Various digestive issues may arise during pregnancy. Usually the first such problem they encounter is the “morning sickness” or nausea or vomiting encountered during the first trimester. The rise in the hormones Human Chorionic Gonadotrophin (HCG) and progesterone are thought to be responsible for the symptoms. It can range from mild nausea or reduced appetite for some, to excessive vomiting (hyperemesis gravidarum) and dehydration for some pregnant mums. Reducing the size of your meals and breaking them up into more frequent small meals or snacks may help. Avoid oily foods or foods with strong smells as these may trigger or increase the sensation of nausea. Gaseous drinks may also increase the bloating and worsen the symptoms. Drink frequently in small amounts to ensure hydration. Besides water you can try different beverages like juices and barley. There are isotonic solutions and water soluble satchets that are available in pharmacies to help replace the electrolytes lost as you drink to correct the dehydration. Some people find ginger capsules helpful. Oral medications like pyridoxine, metoclopramide, promethazine or ondansetron may sometimes be necessary to treat the excessive vomiting.
Bloating and constipation are also common problems that expectant mums may encounter. This is related to the reduced gastric (stomach) emptying and slower motility of the intestinal tract. The increasing size and pressure from the pregnant uterus also contributes to the discomfort. The practice of taken more frequent but small meals through the day will help with this, just as it does for morning sickness. Ensure that you are taking enough fibre in your diet – include sufficient vegetables, fruits and some foods like oatmeal will help. There are dietary fibre supplements available in the pharmacy if you are not able to take sufficient amounts from your diet. Sometimes your doctor may prescribe a stool softener to help if the constipation is still a problem despite the dietary adjustments.
Reflux or “heart burn” may also be experienced for the first time or more frequently during pregnancy. The sphincter between the esophagus and stomach tends to be more relaxed and this allows acidic contents from the stomach to seep back up to the esophagus and cause a burning sensation in the chest area. This may be worsened as the pressure from the pregnant uterus increases during the pregnancy. Avoid spicy or acidic food if you have this problem. Try to stay in an upright position for at least one hour after a meal. Avoid taking a meal near to bedtime. Sometimes sleeping a little more head-up may help, for example use 2 pillows at night as you sleep to elevate the head. Your doctor may prescribe an anti-acid or other medications if your symptoms are frequent or severe.
Story contributed by Dr Cynthia Kew, Obstetrician and Gynaecologist
Mount Elizabeth Novena Hospital