Hormonal changes during pregnancy may contribute to increased gastrointestinal (GI) symptoms. These changes may also trigger or cause irritable bowel syndrome (IBS) symptoms to worsen.

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Approximately 2 in 3 people with IBS are female. Doctors most often diagnose IBS in females of childbearing age.

Pregnancy hormones, including estrogen and progesterone, may contribute to the severity of IBS symptoms. Changes to a pregnant person’s body may also alter bowel patterns.

This article discusses what pregnant people with IBS can expect and its effect on pregnancy. It also explores how a pregnant person can manage IBS symptoms.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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IBS is a persistent and recurring condition that affects the gut. It is the most common functional gastrointestinal disorder characterized by abdominal pain and bowel changes.

Symptoms vary from person to person. Common symptoms may include:

Read more about IBS symptoms here.

What to expect when pregnant

Approximately 75% of females report having one or more functional bowel disorders during their first trimester.

Expecting females are prone to a range of GI symptoms, similar or relating to IBS, due to the increase in estrogen and progesterone when pregnant, including nausea and vomiting and heartburn.

Pregnancy and IBS symptoms tend to overlap. High progesterone slows down motility, worsening constipation. It also affects sphincter function, leading to gastroesophageal reflux disease and heartburn. The changes in the pelvic floor due to the growing fetus and the increased abdominal pressure can also affect bowel movements in IBS.

Pregnant people may take medications for vomiting (antiemetics), such as for morning sickness. They may also take iron supplements to help meet the demands of extra blood volume in pregnancy. However, these types of drugs can worsen constipation.

Magnesium sulfate, a drug to treat preeclampsia and premature labor, can also cause constipation.

A study from 2014 mentioned that sex hormones influence the regulatory mechanisms of the brain-gut-axis. This may contribute to the alterations in the intestinal mucosa that trigger IBS symptoms. Read more about how the gut microbiota affects the brain.

Can pregnancy help IBS symptoms?

Pregnancy may also improve IBS symptoms. The same 2014 study mentioned that high estrogen and progesterone levels might reduce pain sensitivity, and improve chronic pain syndromes like migraine.

However, there is still insufficient evidence to determine the link between pregnancy and IBS for all people who are expecting.

If doctors diagnose a person with IBS before pregnancy, it may put them at a higher risk of complications like ectopic pregnancy. Thus, doctors must be aware of their condition to ensure suitable prenatal care and monitoring.

Unmanaged IBS symptoms can put the pregnancy at risk. Prolonged diarrhea can lead to dehydration. Constant straining caused by constipation can further weaken the pelvic floor, which can cause the uterus to slip out of place (prolapsed uterus).

A person should consult a doctor with any concerns about their pregnancy or IBS symptoms.

Having IBS during pregnancy can be challenging. Below are tips that can help manage symptoms.

  • Drinking more water. Generally, pregnant people need more water. It can soothe stomach distress, improve GI function, and reduce IBS symptoms. Read more about how much water a person should drink.
  • Exercising. Doctors recommend pregnant people do at least 150 minutes of moderate-intensity exercise per week, unless advised otherwise. Physical activity can also aid in GI function. Read more about exercises for pregnancy here.
  • Following a balanced diet. A person with IBS should limit foods which are high in lactose, sugar alcohol like artificial sweeteners, and fructose. These foods contain “fermentable oligosaccharides, disaccharides, monosaccharides, and polyols” (FODMAPS). Read more about a low FODMAP diet.
  • Eating plenty of fiber. Whole grains and most fruits and vegetables can help with digestion. People with diarrhea can add on foods high in soluble fiber. On the other hand, insoluble fiber can speed up digestion and prevent constipation. Read more about the differences between soluble and insoluble fiber here.
  • Keeping a food diary. A person can keep a log of their food and IBS flares. This can help them identify which kinds of foods trigger IBS so they can avoid them. A Food and Symptom Times diary validly measures IBS symptoms and correlates them with specific aspects of diet.
  • Taking over-the-counter medications and supplements. Stool softeners and fiber supplements can help pregnant people with constipation. Probiotics are also found to improve IBS symptoms. If iron or calcium supplements produce GI symptoms, a person may want to talk with their doctors about alternatives.
  • Managing stress. Stress is a known IBS trigger. However, physical discomfort and hormonal fluctuations can cause stress during pregnancy. Prenatal yoga, breathing exercises, meditation, biofeedback, and talk therapy can all help reduce stress and improve overall well-being.

A person should first get clearance from their practitioners before trying any of the management techniques described above.

Most people who are expecting experience a range of symptoms and discomforts during pregnancy. For females with IBS, pregnancy may worsen or improve symptoms.

However, studies related to pregnancy and IBS are still limited. This may be because one’s effect on the other can be difficult to delineate.

It is always best for pregnant people to inform their doctors about any symptoms or changes they are experiencing.