Black stools in pregnancy

Black stool during pregnancy is a cause for concern for the expectant mother and makes her worry not only about her health, but also about the health of her future child. It is very important to consult a doctor in time, because the reason for this can be different. There are cases when it is worth taking action immediately, and sometimes black stool can be a simple reaction to taking medication. Therefore, it is very important to diagnose a dangerous condition for a woman and a child in time and carry out treatment.

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Causes black stools in pregnancy

Pregnancy is a period in a woman's life when all internal organs adapt to the development of the fetus and its vital functions. The development of the fetus occurs gradually and goes through various stages - first, the process of organogenesis occurs, which begins in the first trimester, and then the growth and differentiation of the child's tissues continues. But that's not all, because for normal functioning in the mother's body, normal blood flow and nutrition are necessary, which occurs due to the functioning of the placenta. During this period, a woman may be bothered by various problems in the form of early toxicosis, which lasts throughout the first trimester of pregnancy and corresponds to the period of placenta formation. It is in the first trimester that a woman is bothered by problems with the gastrointestinal tract in the form of lack of appetite, nausea, vomiting, constipation or diarrhea. At the same time, very often there is a change in the nature and color of feces, which occurs under the influence of hormones and normally does not require any action.

There may be various reasons for the change in the color of stool to black during pregnancy. They can be divided into those that are normal and those that require careful diagnostics.

It is very important to distinguish between conditions when you should definitely seek qualified help when your stool color changes to black, and when you should not worry about it.

Often, one of the etiological factors for the appearance of black stool is the intake of products that provide such coloring. Such substances include food products and some medications. If the expectant mother has discovered black stool, it is necessary to remember what she has eaten in the last 24 hours. There are products that contain pigments that can change the color of feces due to incomplete digestion in the stomach and intestines, and insufficient conjugation in the liver. Such food products include:

1. some pigmented fruits - plums, currants, pomegranates, rowanberries, blueberries, as well as dried fruits and vegetables - prunes, tomatoes, beets;
2. offal - liver;
3. meat products – blood sausage and other products with pork blood;
4. drinks – coffee, colored carbonated drinks.

All these products are not able to be fully digested and the pigment that provides their color comes out with feces, which colors it in such a color. Therefore, it is necessary first of all to analyze the diet of a pregnant woman and make a correction, if the color of feces becomes normal, then the problem is solved and there is no need to worry.

Very often, the color of the stool changes to black after taking medications. Such medications include black activated carbon, monocomponent or polycomponent iron preparations, multivitamin complexes, bismuth preparations. Very often, a woman in the case of toxicosis in the early stages of pregnancy takes activated carbon for detoxification, after which the stool very clearly turns black. This happens because carbon is a sorbent by its structure and is not absorbed in the stomach, but is excreted in a completely undigested form, which contributes to the coloring of feces.

Often during pregnancy, women are recommended to take multivitamin complexes, since the vitamin reserves in the female body are sufficient only for the mother, and the fetus needs an additional source of vitamins. Such multivitamin complexes, which contain iron, also color the stool black, since the remaining iron is excreted by the intestines. If during pregnancy the expectant mother is treated for anemia, then iron preparations also contribute to black stool, which is not a reason to consult a doctor.

All these cases of black stool are not a reason to stop taking iron or vitamins. If the woman's general condition is not affected and there are no other symptoms, then there is no need to do anything. In extreme cases, you can stop taking such medications for a while and see if the stool becomes normal.

The reasons that can often lead to black stool during pregnancy and which must be taken into account and help sought are infectious diseases of the intestine of an inflammatory nature.

Normally, when eating foods or taking medications that change the color of stool, its consistency does not change, there is no loose stool or abdominal pain.

