Liquid stool in pregnant women

Fluid stools in pregnant women are frequent pathologies that can develop as a physiological condition, and can also be a sign of a disease that requires serious treatment. Changes in the consistency and color of the stool should always attract attention, as this can be a serious pathology. Statistics show that problems with the gastrointestinal tract in women during pregnancy come to the fore in the first trimester and in the third trimester of pregnancy take second place. It is necessary to diagnose in time any changes in the health of a pregnant woman who are a threat to the future baby.

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Causes of the stool in pregnant women

Pregnancy is a special period in a woman's life, when all organs and systems work differently. At this point, the body is rebuilt to provide another circle of blood circulation and this can affect all organs. This is due to the formation and functioning of the placenta, as a place for the development of the child. During the formation of the placenta there is still no clear boundary that would allow us to separate all the processes, so a woman may be troubled by various problems in the form of early toxicoses that last throughout the first trimester of pregnancy and correspond to the period of placenta formation. It is in the first trimester that a woman is concerned about problems with the gastrointestinal tract in the form of lack of appetite, nausea, vomiting, constipation, or diarrhea. In this case, 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. But it is necessary to distinguish such a normal state from pathological symptoms and differentiate first of all the causes of the development of this state.

First, you need to determine the concept of a liquid stool - a chair that is characterized by three or more episodes of liquid excrement of feces throughout the day.

The causes of the development of liquid stool in pregnant women can be conditionally divided into those that are normal and those that require careful diagnosis.

Often the appearance of a loose stool due to the use of certain foods is considered the norm. During pregnancy, a huge amount of hormones, hormone-like substances and biologically active substances that are able to strengthen not only the intestinal motility, but also increase the sensitivity of the nerve mucosa to the action of certain foods. In this case, food that the woman used before without any problems, can cause irritation of the mucosa and increase motor skills or secretion with manifestations of a loose stool. Such foods can be dairy products, salty foods, oatmeal, prunes, plums, beets, watermelon. All these products can cause liquid stool in pregnant women. Therefore, it is necessary first of all to analyze the diet of a pregnant woman and make a correction if the consistency of the stool becomes normal, then the problem is solved and should not be experienced. Moreover, if such a change in the stool is not accompanied by any other symptoms from the gastrointestinal tract and intoxication manifestations.

Very often, a loose stool during pregnancy happens after the use of medications. Such drugs can cause both increased motility, and some components can be osmotically active substances and stimulate a hyperkinetic type of diarrhea. Most often this happens in the case of vitamins and multivitamin complexes.

There is another reason for diarrhea when taking medications - this is the development of dysbiosis in the case of antibiotic therapy. If a woman for some reason takes an antibiotic, then a violation of symbiosis of normal microflora develops very often. This is due to the state of relative immunosuppression, which is in a pregnant woman, which inhibits normal flora and increases the activity of the opportunistic flora of the intestine. In this case, very often there is a loose stool, as a manifestation of this state.

Causes that often lead to a loose stool during pregnancy and which must be taken into account and seek help are infectious diseases of the intestine of an inflammatory nature. In this case, the pathogen can be both a bacterium and a virus. Among the most common causes of bacterial diarrhea are intestinal yersiniosis, salmonellosis, dysentery, pseudotuberculosis, and escherichiosis. Among viruses, there are more frequent diarrhea caused by enteroviruses of different types, as well as rotavirus infection. These diarrhea have distinctive features, but they are united by a symptom of a loose stool, which during pregnancy can become a dangerous condition due to dehydration.

Therefore, it is very important to diagnose the infectious causes of the development of liquid stool in pregnant women in time and start treatment in time to prevent complications.

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Pathogenesis

The pathogenesis of the development of stool in pregnant women in the case of eating food is that some foods simply increase the intestinal motility by contracting the smooth muscle fibers of the gut. Some products or drugs act in a different way: they have components that stimulate the secretion of secretion into the intestinal cavity and thus, due to swelling, there is an increased excretion of these products.

Infectious diarrhea also has several pathogenetic mechanisms for the development of a loose stool. Some bacteria penetrate into the intestinal wall, destroy its structures, and cause an intense inflammatory process, which is accompanied by all the symptoms of inflammation - there is swelling, a violation of the barrier function of the intestine and secretion increases, which contributes to the formation of a loose stool. Some viruses and bacteria act like a secretory diarrhea - they raise the level of substances that pull water on themselves and, by increasing the volume of fluid in the intestinal cavity, they cause diarrhea.

You need to clearly understand when the liquid stool in pregnant women signals a danger, and when it's just a manifestation of the diet.

