Crohn’s disease and pregnancy: Managing the effects

WHAT IS CROHN’S DISEASE?

Crohn's disease is a long-term condition that causes inflammation, ulcers, and scarring to the lining of the digestive system.

Over time, this can damage sections of the digestive system, resulting in complications such as narrowing of the intestine (stricture), or a channel developing between the end of the bowel and the skin near the anus or vagina (fistula). These problems usually require surgical treatment.

However, while there is no cure currently, the disease can be relieved through medication and / or surgery.

WHAT ARE THE SYMPTOMS?

The symptoms of Crohn’s Disease vary from cases to case, but common warning signs include:

WHO IS AFFECTED?

Crohn's disease can affect people of all ages, including children.

However most cases develop between the ages of 16 and 30 - the period that also happens to be the peak of a woman’s fertility.

This often leads many women diagnosed with Crohn’s to believe that their fluctuating condition, not to mention the medication that helps to manage their symptoms, will make it impossible to fall pregnant.

CAN YOU GET PREGNANT WITH CROHN’S DISEASE?

Fans of Sam Faiers, who famously spoke out about living with Crohn’s Disease, will know that the TOWIE star recently announced that she is pregnant with her first child.

And she is testament to the fact that women with Crohn’s Disease are just as likely to get pregnant as women who don’t suffer with Crohn’s.

However, despite this, most women with IBD who are in remission or have only mild active disease at the time they conceive, are very likely to have a normal uncomplicated pregnancy.

CAN I KEEP TAKING MY MEDICATION WHILE I’M PREGNANT?

Most women are advised to continue to take their medication while pregnant, as evidence suggests that the drugs will do less harm to their unborn baby than active Crohn’s Disease.

You can find out more about the effects of specific drugs over at Crohn’s And Colitis UK now.

However they do offer the following advice:

REMEMBER: Always speak to your doctor about which medications are safe to use for managing your Crohn’s Disease symptoms during pregnancy.

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*** IS IT SAFE TO USE STEROIDS THROUGHOUT MY PREGNANCY?

If you are on steroids, you should not get pregnant. If you are taking a corticosteroid such as prednisone or another steroid and do get pregnant, your doctor will prescribe the smallest possible dose.

WHAT WILL HAPPEN TO MY STOMA DURING PREGNANCY?

Your stoma may change shape and become larger throughout your pregnancy. This is due to your abdomen expanding.

And, in some cases, your expanding uterus can cause it to temporarily block.

This is usually resolved through tweaking your diet, however, so don’t worry.

Make sure you speak to your doctor or midwife about your stoma as early into the pregnancy as possible, so that you can discuss your concerns and so that they can a) monitor it, and b) give you some useful advice.

WHAT SHOULD I EAT WHILE I AM PREGNANT?

Just like any other woman going through pregnancy, it is best that you maintain a healthy and balanced diet.

You can find out more about the foods you should aim to eat, as well as those you should avoid, over at the NHS Choices website now.

WHAT VITAMIN SUPPLEMENTS SHOULD I USE THROUGHOUT MY PREGNANCY?

Speak with your doctor about the best vitamins to take throughout your pregnancy.

However, if you are taking sulfasalazine, you need to be particularly sure you get enough folic acid.

Folic acid prevents neural tube birth defects such as spina bifida. Sulfasalazine blocks the absorption of folic acid.

You may also need extra vitamin B12, especially if you take extra folic acid.

Iron deficiency is quite common in IBD and extra iron may be needed to meet the increased demands of pregnancy. Your doctor will be able to recommend a suitable supplement.

WILL PREGNANCY MAKE MY CROHN’S DISEASE WORSE?

On the contrary.

Crohn’s And Colitis UK explain: “Some research has even suggested that it may have a positive effect on the disease process in the longer term.

“For example, several studies have found that women with IBD had fewer relapses per year after having children than before they got pregnant.”

However this obviously varies from woman to woman; some have reported experiencing a flare-up after their baby is born, despite their symptoms improving throughout their pregnancy.

WHAT SORT OF DELIVERY SHOULD I HAVE?

Most women with Crohn’s Disease can have a normal vaginal delivery.

However if you have an ileo-anal pouch, a stoma, or active perianal Crohn’s Disease, doctors may recommend that you have a caesarean section.

Speak to your midwife, doctor or IBD specialist about your own preferences and any worries you may have.

WILL MY BABY GET CROHN’S DISEASE TOO?

If both parents have IBD, the child has about a one in three chance of having IBD. If only one parent has Crohn's disease, the chance of the baby getting the condition is about 9%.

However it is worth remembering that Crohn’s Disease can affect children more severely than it does adults, as it can slow their growth and delay their sexual development.

WANT MORE INFORMATION ABOUT CROHN’S DISEASE AND PREGNANCY?

Visit the Crohn’s and Colitis UK website now.

You can also phone:

Crohn’s And Colitis UK Information Line: 01727 734470

Crohn’s and Colitis Support: 0121 737 9931

Colostomy Association Helpline: 0800 328 42357