Digestive system - The minor disorders of pregnancy

The minor disorders of pregnancy

These are conditions in pregnancy that are not threat to life but can distress the woman, making life miserable and undermine her health. Even if they can not endanger life, they should not be ignored or treated lightly. They can interfere with nutrition, sleep, outdoor recreation and normal household cores. These conditions should not be accepted as a normal associate of pregnancy but should be treated and alleviated. Minor disorder may escalate and become a serious complication of pregnancy.

The role of the midwife is to health educate the woman in order to tolerate the changes in pregnancy and her anxiety will be alleviated.

Causes can be due to hormonal, accommodation, metabolic and postural changes. Every system of the body changes and is affected by pregnancy.

Digestive system

Nausea and vomiting – (Morning Sickness)

This condition is very common in pregnancy. It occurs between 4 – 16^th weeks gestation in about 50% of all pregnant women. It is associated with high level of oestrogen and progesterone, hypoglycaemia may also be a contributor. It is most marked when the woman wakes up in the morning though it can occur at any time of the day. It is more of retching rather than actual vomiting and may be aggravated by the smell of food.

Treatment

·              Understanding of the cause, and encouragement to look positively towards resolution of the problem between 12 – 16 weeks of gestation.

·              Snacks like dry biscuits, toast etc are more tolerable than full meals, expecially carbohydrate snacks at bed time and before rising up from bed with a cup of tea.

·              Avoidance of food which irritates, – fatty food.

·              Easily digestible foods.

·              Getting up slowly from bed.

·              Take spices that can clear mouth – cola chewing st ick etc can refresh the mouth, a void starvation and dehydration. Avoid self medication as this can be very hazardous to the fetus. Rule out other conditions that have similar symptoms appendicitis close monitoring to ensure it does n ot become severe. Solve emotional problems

·              Involve the husband in care of the woman.

Heart burn

This is a burning sensation in the intestinal region. It is due to reflux of gastric content into the oesophagus, resulting from relaxing effect of progesterone on the cardiac sphincter of the stomach. Heart burn can be very troublesome between 30-40 weeks gestation because the stomach is under pressure from the growing uterus.

Treatment

Depends on the severity of the condition. Avoid rushing over meal, small at a time rest after meal. Take less fatty and greasy food. Avoid bending over for too long. Sleep with extra pillows. Lie on the right side. Severe cases – Refer Dr. who will prescribe Antacides – Mist Magnissium Trislicate(MMT), Gelusi l.

Constipation

Progesterone causes relaxation and decreased peristalsis of the gut, which is also displaced by the growing uterus. It may be very troublesome in pregnancy.

Treatment:

Increased fluid intake.

Fresh fruits, vegetable and whole meal food in diet aid digestion. Exercises also aid digestion. A glass of warm water in the morning helps to reactivate and regulate bowel movement. Mild aperients as last result in severe cases.

Ptyalism (Excessive Salivation))

Excessive salivation may occur from the 8^th week’ gestation. It is thought to be caused by pregnancy hormones. It may prove distressful to the woman. It coincides with time of morning sickness. The woman spit the saliva instead of swallowing it. The condition may reoccur with subsequent pregnancies psychological factors may be contributory.

Treatment

Explanation and attentive listening are helpful treatment.

Pica

This term is used when mother craves for certain strange foods or unusual substances such as coal, chalk, Petrol etc. the cause is unknown but hormones and changes in metabolic imbalance may not be unconnected. Midwife needs to health educate the woman as the substance craved for may be potentially harmful to the unborn baby.