Pregnancy can make your body feel like a foreign landscape, including when it comes to gastrointestinal issues…oh, the gastrointestinal issues. Where do we even begin?
If you want to have a baby, these changes can feel totally worth it. Still, it’s nice to have a heads up about what’s in store and whether or not what you’re going through is considered normal. Here are the gastrointestinal issues you might develop during pregnancy, plus what you can do about them.
1. Nausea and vomiting
Shocker, we know. These are probably the most common gastrointestinal issues people experience during the earlier stages of pregnancy, Heather Beall, M.D., an ob/gyn at Northwestern Medicine McHenry Hospital, tells SELF. This is usually not harmful to the pregnancy, but isn’t exactly a delightful experience.
You’ve probably heard this referred to as “morning sickness,” but the American College of Obstetricians and Gynecologists (ACOG) points out that it can happen during any part of the day (or night). And, while nausea and vomiting usually start before the 9th week of pregnancy and go away by 14 weeks, for some people, they last the whole pregnancy.
Nausea and vomiting in pregnancy seem to happen thanks to pregnancy hormones like human chorionic gonadotropin (hCG), which rises sharply in the first few weeks of pregnancy, Jennifer Aquino, M.D., an ob/gyn at NYU Langone Health, tells SELF. “High hCG levels can contribute to the process of nausea and vomiting,” she says. Estrogen, another hormone that increases during pregnancy, may also cause morning sickness, the Mayo Clinic says.
If you’re dealing with this, there are a few things you can do. Eating bland foods like dry toast or crackers can help, along with drinking plenty of fluids, avoiding smells that bother you, and having small, frequent meals instead of larger ones, ACOG says. If lifestyle tweaks don’t work, your doctor may recommend taking vitamin B6, vitamin B6 with doxylamine (a medication found in OTC sleep aids), or a drug that combines both. (Both drugs—taken together or apart—have been found to be safe during pregnancy, ACOG says, though experts aren’t sure exactly how they may prevent morning sickness.)
If your nausea and vomiting are bad enough to cause severe dehydration or make you lose more than 5 percent of your pre-pregnancy body weight, you may have hyperemesis gravidarum, which is essentially an extreme, potentially debilitating version of morning sickness. If your nausea and vomiting are really impacting your life, see your doctor. They may prescribe antiemetic drugs to control your symptoms.
Constipation can certainly be an issue during pregnancy. This is due to the hormone progesterone, Kyle Staller, M.D., a gastroenterologist at Massachusetts General, tells SELF. “That changes how the colon contracts and, as a result, people get slower colonic motility,” he says. Basically, food moves through your colon at a slower rate than usual, which can lead to build-up, harder-than-usual poops, and trouble going as often as you used to.
Later in your pregnancy, the pressure from your uterus and growing baby can press on your rectum, also making it harder than usual to poop, Daniela Jodorkovsky, M.D., a gastroenterologist at NewYork-Presbyterian/Columbia University Irving Medical Center, tells SELF.
If you’re pregnant and are having way too much trouble pooping, dietary tweaks like increasing your fiber intake may help, Dr. Staller says. This nutrient makes your poop softer and easier to expel. You should work your way up to the recommended daily grams for your age over a few weeks, according to the Mayo Clinic. (That’ll likely be between 25 and 28 grams.) Going all in too quickly can result in issues like gas and cramping. Drinking plenty of fluids like water (it helps fiber do its job) and prune juice (it’s fiber-rich, but only try it if you can stomach it) can help, Dr. Jodorkovsky says.
If that doesn’t do the trick, talk to your doctor. Stool softeners are generally considered OK to use during pregnancy—just get your doctor’s OK first.
Hemorrhoids are swollen veins in your anus and lower rectum, and you can get them during pregnancy from increased pressure on those areas, the Mayo Clinic says. Straining when you poop (like when you’re constipated) can increase the pressure even more, Dr. Jodorkovsky says.
