Crohn's Disease in Pregnancy

by Shaun Damon


Crohn's disease is a chronic illness where parts of the bowel or digestive tract become ulcerated and inflamed. Crohn's disease along with ulcerative colitis falls under the category of diseases known as IBD or Inflammatory Bowel Diseases. Crohn's disease can affect both men and women at any age but are most common among people between the ages of 15 to 30.

Symptoms of Crohn's Disease in Pregnancy

Symptoms of Crohn's disease can vary depending on which part of the bowel is affected. Symptoms can appear for weeks and then disappear during periods of remission. Common symptoms include:

  • Severe or chronic diarrhea
  • Bleeding from the rectum
  • Unexplained weight loss
  • Fever
  • Pain and tenderness in the lower abdomen
  • Feeling of pressure or fullness in the lower right abdomen
  • Bloating
  • Fatigue
  • Loss of appetite
  • Nausea and vomiting
  • Floating stools
  • Development delays or stunted growth in children

Crohn's disease can cause serious complications such as ulcers, fistula, anal fissures, intestinal obstructions and malnutrition.

Causes

The exact cause of Crohn's disease is still not known. Theories range for bacterial or viral infections to genetics. A diet high in saturated fats and low in fresh fruit and vegetables may also contribute towards increasing the risk of developing the condition. Other risk factors include smoking, living in an urban industrialized area, being of European descent or having a Jewish heritage.

Complications of Crohn's Disease and Pregnancy

If you are a woman who suffers from Crohn's disease, conceiving when the symptoms are active may be difficult. However, during periods of remission or when the symptoms have disappeared, getting pregnant should not be a problem.

Medications used to treat Crohn's can also affect a man's sperm count and make conception an issue. If you are planning to get pregnant, it is important for both men and women with Crohn's to stop taking medications such as the drug methotrexate before and after conception as it is deadly to fetuses and newborns.

Other medications for Crohn's such as aminosalicylate class drugs are considered safe during pregnancy and pose no risks to the fetus. If you are taking sulfasalazine, you need to ensure that you get enough folic acid during your pregnancy as sulfasalazine restricts the absorption of folic acid.

Procedures used to diagnose and treat Crohn's disease such as colonoscopies, upper endoscopies, rectal biopsies, and ultrasounds can be performed safely even if you are pregnant.

Crohn's disease can affect pregnancies differently. For some women, the symptoms may decrease. This happens as the body suppresses the immune system during pregnancy to protect the fetus. In turn, this can help lessen the intensity of flare-ups and decrease the severity of the symptoms. If your IBD symptoms are in remission, there should be no problem with your pregnancy or delivery. However, if the disease is in its active stage, there may be a higher risk of miscarriage, premature delivery and stillbirth. Also keep in mind that if one parent has Crohn's there is a possibility that the baby will also get the condition. If both parents have Crohn's, the odds increase to one in three of the baby having Crohn's as well.

Complications of Crohn's disease such as anal fissures or fistula can affect a woman's decision to have a vaginal delivery. In most cases, doctors recommend a c-section as a safer choice. If there are no fissures or fistula in the area however, a vaginal delivery may be considered.

If you do suffer from Crohn's disease it is very important to work closely with your doctor from the beginning. In addition to this your obstetrician and pediatrician should also be consulted to ensure a healthy pregnancy and delivery.

References:

http://www.umm.edu/altmed/articles/crohns-disease-000043.htm#ixzz24wBg5bJZ


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