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IBS products in pregnancy

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 5 minutes read
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Pregnancy can be a tough time for the digestive tract – the hormonal changes and increased pressure on the bowels from your growing baby puts you at higher risk of constipation, loose stools, abdominal pain and increased bloating. Irritable bowel syndrome (IBS) may make this more pronounced. Mild symptoms will not put you or your growing baby at increased risk, but it may feel uncomfortable.

As always, you should take care to avoid any food you know brings on IBS symptoms. Keeping well-hydrated is key, and gentle exercise can help regulate bowel movements and reduce stress. If you feel you need medication, there are options. One of our pharmacists will go through what’s safe.

Pregnancy is a time of great change, and anxiety plays a part for most women. IBS sufferers will know that stress and anxiety can make IBS symptoms worse. So, it’s important to keep yourself calm. Think of techniques that have helped in the past and start them before any flare-up. Or consider putting aside 20 minutes a day for something you find relaxing – reading, music, gentle yoga or putting a mindfulness podcast on.

What will help my constipation?

Women may choose to take iron tablets to protect against any anemia in pregnancy, but these can cause constipation. Iron supplements come in different forms – ferrous sulfate, ferrous gluconate, ferrous fumarate – and switching to another form may alleviate symptoms.

Liquid versions can be more gentle on the gut, and more easily absorbed. Your doctor may start with a prescription formulation, then over-the-counter versions can be bought to maintain levels after an iron deficiency is addressed.

It’s a good idea to take iron supplements with food to help reduce the risk of constipation, although avoid tea, coffee, dairy and so-called "phytic acid" foods (grains, beans, nuts, tubers), as these can make it harder to absorb iron.

Laxatives may help move things along, especially in late pregnancy, as the pressure of the growing baby can slow down your bowels. Osmotic laxatives such as lactulose solution or macrogol sachets (Movicol) are a good option, as they cause less cramping or bloating than other laxatives. They work by drawing more water into the large bowel and thereby hydrate and soften stools, making them easier to pass.

With these laxatives, and constipation in general, make sure you keep your fluids topped up. You’re likely to have even higher fluid requirements in pregnancy.

I’ve got loose stools and increased frequency

If loose stool is problematic in your IBS, you may have been used to turning to loperamide (Imodium) to slow gut contractions down, but this is not recommended in pregnancy. The first step is to make sure you’re keeping well-hydrated with plenty of water, and keeping your electrolytes (salts) in balance.

An oral rehydration salt drink such as O.R.S is safe to rehydrate and rebalance electrolytes and may be a consideration if you are emptying your bowels frequently or diarrhea is very watery. It’s safe to use in pregnancy, as it’s just replacing the electrolytes and fluids you’ve already lost (speak to your doctor first if you have kidney problems or have been put on a low-sodium diet).

Enterosgel intestinal adsorbent is a mineral mixture that’s safe in pregnancy and aims to reduce stool frequency and duration of diarrhea. It’s a gel foam that works physically to bind toxins and bile acids, expelling them in the stool and relieving many of the unpleasant symptoms they bring. It’s less likely to cause bloating than some other products.

Adding soluble fiber such as Fybogel sachets can help alleviate loose stools, and it's safe in pregnancy. It’s also marketed as a laxative, which might sound counter-intuitive, but it adds air to the stools which makes them expand, bulking them up and improving symptoms (it reduces the hard impacted stools in constipation). Fybogel may cause temporary bloating, so take it with water and avoid lying down for 30 minutes afterward, and bloating should ease.

I’m suffering tummy pain, bloating and gas

As your growing baby takes up more room in your tummy, this can put pressure on the gut, causing trapped gas, bloating, and crampy pains. You might have tried oral medications to reduce gut spasms before, such as peppermint oil capsules. Unfortunately, the manufacturers suggest avoiding these as they haven’t run clinical trials on pregnant women.

Manufacturers do add that they are not known to be harmful in pregnancy, so if you are suffering a great deal, this may be a discussion to have with your doctor: whether theoretical risks outweigh the benefits of symptom relief.

Some people stand by the benefits of a simple tea made with fresh peppermint leaves in warm water. This can ease bloating and cramping, and you’re safe to go ahead with this in pregnancy.

Antiflatulents such as Gas-X contain an inert substance called simethicone. This relieves pain and discomfort due to trapped gas by reducing air bubbles, so they pass more easily through the gut, and this is a safe option in pregnancy.

When should I see my doctor?

If you’ve tried the above treatments and your symptoms persist, it’s worth booking an appointment with your doctor. While the symptoms of IBS do not present a risk to your pregnancy, you want to avoid any of them becoming severe, such as dehydration and salt imbalance. And you want to be able to enjoy your pregnancy, too.

Your doctor will consider treatments you’ve tried and may suggest other medications. They may order investigations such as blood tests, and they can refer you to obstetric or gut specialists, depending on their concerns.

With any pregnancy, if you experience vaginal bleeding or severe abdominal pain, or if you experience reduced fetal movements later in the pregnancy, you should speak to your doctor urgently or call the nearest emergency room. They can advise over the phone whether you should come in for evaluation.

Related topics

Read about: Constipation in pregnancy

Read about: Heartburn in pregnancy

Read about: IBS - triggers and treatments to ease your symptoms

Read about: IBS - abdominal pain predominant

Read about: IBS - constipation predominant

Read about: IBS - diarrhea predominant

Read about: IBS: Managing the emotional side

Read about: Flatulence

Read about: Diarrhea

Read about: Food intolerance

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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