Inflammatory bowel disease (IBD) is commonly diagnosed in your 20s and 30s, which is also the time when many people are planning a family. Many people have been diagnosed with IBD (including Crohn’s disease and ulcerative colitis)) Have questions or concerns about fertility, conception, pregnancy, childbirth, or breastfeeding?
Are you thinking about having a child or becoming pregnant?
It is important to make sure your IBD is properly controlled, ideally before trying to have a biological child. This is equally important for patients with male and female reproductive organs.
Patients with female reproductive organs who become pregnant during remission tend to remain in remission throughout their pregnancy. According to research Poorly controlled IBD can lead to decreased fertility and can complicate pregnancies, including preterm labor, premature delivery, low birth weight, and small-for-gestational age babies.
Blood tests, imaging tests, or an endoscopy may be needed before pregnancy to find out if your intestines have ongoing inflammation. Your doctor may also change your medicine to help you control your disease as best as possible.
During pregnancy, you will need the care of many different types of health care providers in addition to a gastroenterologist with expertise in IBD. Depending on your IBD history and severity, it may be beneficial to hire a high-risk maternal-fetal gynecologist, colorectal surgeon, pharmacist, IBD nurse, psychologist, or dietitian as part of your care team. .
What should you do before you start trying to conceive or become pregnant?
It is recommended to take vitamin and folic acid supplements before birth. Vitamin D deficiency is common in inflammatory bowel disease, and your doctor may recommend taking supplements if your levels are low. It’s also important to stay up-to-date on vaccines and review your medication list with your doctor.
Should I change my treatment before conception or pregnancy?
Many IBD drugs Has a favorable safety profile During and during pregnancy. However, some medications can affect fertility (such as decreasing sperm count) and may not be safe to continue during pregnancy. For example, it is generally recommended to stop taking the drug methotrexate three months before pregnancy.
Research into the safety of IBD treatments continues as new drugs are developed. It is important to discuss any medications you are taking and any concerns you may have during your pregnancy planning period.
How will I be monitored during pregnancy?
Your gastroenterologist will closely monitor your symptoms before, during, and after pregnancy. You may be asked to provide a stool sample to assess your stool calprotectin levels (a marker of inflammation measured in the stool). This will help the doctor monitor her IBD activity before pregnancy and during each trimester of pregnancy.
Drug levels of certain IBD medications may also be monitored through blood tests to ensure proper drug administration. Monitoring and management of her IBD during pregnancy is individualized for each patient, and the goal is to increase the likelihood of a healthy outcome for both mom and baby.
What should I do if IBD comes back during pregnancy?
During an IBD flare-up during pregnancy, the goal is to quickly reduce inflammation and optimize the IBD treatment plan to avoid complications for mom and baby. This may include monitoring drug levels, adjusting drug doses, or switching drug types. In some cases, a short course of steroid medication may be necessary.
If blood tests show iron deficiency anemia (which can be caused by inflammation of the gastrointestinal tract, but can also occur during pregnancy due to increased iron requirements for the baby), oral or intravenous You can improve your blood by using iron supplements within. Count.
What shipping options are available?
Most people with IBD are able to give birth any way they wish.You may decide to give birth vaginally or by caesarean section. Depends on the patient’s medical history. If the patient has Crohn’s disease and active perianal disease, a caesarean section may be recommended. This is because active perianal disease increases the risk of severe tears and trauma to the perineal area (the area around the anus and vagina).
Patients with a history of steroid exposure or bone complications (such as osteoporosis) may want to avoid straining during vaginal delivery. A caesarean section may also be recommended if there are significant risk factors, such as perineal damage or obstetric complications unrelated to Crohn’s disease or ulcerative colitis.
What happens after giving birth?
It is important to continue IBD treatment after giving birth. Approximately one-third of patients will have a flare-up of their IBD within a year after giving birth. Patients with poorly controlled IBD during late pregnancy or during treatment de-escalation (drug reduction) during or after pregnancy are at highest risk for postpartum relapse. For this reason, it is important to continue close follow-up with her IBD doctor during this period.
Can I breastfeed or breastfeed?
Breastfeeding/breastfeeding It has many benefits for both the person and the baby after giving birth. Many IBD treatments have a favorable safety profile for breastfeeding/breastfeeding. Some new biologics have not yet been fully studied. Your doctor will discuss the risks and benefits of individualized her IBD treatment so that both your treatment plan and breastfeeding goals are optimized.
Will my baby have IBD?
Although IBD has a genetic component, the risk of IBD to biological children of people with IBD is usually low. First-degree relatives (particularly siblings) of people with IBD are at increased risk for Crohn’s disease and ulcerative colitis.
conclusion
It’s important to discuss your family planning goals with your doctor early. That way, your doctor can focus on optimizing your health and achieving remission before pregnancy. Fortunately, many IBD medications are considered safe and effective during, during, and after pregnancy. During pregnancy, proactive monitoring and early treatment of recurrence are essential. Every pregnancy is different. Close communication with your medical team is important to keep you and your developing baby healthy.