro or food poisoning

What if it was a shrink?

A risk of contractions

Can anti-diarrheal medication be taken during pregnancy?

Pregnant women tend to be constipated during pregnancy . However, there are two specific causes of diarrhea in pregnant women.

An unwanted effect of iron supplementation

"A pregnant woman can suffer from diarrhea due to iron intake , the need for this mineral being very important during pregnancy," says Professor P. Duruelle.

Iron requirements are, especially in the last two quarters, 30 mg per day . However, iron supplementation can lead to undesirable effects including diarrhea but also abdominal pain, nausea.

Diarrhea: what if it was appendicitis?

" Appendicitis is more common in pregnant women because of the slowing of intestinal peristalsis, explains the obstetrician-gynecologist. And the signs are also different, with abdominal pain, but also diarrhea. "

What treatment offered? "Firstly, the future mother is offered treatment with antibiotics based on metronidazole, which acts on the digestive germs, at least 7 to 10 days , while being very attentive to the development of symptoms during the first 48 to 72 hours. . "

It is only if this treatment fails that surgical intervention is necessary.

The usual causes: gastro or food poisoning

Besides these two particular causes of pregnancy, the reason most often found, especially in a family context, is gastoenteritis .

"The treatment is mainly based on the fight against dehydration, warns the doctor. For this, it is important to force yourself to drink 2 to 3 glasses every hour of cola soda, vegetable broth or sweet herbal teas which provide a necessary energy supply. We also adopt a suitable diet based on quince, apple, rice which we can also drink the cooking water, and other low-fat foods. "

Manon Forthoffer, midwife, added: “We avoid salads, raw vegetables, legumes and whole grains, which are difficult to digest, as well as diuretic drinks like tea or coffee, and of course we do not drink alcohol! "

We watch for signs of dehydration : dry mouth, cracked lips, fatigue and significant thirst. If you suffer from any of these signs, you should consult your doctor immediately.

Another rarer cause is food poisoning, especially after consuming raw cheese, cold meats, seafood, not recommended for pregnant women.

" Diarrhea can then be a symptom of listeriosis, which also causes fever and a flu-like symptom," said the midwife. "The treatment for diarrhea will then be the prescription of amoxicillin-based antibiotics," adds Professor Deruelle. "

What if it was a shrink?

"When faced with diarrhea , we must also ask ourselves the question of anxiety ," warns the midwife. This symptom is one of the manifestations of worry in pregnant women who may then need psychological support. "

A risk of contractions

“ Diarrhea causes digestive spasms that can potentially stimulate the uterus and cause contractions , warns the midwife. It is then necessary to consult. "

Can anti-diarrheal medication be taken during pregnancy?

Although the treatment of diarrhea is mainly based on diet and hygiene measures, “the pregnant woman can take, if necessary, a drug based on clay powder such as Smecta ( diosmectite ), or based on loperamide , such as 'Imodium,' says Manon Forthoffer.

If the ANSM (National Medicines Agency) recommended, since February 28, 2019, no longer administer drugs based on clay powder for children under two years of age, due to the possible presence of minute amount of lead, for its part, the CRAT (Reference Center for Teratogenic Agents) informed, on March 14, 2019, that in case of acute diarrhea without sign of severity, during pregnancy loperamide and clays could be taken at effective dosage.

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