If black stool is a symptom of a disease, then it most often happens in a woman who has a history of chronic gastritis or gastric ulcer or duodenal ulcer. In this case, black stool is the cause of complications of these diseases in the form of internal intestinal bleeding. The pathogenesis of the development of black stool in this case is that the blood that is released into the cavity of the stomach or duodenum from an erosive vessel combines with gastric juice and a reaction occurs that changes the color of the blood entering the feces. In this case, such bleeding is accompanied by symptoms of abdominal pain, which are very sharp at first, then subside. Bleeding is also accompanied by general symptoms in the form of increasing anemic syndrome - pale skin, weakness, palpitations, cold sticky sweat on the face, dizziness. Internal bleeding is a very dangerous condition not only for a woman, but also for her child, so in the case of a combination of black stool with other similar symptoms, you must urgently consult a doctor. Long-term use of non-steroidal anti-inflammatory drugs can also provoke bleeding, so this can also be an etiological factor for black stool during pregnancy.

Therefore, it is important to clearly understand when black stool during pregnancy signals danger, and when it is simply a manifestation of dietary peculiarities.

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Symptoms black stools in pregnancy

Various symptoms from the digestive system of a pregnant woman may indicate certain pathologies. The nature of the stool, its consistency, color, quantity - all this is an indicator of the work of the stomach, intestines, liver and pancreas. Therefore, black stool during pregnancy can be one of the symptoms of the disease.

The first clinical manifestations that may indicate intestinal bleeding are black stools, so it is necessary to pay attention to this symptom.

If the change in stool color is also accompanied by diarrhea, then it is necessary to assume an intestinal infection. In this case, the symptoms of stool changes will be accompanied by other clinical signs. In this case, there will be abdominal pain of a spasmodic or constant nature, symptoms of intoxication in the form of an increase in body temperature, chills, headache, nausea and vomiting are also possible. All these clinical signs indicate an intestinal infection, which requires urgent complex treatment using antibacterial agents. At the same time, the feces have their own characteristics - they become black-green and liquid. This indicates not only an intestinal infection, but also a small bleeding in the intestinal cavity, which contributes to the formation of black-green feces. If the stool changes color, and the general condition of the pregnant woman does not change, then this should be associated with the characteristics of food or with the intake of medications.

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Complications and consequences

If black stool during pregnancy is normal, then no consequences should be expected, you should not even stop taking vitamins. But if the cause of black stool is intestinal bleeding, then the rapid increase in anemia can have bad consequences. It is necessary to immediately replenish the volume of lost blood and eliminate the cause of bleeding. If black stool during pregnancy is one of the manifestations of an intestinal infection, then the consequence of such a pathology can be not only complications from the gastrointestinal tract, but also from the course of pregnancy.

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Diagnostics black stools in pregnancy

It is very important to diagnose intestinal bleeding in time, one of the obvious manifestations of which is a change in the color of feces to black, and at the same time it is important to differentiate this symptom from the normal state. Therefore, it is very important to carefully examine the woman when applying.

It is very important to find out all the details and carefully collect anamnesis. When a pregnant woman comes to the doctor, it is necessary to clarify the pregnancy period, the presence of gestosis, anamnestic data on diseases of the digestive system. It is necessary to detail the complaints and find out how many times black stool was observed, whether it was liquid, as well as the presence of nausea, heartburn, vomiting, abdominal pain. It is necessary to find out the details of the pregnant woman's diet and the intake of drugs that could affect the nature of the stool. Sometimes only at this stage can the cause of black stool be determined and no additional diagnostic methods are required. But if there is any suspicion of intestinal bleeding or peptic ulcer disease in the anamnesis, then additional research methods must be carried out.

The tests that must be taken without fail during pregnancy are general clinical tests - a general blood and urine test, a biochemical blood test, and a stool test. The stool test must be carried out with a bacterial examination and determination of sensitivity to antibiotics. If it is not possible to identify the type of pathogen, then the accurate diagnostic method is the polymerase chain reaction. This method allows you to identify the DNA of bacteria or viruses. Which also allows you to accurately establish a diagnosis.

Coprogram is a method of microscopic examination of feces, which allows to establish the degree of dyspeptic disorders and the function of the pancreas. This study can provide data on the presence of leukocytes, erythrocytes, mucus, which allows to differentiate intestinal infection, hemorrhoids, bleeding. It is necessary to conduct a study of feces for the Gregersen reaction - this is a reaction to occult blood. Also, in the presence of vomiting, it is necessary to determine the acetone in the urine.

