Pregnant women sometimes suffer from abdominal pain and diarrhea. Many people don’t care much about such symptom; they think it is caused by hormonal changes during pregnancy or by an improper diet. They don’t know that it may be ulcerative colitis.
The most common symptom of ulcerative colitis is diarrhea. Moreover, the symptoms often appear alternately in the active stage and the remission stage. When in the remission stage, the pregnant woman can be basically asymptomatic, such as stool can be shaped, no pus, no blood, only slight abdominal pain or abdominal discomfort. Even if there is occasional nausea, vomiting, upper abdominal discomfort,fever and other systemic symptoms, it is easy to be confused with some physiological reactions during pregnancy or other intestinal diseases.
Maleficence of Pregnancy Ulcerative Colitis
Although some women in remission stage are no different from ordinary pregnant women, pregnant women in active stage will get worse off with the increase of gestational age (about 30%-100%). When the disease is serious, symptoms such as severe diarrhea, frequent hemafecia and temperature rising up to 40 ℃ may occur.
Among them, diarrhea and hemafecia are prone to cause malnutrition in pregnant women to varying degrees, thus affecting fetal development, resulting in fetal growth retardation, low birth weight and so on. Severe diarrhea will further increase the load on the heart, kidneys and other organs, which can easily induce premature delivery, abortion and even endanger the life of pregnant women.
Unhealthy Psychology and Dysbacteria May Be the Cause of the Disease
Although the pathogenesis of ulcerative colitis is not yet clear, most studies believe that it is related to genetic factors, psychological factors, immune factors, alteration of intestinal flora and so on.
Because pregnant women are more susceptible to anxiety, depression and other adverse emotions, some studies believe that the symptoms of ulcerative colitis can be changed with the emotional fluctuation of patients, and psychological factors are their predisposing factors . There are also studies that believe that psychosocial factors affect the disease occurrence and account for 74% of the development, and psychological stress can aggravate the inflammatory damage and ulcer formation of ulcerative colitis .
In addition, many studies have confirmed the close relationship between intestinal flora and ulcerative colitis. Healthy intestinal flora is the dynamic balance of beneficial bacteria, harmful bacteria and neutral bacteria. Once the microenvironment is broken, the harmful bacteria are dominant in the intestine, which may lead to the defect of intestinal barrier function and the decrease of intestinal defense function. When the intestinal mucosa is damaged, it can cause or aggravate ulcerative colitis.
Protection and Treatment of Ulcerative Colitis
Since every single symptom matters during pregnancy, pregnant women should learn to observe the physical conditions for their and baby’s safety. After defecation, it is advisable not to flush it out immediately; observe the amount, color and character of the stool. Pregnant women should pay attention to their physical changes at ordinary times. When abnormal symptoms occur, they should not judge by themselves and must seek medical treatment in a timely manner.
For pregnant women who are in the active stage of ulcerative colitis, doctors will take into account their physiological characteristics and choose a medical treatment. For example, mesalazine, biological agents, etc., these drugs are relatively safe to take during pregnancy.
Probiotics as Adjuvant Therapy for Ulcerative Colitis
In addition, probiotics can also assist in the treatment of ulcerative colitis. Some studies have pointed out that probiotics combined with mesalazine has a significant effect on ulcerative colitis, which can effectively reduce the disease recurrence rate and the level C-reactive protein . Moreover, the combination of the two can not only effectively improve and control the disease, but also can reduce complications and other adverse reactions .
Last but not least, anemia is the most common complication in patients with ulcerative colitis, and the symptoms of anemia will be aggravated during pregnancy. Therefore, pregnant women should follow the advice of doctor to supplement iron and folic acid in time. Also, they should eat less crude fiber food, pay attention to nutritional balance, and avoid raw, cold, spicy food at ordinary times.
 Bitton A, Sewitch MJ, Peppercorn MA, deB Edwardes MD, Shah S, Ransil B, Locke SE. Psychosocial determinants of relapse in ulcerative colitis: a longitudinal study. Am J Gastroenterol. 2003, 98(10): 2203-2208
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 Ren Weihua, Wu Yuxia. Clinical effects and value of probiotics combined with mesalazine in the treatment of ulcerative colitis [J]. Chinese Community Doctors, 2019, 35 (26): 47 + 49
 Zhang Nan, Li Jieshu. Clinical effect of probiotics combined with mesalazine in treating ulcerative colitis [J]. Heilongjiang Medicine and Pharmacy, 2019, 42 (04): 80-81 + 83