[3], [4], [5]

Symptoms of the stool in pregnant women

Various symptoms from the digestive system of a pregnant woman can testify to these or other 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, loose stools in pregnant women can be one of the symptoms of the disease. Also it is necessary to distinguish the time of diarrhea appearance. Liquid stool in pregnant women in early terms can develop with early gestosis. In this case, diarrhea occurs in conjunction with nausea, vomiting and is one of the normal manifestations that does not require special etiological treatment. A liquid stool in pregnant women in later terms is a more dangerous symptom, as it makes you think about a possible infectious cause.

If the liquid stool in pregnant women is a manifestation of intestinal infection, then the symptoms of stool change will be accompanied by other clinical signs. In this case, there will be abdominal pains of a spasmodic or persistent nature, symptoms of intoxication in the form of fever, chills, headache, nausea and vomiting are also possible. All these clinical signs indicate intestinal infection, which requires urgent comprehensive treatment with the use of antibacterial agents. In this liquid chair has its own characteristics depending on the pathogen - it can have different characteristics in the form of mush, watery, mucous, and can also have a different color - from green to black. All these features are diagnostic features of certain infections.

Intestinal infection is often accompanied by manifestations of intoxication and dehydration. At the same time, dry skin and mucous membranes develop, intoxication manifestations in the form of increased body temperature, exhaustion, dizziness, fatigue, headache. All these symptoms require careful attention and diagnosis because of their possible infectious nature.

Complications and consequences

The main complications that can occur with a pregnant woman's diarrhea are not only an effect on her condition, but also an effect on the baby. Any toxins in the body of a woman are potentially dangerous for a child, as they penetrate the blood from where they get to the baby. The main complications of liquid stools that occur most often are severe dehydration. At the same time, the blood filling of all organs is disrupted due to blood thickening, including the placenta, which is accompanied by oxygen starvation of the child.

Possible complications of a loose stool in case they are caused by an intestinal infection. In this case, intestinal bleeding, anus prolapse, intestinal obstruction, intussusception of the intestine can develop. These consequences are rare because of timely and adequate diagnosis.

Diagnostics of the stool in pregnant women

Diagnosis of liquid stool in pregnant women should be perceived from the very beginning, as a serious phenomenon requiring the elimination of acute intestinal infection.

It is very important to find out all the details and carefully collect the anamnesis, then this is the guarantee of a possible diagnosis. When applying to a pregnant woman, you need to clarify the duration of pregnancy, the presence of gestosis, anamnestic data on the diseases of the digestive system. If diarrhea is early in pregnancy and accompanied by nausea and vomiting, then it is possible manifestation of early gestosis. It is necessary to detail the complaints and find out how many times there was a loose stool, was there a color change, its consistency, and also the presence of nausea, heartburn, vomiting, abdominal pain. It is necessary to find out details of the diet of a pregnant woman and taking medications that could affect the character of the stool. Sometimes only at this stage you can find out the cause of the loose stool and do not need additional diagnostic methods. But if there are any suspicions of an intestinal infection, then it is necessary to conduct additional methods of investigation.

Analyzes that must be submitted in compulsory order in pregnancy are general clinical - a general analysis of blood and urine, a biochemical blood test, and a stool analysis. The analysis of stool needs to be carried out with bacterial examination and with the determination of sensitivity to antibiotics. If you can not identify the type of pathogen, then the exact method of diagnosis is a polymerase chain reaction. This method allows you to identify the DNA of a bacterium or a virus. That also allows you to accurately establish the 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, red blood cells, mucus, which allows you to differentiate the intestinal infection, hemorrhoids, bleeding. In a general blood test in case of an inflammatory intestinal infection, leukocytosis and a shift of the formula to the left in case of bacterial intestinal infection will be determined.

It is necessary in the case of diarrhea and vomiting in the early stages of pregnancy to determine the level of acetone, which allows you to judge the degree of intoxication of the body, as well as determine the tactics of treatment.

Instrumental diagnosis of stool in pregnant women includes mandatory ultrasound to determine the condition of the fetus, and also in a short time you can visualize the intestine. If pregnancy is in the third trimester, then cardiotocography with registration of the basic indicators of the fetal vital activity must be performed to determine the degree of dehydration and how this affects the fetus.

[6], [7], [8], [9], [10],

Differential diagnosis

Differential diagnosis of liquid stool in pregnant women should be carried out primarily between intestinal infections and the normal phenomenon during pregnancy due to the use of products or medicines. Intestinal infection or food toxicoinfection is accompanied not only by a liquid stool, but also by other symptoms from the digestive tract, as well as by intoxication syndrome. When intestinal infection will be characteristic blood tests, coprograms, as well as general condition.

In the case of liquid stool, as manifestations of the diet, the general condition does not change. If the liquid stool in pregnant women is not accompanied by an increase in it or does not affect the general condition, then this is a normal phenomenon provoked by hormonal changes.

