Diarrhea During Pregnancy: Causes & Treatment Options

Clinical review: Tatiana Zanin
Registered Dietitian
March 2022

Diarrhea and other intestinal changes are relatively common in pregnancy. In most cases, these happen due to changes in hormone levels, new food intolerances, or excess stress. Therefore, diarrhea is not usually a sign of anything serious. 

However, if diarrhea is frequent or lasts for a long time, women are at risk to become dehydrated, which can lead to potential health problems in the mother and baby.  

Ideally, diarrhea should be treated as soon as it appears. In addition to eliminated the underlying cause, women should increase their water intake as well as incorporate some dietary changes. If diarrhea does not improve within 3 days, you should seek medical assessment. 

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Main causes of diarrhea during pregnancy

Diarrhea can generally occur for several reasons, from food poisoning to intestinal worms. However, it is more common for diarrhea during pregnancy to be caused by simple conditions like:

1. Hormonal changes

Natural pregnancy-related hormonal changes can significantly change the way the body works. They can especially affect digestion and intestinal function, and lead to constipation or diarrhea. 

2. New food intolerances

Amongst the many changes that pregnant women may undergo, new food intolerances can emerge due to increased intestinal sensitivity to some foods. Foods that were well-tolerated prior to pregnancy can suddenly cause symptoms like increased gas and diarrhea. 

3. Changes in diet

Many women may opt to change their diet when pregnant for health-related reasons or to compensate for other symptoms, like vomiting. The new diet can lead to diarrhea, especially in its first few days. 

4. Use of supplements

The use of supplements during pregnancy is relatively common, as they are often recommended for optimal embryonic development. Even though these supplements are safe and are often prescribed, they can often cause diarrhea and stomach sensitivity, particularly in the first days of use. 

How to treat diarrhea 

Most cases of pregnancy diarrhea can be treated at home without medication by eating lighter food and increasing intake of liquids. Here are some other important tips: 

  • Avoid eating fried food, fatty food, and very spicy food;
  • Opt for boiled or grilled food such as rice, chicken, pasta without sauce, rice pudding, or a slice of toast
  • Eat poached fruit without the peel such as apple, pear, or banana;
  • Drink filtered or boiled water, homemade saline and sugar water solutions, coconut water, or fruit juices.

However, if diarrhea does not improve within three days or if you experience other symptoms such as vomiting or fever (which are signs of food poisoning), you should see your doctor or obstetrician for assessment and possible treatment with medication. 

Is it safe to take medication for diarrhea?

Some medication for diarrhea, such as Imodiumor  Pepto-Bismol are considered to be safe during pregnancy, however they should only be used as guided by your doctor. This type of medication may end up worsening the situation, depending on the cause of the diarrhea.

Can diarrhea be a sign of labor?

Diarrhea is more common in the last trimester of pregnancy, and it seems to be linked to the fear and anxiety that the expectant mother experiences in relation to labor. In addition, some women also report having diarrhea crises a few days before labor, which may be a natural response of the body to prepare for labor. 

However, the classic signs of labor do not include diarrhea. The most common signs of labor are placental rupture and contractions that increase in frequency and intensity. 

When to go to the doctor

You should go to the doctor when diarrhea takes more than three days to resolve or when there are other symptoms, such as:

  • Bloody stools;
  • Strong abdominal pain;
  • Frequent vomiting;
  • Fever over 38 °C;
  • More than 3 liquid bowel movements in one day;
  • More than 2 liquid bowel movements in several days.

If any of these happen, it is important to go to a doctor so that a cause can be identified and appropriate treatment can be initiated. 

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Edited by Tua Saude editing team in March 2022. Clinical review completed by Tatiana Zanin - Registered Dietitian in March 2022.

References

  • RIDDLE, Mark S. et al.. ACG Clinical Guideline: Diagnosis, Treatment, and Prevention of Acute Diarrheal Infections in Adults. The American Journal of Gastroenterology. 2016
  • ELSEVIER. Constipation and Diarrhea in pregnancy. Available on: <https://www.gastro.theclinics.com/article/S0889-8553(05)70353-8/pdf>. Access in 22 Apr 2020
Show more references
  • AMERICAN PREGNANCY ASSOCIATION. Dehydration During Pregnancy. Available on: <https://americanpregnancy.org/pregnancy-complications/dehydration-pregnancy/>. Access in 22 Apr 2020
  • NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES. Treatment for Diarrhea. Available on: <https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea/treatment>. Access in 22 Apr 2020
  • GOMES, Catarina Frias et al.. Gastrointestinal diseases during pregnancy: what does the gastroenterologist need to know?. Annals of Gastroenterology. Vol.31, n.4. 385-394, 2018
Clinical review:
Tatiana Zanin
Registered Dietitian
Graduated in Clinical Nutrition in 2001 and has a Master’s in Clinical Nutrition. Licensed to practice under the CRN-3 in Brazil and the ON in Portugal