In the general blood test, in case of inflammatory intestinal infection, leukocytosis will be determined and a shift of the formula to the left in case of bacterial intestinal infection. If there is intestinal bleeding, then anemia develops, especially if it is a long-term chronic process. In this case, anemia will be indicated by a decrease in the amount of hemoglobin. Instrumental diagnostics of black stool during pregnancy includes mandatory ultrasound examination to determine the condition of the fetus, and in the early stages it is possible to visualize the intestines.

Also, if there is a suspicion of ulcer disease complicated by intestinal bleeding, a mandatory instrumental examination is esophagogastroduodenoscopy. This method is of priority importance, since it allows diagnosing intestinal bleeding, seeing its cause and simultaneously coagulating the bleeding vessel using an endoscopic method.

If there is a suspicion of peptic ulcer disease, non-invasive methods are used, most often this is a breath test, determination of H. Pylori.

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Differential diagnosis

Differential diagnosis of black stool during pregnancy should be carried out with food poisoning, intestinal infections, hemorrhoids, as well as with a normal phenomenon during pregnancy due to the use of food or medications.

Intestinal infection or food poisoning is accompanied not only by changes in stool color, but also by other symptoms from the gastrointestinal tract, as well as intoxication syndrome. If we are talking about hemorrhoids, which often happens during pregnancy, then the feces are not completely black, but have streaks of fresh blood, which is visible if you look closely. Coprogram for hemorrhoids will contain fresh erythrocytes, which confirms the localization of the process in the distal parts of the intestine. If black stool during pregnancy is not accompanied by an increase in its frequency or does not affect the general condition, then this is a normal phenomenon caused by hormonal changes.

Treatment black stools in pregnancy

As already mentioned, treatment of black stool during pregnancy is necessary only if it is a pathological symptom and the etiology of the disease is confirmed.

In the treatment, medications and non-medicinal means are used - folk methods and homeopathic remedies. It is very important to follow the regime and nature of nutrition in case of intestinal infection, especially if black stool is accompanied by nausea, vomiting and other symptoms.

The regime of a pregnant woman should exclude excessive loads, but at the same time it is necessary to have minimal physical activity, therefore room mode is recommended.

With black feces during pregnancy, to maintain body weight and as an important stage of treatment, it is necessary to adhere to a diet. Since the processes of normal digestion, absorption and evacuation function are disrupted, it is necessary that the products are gentle.

Basic principles of the diet:

• It is better to eat food cooked, warm, not hot or cold, as this is an additional burden on the digestive tract.
• The caloric content of food should be minimal, without complex saturated fats and with limited dietary fiber, as they stimulate the motility of the gastrointestinal tract.
• Sour, salty, smoked foods – exclude completely.
• It is necessary to exclude "simple" carbohydrates - sweets, buns, cookies, candies. Fresh white bread should also be excluded, since it tends to form adhesions in the intestines.
• The diet needs to be supplemented with complex carbohydrates; the ideal option is oatmeal, which has an enveloping effect.
• It is necessary to consume protein daily in the form of boiled meat and fish, but legumes should be excluded.
• Dairy products should be limited as they cause fermentation.
• You need to drink in sufficient quantities, it is advisable to exclude juices with a high glucose level, since this also causes fermentation in the intestines. It is better to drink boiled fruit drinks, alkaline waters, warm tea.
• The amount of fruit should also be limited, as this is an additional burden on the gastrointestinal tract.

These are the basic principles of dietary nutrition, which are a mandatory component of the complex treatment of bowel disorders during pregnancy.

In case of proven intestinal infection of bacterial etiology, which is the cause of black stool during pregnancy, it is necessary to conduct complex treatment using antibiotics, probiotics and sorbents. But drug treatment has its limitations, since many drugs are contraindicated during pregnancy. When prescribing antibiotics, preference should be given to those drugs that do not affect the fetus. At the same time, it is necessary to monitor the child's condition and be ready to take measures in case of complications.

If a woman has experienced severe vomiting and diarrhea, it is necessary to replenish the water balance orally, which is an important stage of treatment from a pathogenetic point of view, and in the case of intestinal bleeding, it will replenish the volume of circulating blood.