[11], [12], [13], [14], [15], [16], [17]

Treatment of the stool in pregnant women

Intensive treatment of liquid stool in pregnant women is necessary only if it is a pathological symptom and the etiology of the disease is confirmed. In the treatment use medicamentous drugs and non-drug - alternative methods and means of homeopathy. It is very important to observe the regime and the nature of nutrition in acute intestinal infections, especially if the liquid stool has other manifestations.

The regime of a pregnant woman should exclude excessive loads, but at the same time it is necessary to have minimal physical activity. If the etiology of intestinal infection is confirmed, it is necessary to adhere to bed rest for an acute period.

It is very important to observe an adequate drinking regime with control of the injected and withdrawn liquid. It is necessary to take into account pathological losses not only with a liquid stool, but also with vomiting, perspiration and diuresis. Therefore, it is necessary to drink a lot of alkaline liquids in non-carbonated form. Mineral water is recommended - Borjomi, Luzhanskaya, Polyana Kvasovaya without gas. It is very important to control the degree of dehydration and the condition of the child and amniotic fluid.

Since the processes of normal over-dressing, suction and evacuation are violated, it is necessary to adhere to a diet:

• Caloric content of food should be the smallest, without complex saturated fats and with the restriction of dietary fiber, as they stimulate the motility of the gastrointestinal tract.
• Food should be taken in boiled form, warm, not hot and not cold, as this is an additional load on the digestive tract. You can use soups on the water with a grains of any, except buckwheat, without fat, meat and fish.
• Sour, salty, smoked products - to exclude completely. Potatoes can be boiled in the form of mashed potatoes or baked potatoes in the shell.
• It is necessary to exclude "simple" carbohydrates - sweets, biscuits, cookies, sweets. Fresh white bread should also be excluded, since it has the property of forming adhesive processes in the intestine. It is recommended to eat kalachki, dietary cookies, bread crumbs.
• The diet must be replenished with complex carbohydrates, the ideal option is oatmeal, which has an enveloping effect, as well as all the porridges on the water, except buckwheat.
• Dairy products should be excluded in the acute period, as they cause fermentation.
• It is necessary to exclude sweet fruits and fruit juices in an acute period with severe diarrhea.

These are the main principles of dietary nutrition, which are an obligatory component of complex treatment of liquid stool in pregnant women.

In the case of a proven intestinal infection of bacterial etiology, it is mandatory to carry out complex treatment using an antibiotic, a probiotic and a sorbent. But drug treatment has its limitations, since many drugs are contraindicated in 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 action in the event of complications.

If a woman experienced pronounced vomiting and diarrhea, it is necessary to replenish the water balance by the oral route, which is pathogenetically an important stage of treatment, and also in the case of intestinal bleeding replenish the volume of circulating blood. It is also necessary to carry out infusion therapy in a volume that will replenish all pathological losses.

In the case of proven infectious genesis of liquid feces, the necessary component of treatment is the administration of antibiotics, but given the possible negative effects on the fetus, it is necessary to choose the type and dose. In pregnant women with liquid stool, intestinal antiseptics of the nitrofuran series, as well as antibiotics of the fluoroquinolones group, should not be prescribed, since they have a pronounced effect on fetal development. Preference is given to the antibiotic group of cephalosporins, which are relatively safe because of the lack of proven harmful effects on the child. Therefore, with bacterial intestinal lesions in pregnant women, the drug of choice is cephalosporins.

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

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

There was no adverse effect on the fetus during pregnancy. Side effects are possible on the part of the gastrointestinal tract, allergic manifestations, reactions of the nervous system in the form of headache, drowsiness, dizziness.

Antibacterial therapy for colitis during pregnancy should be carried out with strict control of the condition of the mother and fetus. It is important to conduct antibiotic sensitivity before the appointment of therapy and further guided by the results.

To date, there is a huge amount of sorbents, but some of them are preferred because of the possibility of taking during pregnancy. 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 clean the intestines and resume normal flora.

Smecta is a naturally occurring sorbent that is able to 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.

Produced in bags of 3 grams.

The drug can be used during pregnancy and lactation, because it is not absorbed, but is withdrawn in an unchanged form. Side effects occur rarely, allergic reactions may occur. The drug is contraindicated with intestinal obstruction and hypersensitivity to it. Precautions - should be taken with an interval of at least 2 hours with other medicines, because it reduces their absorption.

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

During treatment with antibiotics, and also considering the violation of normal intestinal biocoenosis in diarrhea in pregnant women, it is necessary to prescribe probiotics in a complex therapy.

Linex is a drug that contains lactic acid bacteria and bifidobacteria and contributes to the normalization of the intestinal flora and also has antidiarrheal action. Available in the form of capsules 1 gram. The drug has no significant side effects, it can be used during pregnancy because of. Dosage - 2 capsules 3 times a day after meals, treatment for colitis for at least three days.

