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Pregnancy and partial obstruction

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Crohn's Disease
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Posted 10/1/2007 9:41 PM (GMT 0)
Hello everyone. I am 8 weeks pregnant with my first pregnancy and have Crohns Disease. I have had two Small Bowel Ressections in the past. Last week I started getting really bad painful stomach distension, which in the past for me has been a sign of a bowel obstruction. My doctor put me on ensure for last week and soft foods this week. So far, all the distension is gone. I am wondering if anyone had a similar experience and what the outcome was of the pregnancy. The doctor wants me to have blood work/ultrasound at the end of the week and then discuss treatment options. Currently I'm on Pentasa-got off Immuran, neither seem to work for me. I am concerned about taking Prenizone during the first trimester. Any suggestions? THANKS!!!
Posted 10/3/2007 7:12 PM (GMT 0)
Hi Emmy,


I'm new here but not new to CD.  I was diagnosed in 1995 and have had 3 surgeries so far.

I have two daughters (DD#1 born 12/2004 and DD#2 born 10/2006) and I was on prednisone through my entire first pregnancy and the last half of my second.  Both girls were early (5-6weeks), but healthy.  Not sure if they were premature due to the CD, the pred, or other reasons.  I believe prednisone can increase your chances of gestational diabetes - I was told this during my second pregnancy.

I also had problems with obstruction-like symptoms around week 20-22 of my second pregnancy.  I was hospitalized due to dehydration and found out that bowel spasms were causing many of my symptoms.  With meds the spasms are now under-control.

I just wanted to post to let you know that predisone is ok to use during pregnancy.

Good luck!

Posted 10/3/2007 7:22 PM (GMT 0)
What dosage were you on? What was the weight of your babies? Did either of your daughters end up with clef palate? How was recovery in terms of your Crohns afterwards? Have you had any miscarriages? Did you seee a high risk OB with both pregnancy and what was there knowledge regarding Crohns? Were you able to stay off medicationafter pregnancy? What were the signs of your obstruction? Have you felt healthier since pregnancy than before? Have you ever heard that there is  correlation between having an odd amount of pregnanies and your Crohns going into remission? Thanks!!!!!!!! -Emily


Post Edited (EmmyT) : 10/3/2007 1:39:02 PM (GMT-6)

Posted 10/3/2007 7:42 PM (GMT 0)
Daughter #1 was born at 34 wks 3 days and weighed 5lbs 3oz.  I was on approximately 30-35mg throughout the entire pregnancy - tried to taper but was unsuccessful.  No cleft palate.  Only trouble was jaundice (4-5 days under the bilirubin lights) and too sleepy to eat which meant for 12 days in the NICU sad    She was exclusively breastfed once she came home and has grown wonderfully!  She is almost three and you would never know she was premature.

Daughter #2 was born at 34 wks 6 days and weighed 6lbs 13oz!  I know a BIG preemie.  Didn't start prednisone until I was hospitalized at 20-22 wks.  I think I was on 35-40mg that time.  No cleft palate.  Again we had to deal with jaundice, but she was delivered at a different hospital and only spent maybe an hour in the NICU for observation and went home 4 days after delivery due to jaundice.  Because of the different hospital we (her father and I) were able to stay with her in a non-patient room - can't remember what they called it, but because I was breastfeeding they allowed us to stay with her the entire time.  She did come home with a bili-blanket for the jaundice, but that was only needed for few days.  She is turning one on Monday and is very healthy!

I'm proud to say that both girls were born vaginally.  Because I had to switch OBs mid-pregnancy with D#2 I had to deliver at another hospital.  There was a lot of pressure for me to have a cesarean with my second daughter at the new location.  My persistance prevailed and she was delivered vaginally.  No CD related complications with either delivery.

There are alot of meds that the GI docs will outright say are not safe for breastfeeding or pregnancy.  Whether or not you plan to breastfeed, if you question any of the meds you're prescribed I would suggest you contact a lactation consultant.  I believe most hospitals employ at least one.  My 'new' hospital has a wonderful group of ladies.  They have the latest information on meds that are safe for moms and their babies.

Good luck!

Posted 10/3/2007 7:56 PM (GMT 0)

Ok I see you add some questions while I was replying :)

I had one early miscarriage (9wks) before either of my daughters were born.

I would have to say my CD symptoms were unchanged during my first pregnancy.  I saw a regular OB and they did not classify me as high-risk.  My pregnancy was uneventful until my water broke at 34 wks.  I don't recall a problem post-delivery.  However, I did have a terrible stricture in my sigmoid when D#1 was 10mos old and had my colon removed - small bowel was attached to my rectum.