In case of proven infectious genesis of black and liquid feces during pregnancy, a necessary component of treatment is the prescription of antibiotics, but taking into account the possible negative impact on the fetus, it is necessary to select the type and dose. In pregnant women with colitis, intestinal antiseptics of the nitrofuran series, as well as antibiotics of the fluoroquinolone group, should not be prescribed, since they have a pronounced effect on the development of the fetus. Preference is given to antibiotics of the cephalosporin group, which are relatively safe due to the lack of proven harmful effects on the child. Therefore, in case of bacterial intestinal lesions in pregnant women, cephalosporins are the drug of choice.

Cefepime is a beta-lactam antibiotic from the 4th generation cephalosporin group, which has a pronounced bactericidal effect on gram-positive and gram-negative microorganisms, i.e. covers a huge range of microbes. It is produced in the form of a powder for injections of 1 gram. The drug is used in a dose of 1 gram per day, administered intramuscularly or intravenously at intervals of 12 hours. The course of treatment is 7-10 days.

Contraindications for use are allergic reactions to penicillins or other beta-lactam antibiotics.

No negative impact on the fetus during pregnancy has been identified. Side effects are possible from the gastrointestinal tract, allergic reactions, nervous system reactions in the form of headache, drowsiness, dizziness.

Antibacterial therapy of colitis during pregnancy should be carried out with strict monitoring of the condition of the mother and fetus. It is important to conduct antibiotic sensitivity before prescribing therapy and then be guided by the results obtained.

Today, there are a huge number of sorbents, but some of them are preferred because they can be taken during pregnancy. Black liquid stool of any genesis is accompanied by a violation of the excretory function of the intestine and the accumulation of a huge number of toxins and metabolic products, so the use of sorbents allows you to cleanse the intestines and restore normal flora.

Smecta is a natural sorbent that can adsorb viruses and bacteria, and also has a protective effect by stabilizing the mucous-bicarbonate barrier and increasing the amount of mucus. The drug reduces the symptoms of bloating and heartburn.

Available in 3 gram sachets.

The drug can be used during pregnancy and lactation, since it is not absorbed, but excreted unchanged. Side effects are rare, allergic reactions may be observed. The drug is contraindicated in case of intestinal obstruction and hypersensitivity to it. Precautions - it should be taken at least 2 hours apart from other drugs, since it reduces their absorption.

Dosage: 3 grams of the substance (one packet) must be diluted in half a glass of warm water and taken 3 times a day, the course is 5-7 days.

During treatment with antibiotics, and also taking into account the disruption of the normal intestinal biocenosis with black stool in pregnant women, it is necessary to prescribe probiotics as part of complex therapy.

Linex is a drug that contains lactic acid bacteria and bifidobacteria and helps to normalize the intestinal flora and, in addition, has an antidiarrheal effect. It is available in the form of capsules of 1 gram. The drug has no pronounced side effects, can be used during pregnancy due to. Dosage - 2 capsules 3 times a day after meals, the course of treatment for colitis is not less than three days.

Antispasmodic drugs are most often used as pain relievers, which can additionally reduce the tone of the uterus.

No-shpa (Drotaverine) is an antispasmodic drug widely used in surgery and gynecology. It is available in tablets in a dosage of 40 milligrams, as well as in ampoules in the same dose of 2 milliliters. Side effects of the drug are tachycardia, a feeling of a rush of heat to the face, increased sweating, dizziness, allergic reactions. No significant harm to the fetus is detected, since the drug does not penetrate the hematoplacental barrier. Contraindications for use are closed-angle glaucoma, prostatic hyperplasia. The drug is used for colitis in pregnant women to relieve intestinal spasm during pain syndrome. Dosage is 40 mg per dose. It can be taken as a tablet, but it is better to inject in the same dose, no more than 3 times a day.

It is better not to carry out vitamin therapy during the acute period of intestinal bleeding.

Physiotherapy treatment is recommended only during the period of remission, especially in case of peptic ulcer disease; it cannot be used during the acute period of the disease, as it can provoke complications.

Surgical treatment of black stool during pregnancy is not used; only surgical interventions are possible if severe complications arise.

Folk remedies for black stool during pregnancy

Traditional methods of treating colitis are widely used by expectant mothers due to the minimal harm to the child. There are many methods of treatment using both herbs and traditional and homeopathic preparations. The main effect of such treatment is a reparative effect in case of gastric ulcer and an antianemic effect.