As an anesthetic, most often used antispasmodics, which can further reduce the tone of the uterus.

But-spa (Drotaverin) 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 - a tachycardia, a sensation of hot flushes to the face, increased sweating, dizziness, allergic reactions. Expressed harm to the fetus is not detected, because the medicine does not penetrate the hematoplacental barrier. Contraindications for use are closed-glaucoma, prostatic hyperplasia. The drug is used in colitis in a pregnant woman to relieve spasm of the intestine with pain. Dosage - 40 mg per reception. You can take as a pill, but it is better to inject in the same dose, no more than 3 times a day.

Vitaminotherapy in an acute period of diarrhea is better not done.

Physiotherapy is recommended only during remission.

Operative treatment of diarrhea is possible in extreme cases with complications such as intestinal bleeding, intussusception and obstruction. Such complications arise very rarely.

Alternative treatment of loose stool in pregnant women

Alternative treatments for diarrhea are widely used by future mothers because of minimal harm to the baby. There are many treatments with the use of both herbs and alternative remedies and homeopathic medicines. The main effect of such treatment is the restoration of water-electrolyte balance, bactericidal effect and regenerative.

Basic methods of alternative treatment:

• Tincture of propolis reduces inflammation of the intestinal wall, promotes the regeneration of the epithelium and has a bactericidal effect. To make 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, then applied inward on a tablespoon 2 times a day.
• The use of natural remedy - mummy - is widely used in the treatment of diarrhea, especially in pregnancy. This substance has a pronounced anti-inflammatory, regenerating, analgesic effect. To prepare the preparation, you need to dissolve 100 milligrams of mumiy in a tablespoon of water and take it 2 times a day for seven days. Such a solution can inhibit the normal intestinal microflora, so it is necessary to take probiotics.
• The tincture of starch, which is prepared from one tablespoon of starch, dissolved in a glass of warm water, promotes the normalization of the stool consistency and is a good antidiarrhoea.
• Herbal treatment also has its advantages, as phytotherapy in addition to local action has a general soothing effect, and it also replenishes the body after pronounced dehydration.
• Infusion of rose hips, which is boiled for five minutes in hot water replenishes the water balance and promotes the normalization of liver function, which enhances its antitoxic function.
• Infusion of chamomile, which is prepared from three tablespoons of chamomile leaves, which are brewed in a liter of boiled water. Before taking a spoon of honey and take as possible in the acute period as often as possible, not less than a liter per day.
• Raspberry leaves and raspberry juice are boiled in water and make an acidic compote, which is taken in an arbitrary mode in an acute period for rehydration.

Homeopathic remedies:

• Nux vomica-Homaccord - a combined homeopathic preparation, has an anti-inflammatory effect on the intestinal mucosa. Produced in drops, dosage - 10 drops per tablespoon of water 3 times a day. Side effects in the form of an allergic rash.
• Mucosa compositum is a homeopathic remedy that has a regenerative, antispasmodic, anti-inflammatory effect. Also, the drug has a mucolytic effect and is capable of enhancing intestinal motility. It is available in the form of a solution for injection in a dose of 2.2 ml. Dosage - 2.2 ml intramuscularly or subcutaneously, with acute conditions once a day, and with chronic colitis once a week. It is not contraindicated in pregnancy, side effects can be in the form of allergic manifestations.
• Traumeel S is a complex homeopathic remedy, which is available in the form of tablets and injections. Has anti-inflammatory, regenerating effect. Dosage in acute period - 1 ampoule 2.2 ml per day, later or for chronic colitis take 1 tablet 3 times a day.
• Viburkol is a homeopathic preparation that has analgesic, anti-inflammatory, antispasmodic, soothing effect. Produced in the form of rectal suppositories. Apply one suppository 2-3 times a day. Possible reception during pregnancy, side effects are not frequent in the form of allergic reactions. Contraindications to the use of the drug is not revealed.

[18], [19]

Prevention

Prevention measures are nonspecific, which include mainly dietary recommendations for a pregnant woman. When pregnancy is necessary to carefully monitor their diet, which ensures a normal caloric intake of food and the full value of food with a balanced composition of microelements. It is necessary to limit products that cause fermentation and are strong stimulants of intestinal motility. Do not eat foods of questionable quality, because during pregnancy the gastrointestinal tract works differently and should not risk their health.

Liquid stools during pregnancy can be a serious symptom and if it is combined with other manifestations from the gastrointestinal tract, then chances are that it is an intestinal infection. In this case, you need to seek qualified help, especially considering the life and health of the unborn child.

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Forecast

The prognosis for recovery is favorable, for life is also favorable.