Hemorrhoids aren’t fun to deal with: They can cause bleeding when you poop, anal swelling, itching, irritation, and pain down there, the Mayo Clinic says.
For relief, you can try methods like soaking in a warm tub or using an OTC hemorrhoid cream, according to the Mayo Clinic. Talk to your doctor before using any medication to make sure the one you’re interested in is safe during pregnancy.
Since constipation can also contribute to hemorrhoids, having more fiber in your diet and drinking plenty of fluids may also help you get relief, Dr. Jodorkovsky says
4. Anal fissures
We hate to put this mental image in your head, but anal fissures are small tears in the thin, delicate lining of your anus, as the Mayo Clinic explains. These can cause pain and bleeding when you poop. This health issue, which should honestly be illegal, can also cause pain that lasts several hours after you poop. Or after you try to, anyway, because you probably won’t be surprised to hear that anal fissures can be a complication of constipation. All that pushing can rip your fragile skin.
If you happen to develop an anal fissure during pregnancy, at least know that it will likely heal in a few days or weeks. Keeping your poop soft enough that you don’t need to strain and irritate the area even further should help, Dr. Staller says. The best ways to do that? Drum roll…try to drink more fluids and increase your fiber intake. Soaking in a warm tub for 10 to 20 minutes can help relax your sphincter (the ring of muscle around the opening of your anus) and may help you to heal faster, the Mayo Clinic says.
5. Acid reflux
Acid reflux happens when acid that should stay put in your stomach goes rogue and flows back into your esophagus, the tube that connects your mouth and stomach, the Mayo Clinic says. This backwash can irritate the lining of your esophagus and cause symptoms like heartburn, chest pain, difficulty swallowing, feeling like there’s a lump in your throat, a chronic cough, laryngitis, and disrupted sleep. As a not-at-all-welcome bonus, heartburn can also cause excessive burping.
This issue progresses into gastroesophageal reflux disease (GERD) if you have mild acid reflux at least twice a week, or if your acid reflux is moderate to severe and happens at least once every seven days, according to the Mayo Clinic.
Acid reflux can happen more frequently during pregnancy because the hormone progesterone causes your esophageal sphincter (which is supposed to keep acid and food in your stomach) to relax, the Mayo Clinic explains. “The growing baby also pushes on the stomach, putting pressure on it, and making acid more likely to go out,” Dr. Staller says.
To help combat this, the Mayo Clinic recommends that you eat small, frequent meals and avoid foods you’ve noticed make your reflux worse. (Common items include spicy or fried foods, citrus fruits, and chocolate, the Mayo Clinic says. Sorry.) Trying not to eat in the three hours before bedtime can also help, because lying down makes it easier for that acid to creep up.
Gallstones are hardened deposits of digestive fluid that can form in your gallbladder, a small, pear-shaped organ on the right side of your abdomen just beneath your liver, the Mayo Clinic says. Your gallbladder holds a digestive fluid called bile that's released into your small intestine to help with the crucial task of breaking down your food.
You can have gallstones and not know it, or you can have intense symptoms like sudden and severe pain in the upper right or center portion of your abdomen, pain between your shoulder blades, pain in your right shoulder, or nausea and vomiting. The pain can last anywhere from several minutes to a few hours, the Mayo Clinic says.
There are a few reasons why you might have gallstones during pregnancy. One is that estrogen tends to increase the production of HDL cholesterol, which is a component of bile, Dr. Aquino says. At the same time, progesterone slows the rate at which your gallbladder empties, she says. “This combination can ultimately cause changes in bile consistency, resulting in gallstones in pregnancy,” she says.
If you’re having pain or any other symptoms that you suspect are due to gallstones, talk to your doctor as soon as possible. They may give you medication to try to manage the pain, Dr. Staller says. Surgery to remove the gallbladder is also a common treatment for this issue and is generally safe during pregnancy.
Your body can do weird things when you’re pregnant. If your gut is quite literally telling you something is off, don’t hesitate to call your doctor, Dr. Beall says. They’re there to help.