The main methods of folk treatment:

• Sea buckthorn oil enemas promote healing of the intestinal mucosa, in case of black stool due to mucosal erosions. To prepare enemas, you need simple sea buckthorn oil, which can be bought at a pharmacy. Then you need to collect 5 milliliters of oil in a pear and perform an enema. During pregnancy, you should consult a doctor before using such enemas, as this depends on the period of pregnancy.
• Propolis tincture reduces inflammation of the intestinal wall, promotes epithelial regeneration and has a bactericidal effect. To prepare the tincture, 10 grams of propolis should be boiled in boiled water for about 20 minutes, this solution should be infused for at least an hour, after which it is used internally by a tablespoon 2 times a day.
• The use of a natural remedy - mumiyo - is widely used in the treatment of colitis. This substance has a pronounced anti-inflammatory, regenerating, analgesic effect. To prepare the remedy, you need to dissolve 100 milligrams of mumiyo in a tablespoon of water and take it orally 2 times a day for seven days. Such a solution can suppress normal intestinal microflora, so it is necessary to take probiotics.
• A starch tincture, which is prepared from one tablespoon of starch dissolved in a glass of warm water, helps to normalize the color of stool and is an antidiarrheal agent.

Herbal treatment also has its advantages, since herbal medicine, in addition to its local action, has a general calming effect.

• The leaves of immortelle and St. John's wort must be dried, boiled for five minutes and infused for ten minutes, then cooled and taken a quarter of a glass three times a day.
• Chamomile infusion, which is prepared from three tablespoons of chamomile leaves, which are brewed in a liter of boiled water. Before taking, add a spoonful of honey and take half a glass 3 times a day.
• Sage in the amount of 2 tablespoons is brewed in boiled water and infused, after which it is taken half a glass 2-3 times a day.

Homeopathic remedies are widely used for black stools during pregnancy. The main drugs are:

• Nux vomica-Homaccord is a combined homeopathic preparation that has an anti-inflammatory effect on the intestinal mucosa. It is available in drops, the dosage is 10 drops per tablespoon of water 3 times a day. Side effects include allergic rash.
• Mucosa compositum is a homeopathic remedy that has a regenerative, antispasmodic, anti-inflammatory effect. The drug also has a mucolytic effect and can enhance intestinal motility. It is available in the form of an injection solution in a dose of 2.2 ml. Dosage - 2.2 ml intramuscularly or subcutaneously, in acute conditions once a day, and in chronic colitis once a week. It is not contraindicated in pregnancy, side effects may be in the form of allergic reactions.
• Traumeel S is a complex homeopathic remedy that is available in the form of tablets and injections. It has anti-inflammatory and regenerative effects. Dosage in the acute period is 1 ampoule of 2.2 ml per day, later or for chronic colitis, take 1 tablet 3 times a day.
• Viburcol is a homeopathic drug that has analgesic, anti-inflammatory, antispasmodic, and sedative effects. It is available in the form of rectal suppositories. Use one suppository 2-3 times a day. It can be taken during pregnancy, side effects are not common in the form of allergic reactions. There are no contraindications to the use of the drug.

Prevention

Preventive measures are non-specific, which exclude all possible causes of the development of black stool. During pregnancy, it is necessary to adhere to the rules of proper nutrition, which ensure normal caloric content of food and the completeness of food products with a balanced composition of microelements. It is necessary to limit products that cause fermentation and are strong stimulants of intestinal motility.

Preventive measures should also be taken in the form of avoiding contact with infectious patients and hygiene measures - washing hands and food before use. In case of a history of ulcer disease, it is necessary to carry out preventive treatment before pregnancy to avoid complications during pregnancy.

Black stool during pregnancy can be a symptom of a certain pathology, or it can be a normal phenomenon, so these conditions should be correctly differentiated and treated in a timely manner to prevent complications. You need to pay attention to any symptoms that are alarming during pregnancy, because we are talking about the health of the future baby. Chronic diseases need to be treated before pregnancy so that the pregnancy goes well, so take care of your health!

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