Ulcerative colitis is a disease characterized by chronic inflammation and ulcers of the inner layers of the colon and rectum. The symptoms include bleeding, mucus, pus and diarrhea. Then what is the relation between ulcerative colitis and pregnancy? Normally, pregnant women with ulcerative colitis worry how this disease will affect their babies. They also wonder whether there are safe treatment options for this disease. Every pregnant woman who has ulcerative colitis needs to be closely monitored during the entire pregnancy.
Can You Give Birth to a Healthy Baby If You Have Ulcerative Colitis?
Normally, if the disease is in remission while you are pregnant, you will most likely have a normal pregnancy and give birth to a healthy child, just like other women who are not affected by the disease. However, if you do have flare-ups during the pregnancy, or if the disease is active, there is a slight risk for your baby. Your baby is likely to have a lower weight at birth or even to be born before the due date. In severe flare-ups of the disease, the potential risk for the baby is higher. It has been estimated that in these cases only 4 out of 10 babies survive. Once your body shows the symptoms of ulcerative colitis during pregnancy, visit your doctor as soon as possible to keep the disease under control.
Will Your Baby Be Born with Ulcerative Colitis?
Children born from parents with ulcerative colitis are more likely to develop the disease themselves. However, their overall risk is low. There is only 2-5 % chance of inheriting the disease if the mother is suffering from it. In cases when both of the parents have irritable bowel syndrome, this risk increases up to 30%.
Will Pregnancy Affect Ulcerative Colitis?
This question is another thing that you may wonder when it comes to ulcerative colitis and pregnancy. Actually, pregnancy has little or no effect on your disease. 1/3 of moms-to-be may experience relapses during pregnancy, but this ratio is similar to other non-pregnant women with ulcerative colitis. If you do have a relapse, it tends to occur in the first three months.
If you do have a relapse while pregnant, it is more likely that your disease will become active in future pregnancies. However, if you have a normal pregnancy and your irritable bowel syndrome remains inactive while pregnant, it does not mean that it will not become active in future pregnancies.
Safe Medicines for Ulcerative Colitis During Pregnancy
The following medications are generally considered safe. But you should seek your doctor's permission before taking any of them.
Mesalazine is considered as safe while pregnant. If this kind of medication is used during pregnancy, higher doses of folate supplements are required, as it interferes with folate absorption.
These medications are also considered safe to use while pregnant. However, corticosteroids used for the treatment of ulcerative colitis can cross the placenta. A good thing is that these corticosteroids are quickly inactivated by the enzymes in the placenta, so the baby is exposed to very low levels of corticosteroids. In the late stages of pregnancy, high doses of corticosteroids should be avoided. Some studies have linked cleft lip/palate in the babies and the use of steriods during the first trimester of pregnancy, though it has not been confirmed yet.
3. Azathioprine and Mercaptopurine
These two medications are considered safe in general when it comes to ulcerative colitis and pregnancy, though several cases of low birth weight, premature delivery or miscarriage have been reported. It is kind of hard to determine if these complications are associated with the use of these two medications or with the active disease itself. Ask for your doctor's permission before using them.
4. Antidiarrheal Drugs
Antidiarrheal drugs have questionable safety when used during pregnancy. However, alternate drugs such as psyllium or Kaopectate are mostly recommended while pregnant.
Note: Surgical treatment while pregnant is rarely indicated. However, in certain cases when surgical treatment is the only option, the risk to the baby is less than the risk when this surgical procedure is not performed.
Tips for Pregnancy with Ulcerative Colitis
Here are some tips to follow while pregnant:
- Try to maintain remission while pregnant. If the disease is remained under control while pregnant, it is more likely for you to have a normal pregnancy and deliver a healthy baby.
- Watch your diet. A balanced diet is very important during pregnancy, especially while having ulcerative colitis and pregnancy at the same time. Seek the advice of a dietitian about the nutritional plans during pregnancy.
- Exercise regularly. You can choose swimming, walking or even yoga, whichever you prefer to boost your immune system.