Proactive Health for Women with Inflammatory Bowel Disease

Tuesday, July 15, 2014

Swapna Reddy, MD

I am in the shopping mall. My plan is to dash into the store to buy my newborn an outfit for a party. It is only a 30-minute task, but on little sleep, still feeling weak, and with my breast milk threatening to soak my shirt, it is easy to feel a moment of helplessness.

Now compound that feeling with a myriad of questions that many mothers with inflammatory bowel disease (IBD) face:

  1. How can I achieve and maintain a healthy pregnancy?
  2. Can I breastfeed my baby even with being on medications to maintain my IBD in remission?
  3. What preventative steps can I take to be a healthy mother in the future?

Like many challenges in our life, having an open discourse, getting the facts, and having a sense of support can take us from helpless to strong.

Let us take a moment to address the three aforementioned concerns. To our advantage, studies have been done and provide a backdrop to our answers. As a community of Gastroenterologists seeing women with IBD, we can make some recommendations.

1. A healthy gut can lead to a happy pregnancy.

The most important factor in determining a healthy pregnancy is being in remission with your IBD. This means that you feel well (painless, non-bloody, formed stools and no inflammation on your endoscopy, imaging, blood, or stool studies) at the time of conception. Achieving and maintaining remission may require medications, many of which are safe to continue during pregnancy. A gastroenterologist can help guide you in regards to which medications are safe to continue for conception and pregnancy. Being cared for during your pregnancy by a high risk obstetrician is recommended. A well balanced diet, multivitamin, and adequate folic acid are important.

2. Breastfeeding may still be an option, even if you are taking certain medications used to treat IBD.

The degree to which most medications are excreted into breast milk is typically low. Some medications are okay to continue during nursing. However, other medications should be avoided and an acceptable decision may be to continue these medications to maintain you in remission and provide your baby with formula. This, along with stopping medications if you are in deep clinical remission with your IBD, can be discussed further with your gastroenterologist.

3. “An ounce of prevention is worth a pound of cure” (Benjamin Franklin)

Keeping routine follow up with your primary care provider and/or gastroenterologist is paramount. Getting appropriately timed bone density scans to check for osteoporosis, screening for cervical cancer, colon cancer and skin cancer, quitting smoking if you have Crohn’s disease, and receiving certain immunizations can be helpful in keeping up your health. Maintaining a healthy lifestyle with food choices and exercise can also make a positive impact in how you feel.

If you or someone you know has IBD (Crohn’s disease or Ulcerative Colitis), please contact The Oregon Clinic Gastroenterology if we can provide you with any assistance.