Dealing with pregnancy-related discomfort
March 9th, 2010
Pregnancy is a very special time in a woman’s life. many womenreport a feeling of fulfilment as they bring a new life onto this planet.however pregnancy can also be a time of great discomfort. Some of thechallenges require adjustments in lifestyle while others may require treatmentwith medications.
It is important to always check with your doctor or midwifebefore taking medicines while you’re pregnant. They will evaluate how bad youare feeling against the risks (to your baby) of taking a drug at your stage ofpregnancy. Other health professionals like pharmacists are another good sourceof advice.
Nausea
Nausea and vomiting is quite common amongst pregnant women. Inmost cases, the symptoms disappear before the 20th week of pregnancy but somewomen experience it through the second trimester, or even during the wholepregnancy.
It is a miserable time for many who are left to deal with it ontheir own as it is often ignored or downplayed.
The likely causes of nausea are elevated levels of pregnancyhormones as well as psychological and gastrointestinal dysfunction.
There is no simple cure for pregnancy nausea and what works willvary greatly. however, it is of the utmost importance that the nausea not beallowed to interfere with the good nutrition that is so vital in pregnancy. Inmild cases, making simple adjustments in diet and lifestyle could solve theproblem, see the note box. Otherwise sea-sickness medicines and antihistamineswith antiemetic effect could be used e.g. meklozin.
Dopamine receptor blockers with motoric stimulating effect canalso be used e.g. metochlopramide. very severe cases may requirehospitalisation and nutrients via infusion.
Heartburn and dyspepsia
Even for women who have never experienced it before, heartburnmay occur for the first time while they are pregnant. it usually begins in thesecond trimester of pregnancy. Fortunately, the heartburn is usually mild andintermittent, but in some cases it could be severe.
It occurs for a number of reasons. Increased levels of hormonesin your body while pregnant can soften the lower oesophageal sphincter, LES,(the muscular valve between the stomach and oesophagus) allowing food andstomach acids to reflux back up into your oesophagus and throat. also morepressure is put on your stomach as your baby grows. The enlarged uterus cancrowd the abdomen, forcing stomach contents upwards.
Though you may not be able to eliminate heartburn completely,you can take some steps to minimise your discomfort. These simple lifestyle anddietary changes can help to ease symptoms.
If the suggested changes do not work, treatment can be startedwith antacids, alginic acid/antacid combination and sucralfate. These drugs areminimally absorbed into the body and therefore not a potential threat to thefoetus. it is reasonable to start with antacids alone, one hour after meals andat bedtime. if antacids are not effective alone, then combine with alginicacid/antacid to be taken after meals and at bedtime more frequently ifnecessary.
If the above regimen is not effective in controlling heartburn,then proton-pump inhibitors or H2 antagonists could be an alternative, understrict supervision by a doctor or mid-wife.
Constipation
Constipation is a common problem during pregnancy and it isbecause of the increase in the female hormones especially progesterone whichslows the movement of food through the whole digestive system. Anothercontributing factor is the pressure of the growing uterus on the rectum. Alsoiron supplements can make constipation worse.
The best way to treat constipation during pregnancy is withdiet. Eat high-fibre foods such as cereals, whole-grain breads and fresh fruitsand vegetables. Fruits such as paw-paw, pears, and peaches are helpful.
Also drink plenty of water, at least six glasses every day.
Regular exercise or physical activity like walking, swimming canall help to ease constipation, leaving you feeling more fit and healthy.
If constipation does not resolve with dietary modifications,bulk-forming or osmotic laxatives could be tried.
Stimulant and irritant laxatives should only be used withrestriction or doctor’s permission.
Haemorrhoids
This is as awkward as it is painful for many pregnant women. Itis largely due to the varicose (swollen) veins around the rectum. While theuterus expands, pressure increases in veins in all of the lower body, causingswelling and ultimately haemorrhoids. Constipation and straining while going tothe toilet can also contribute to haemorrhoids during pregnancy.
External haemorrhoid is treated only if symptoms occur. Internalhaemorrhoid is treated through the prevention of constipation, and withsuppositories to relieve the pain and irritation.
Nasal congestion
A stuffed-up or runny nose is unfortunately a common pregnancyniggle. While it is not dangerous, it can make life uncomfortable particularlyaffecting quality of sleep, which can make you very tired and fatigued. it canstart at anytime during the pregnancy. it is due to hormonal changes that causethe mucous membranes of the airways to swell, accompanied by increasedcirculation.
So how can you clear your stuffy nose? Some of the simplemeasures that work for a cold may provide relief. Try a steam inhalationespecially before going to bed.
Nasal Saline
Irrigation is a type of treatment that uses a saline wash tohelp remove mucus from the nasal passageways. All you need to do is flush eachnostril out with the saline solution. Saline washes help to improve comfort andbreathing and lubricate the mucosa in the nostrils, allowing them to work moreeffectively in the future.
Saline spray also provides relief and comfort.
If these do not help and you’re really suffering, there are somemedicines you could try. The first line of treatment is usually a nasal spraycontaining a steroid e.g. beclomethasone. if this doesn’t help, your doctor mayrecommend an antihistamine.
Heart palpitation
Heart palpitations occur during pregnancy because of theincreased blood volume and increased hormones, particularly progesterone.
Other factors that might put added stress on the heart areanxiety, stress, exercise, fever, caffeine, nicotine, alcohol etc. Most ofthese factors can easily be controlled.
In some cases, heart palpitations occur as a result of anunderlying condition such as anaemia, low levels of oxygen, hypoglycaemia,changes in blood pressure and certain thyroid conditions.
Heart palpitations during pregnancy are almost always harmlessalthough they might seem alarming. Nevertheless, they should never be ignored.let your doctor know if you experience heart palpitations accompanied bydizziness, chest pain, weakness, light headedness, unusual sweating, shortnessof breath, and fainting.
As I noted earlier, it is always advisable to consult with yourhealth provider (doctor or midwife) before taking any medicines duringpregnancy.
Ifeoma Asiegbu is aPharmacist and a Parasitologist. she works with the Swedish Medical ProductsAgency, a vital arm of the European Medicines Agency EMA. she lives in Swedenwith her husband and two children.