When I was 20+weeks pregnant with D#2, I was having horrible spasms/pain.  At times I could hardly control my bowels and at others I couldn't go for anything.  I could hardly eat/drink because I felt so sick.  Went for my first visit with a new midwife and she recognized how ill I was and sent me to the ER.  Obviously no one wanted to touch me because I was pregnant.  Ended up having a sigmoidoscopy and they essentially found minimal inflamation and diagnosed me with anal stenosis.  I think the scope helped dialate my anus and I was much better.  They put me on hyoscyamine to control the spasms - I'm still on it now.

After my hospitalization I was seen by the high-risk OBs.  Multiple ultrasounds to monitor baby's growth.  Essentially it was another uneventful pregnancy (baby-wise) until my water broke at 34 wks 5days.

My CD doesn't appear to be phased by pregnancy.  I stayed on meds throughout pregnancy #1 and the last half of the second (I had a lapse in care and was off meds for the first half - old GI doc's fault (long story) mad ).  I should mention that when my second daughter was almost 3mos I was hospitalized for an obstruction due to adhesions.  It took them two weeks to figure this all out and I ended up with another surgery in January of this year.

I'm currently on a long list of meds due to a fistula I currently have :P

gotta go for now, but I'll be back later.

Posted 10/3/2007 11:46 PM (GMT 0)

Was the jaundice a side effect of the prednizone? Did the doctor feel your early delivery was? I am having simlar symptoms where my stomach is incredibly distended and painful and today I went to the bathroom like 6 times so far (it's 4pm) and the last two days I didn't go at all. I feel anxious because low birth weight already runs in my family (my mom's biggest baby was just over 5 lbs and we were all three full term). Have you heard about anything with odd numbers of children?

Thank you so much for your response. Other people have tried to tell me about their experiences, but it seems to be people who have always been stable and who haven't had surgery, strictures, etc... So it doesn't feel like it applies!!!

-Emily

Posted 10/4/2007 2:27 AM (GMT 0)
First, congrats!!!

My pregnancy was very very very hard. I had so many problems, it was unbelievable. My child was born healthy, and still is after a few years now.

During my pregnancy because of all the problems I had, i rested all the time, didn't go for long walks, didn't do ANY major housework or laundry. I was on prednisone and pentasa and I ate the EXACT same thing EVERYDAY for almost the entire pregnancy! My eating habits were the most important.

My suggestion to you is first, go on a soft food diet that consists of cooked and well PUREED veggies, fruits, meats and fish (don't eat pork). You can add unheated/unpasteurized honey, real butter, natural spices and sea salt, and olive oil. This is all at the local grocery store.

Mashed/pureed sweet potatoe is very good for inflammation. So are berries, but you must watch the skins and puree them well because of your obstruction. Drink camomile tea, it is also very helpful. Make sure it is safe for pregnancy, tho. Ask your doc.

Cut out all sugar and flour products and processed food with chemicals. I also suggest you try sprouted grain breads, they are easier to digest than every other type of bread, but I do not suggest you eat alot of grains while you are obstructed.

The idea about the diet is to eat as naturally as possible. Processed/fast foods, sugar, white flours should be stopped completely.

Don't overeat and chew your food until it is complete mush.

I wish you the absolute best!
Roni.
Posted 10/4/2007 3:13 AM (GMT 0)
I believe jaundice is common in general and more so in preemies.  I know that I was jaundiced at birth and I was full-term weighing 8+lbs.  I don't think that the prednisone has any effect on that but I'm no doctor.  I do have a local girlfriend with CD and she has two daughters as well and they were both born 4-5 weeks early.  Not sure if they were jaundice because I believe they were discharged with their mom.  I also think she was on steroids (not certain) - maybe budesinide/entocort?

I've never heard anything about an odd number of pregnancies easing the symptoms of CD.  It didn't work for me unless it only counts successful pregnancies and doesn't include miscarriages. 

My husband and I would like one more baby and if I had my way we would be trying in the next few months.  Not sure that it will happen though due to a complex fistula that recently surfaced.  This is my first one and I need to ask my GI more about this.

I will say one more thing, about birth weight... I gained 30 lbs with my first pregnancy and baby was 5lbs 3oz.  With my second pregnancy, I gained, then lost (more than I'd gained), then gained some more... just trying to point out that I started out losing weight and still ended up with a good sized baby.  I think you can look at your birth weight and the father's birth weight to help get an idea on baby's potential birth weight.  That may be an old wives tale, but I'm not sure. :)  I also wondered about the effects of the prednisone and birth weight and I was told that the prednisone wouldn't effect the baby in a way that it would cause it to gain extra weight.  Rather by causing the mother to want to eat more it will allow the baby to grow more - so indirectly it can have an effect on growth.

that's all I have for now... it's late

Posted 10/4/2007 11:20 PM (GMT 0)
Thank you both for your responses. Will see the dtr on Tues and discuss it. Thanks again! -Em

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