Gastrointestinal Issues After Pregnancy: A Comprehensive Guide

Q: Gastrointestinal Issues After Pregnancy: A Comprehensive Guide

Dear Minishiuan： Your condition is relatively complex. <br>Generally, diverticulitis may lead to your current symptoms; of course, a pelvic infection combined with mild peritonitis can also present in this manner. <br>It is advisable for you to seek evaluation from a gastroentero

Gastrointestinal issues

Hello, doctor.
I gave birth to my baby last December and have been supplementing during my confinement period.
One night, I had stomach pain after drinking chicken soup before bed.
After taking probiotics, I felt fine! However, after the confinement period, I started passing gas excessively.
For about 3-5 days, after taking probiotics for two consecutive days, I had two bowel movements with very dark brown, hard stools.
After that, the front part of my stool became hard while the end was soft.
Then, because I was breastfeeding, I drank sesame oil chicken soup one day for nourishment, which led to abdominal pain and fresh blood on the toilet paper after wiping.
I went for a colonoscopy, and the doctor said I had intestinal degeneration, diverticula, and many polyps.
However, the pain in my upper right abdomen has not improved.
During this time, my stools have been deep brown and soft (with a sour smell).
Initially, I would have a bowel movement once a day, but now it has increased to 2-3 times a day.
Every morning, I eat sweet potato porridge and drink a mix of brown rice, oats, sesame, and red quinoa to support my gut health! However, the color of my stools has not improved.
I also feel an urgent need to have a bowel movement every morning, and the stools remain deep brown and soft.
Later, I had an abdominal ultrasound (the doctor said it was normal).
The pain in my upper right abdomen comes and goes, sometimes with tenderness, but it doesn’t hurt when not pressed.
Therefore, I went for an upper endoscopy (the doctor said I have gastroesophageal reflux, and everything else was normal.
I was prescribed pantoprazole and bisacodyl).
Additionally, I have noticed that I feel acid reflux and nausea when fasting.
My stools are still deep brown and soft (with a sour smell), occasionally normal yellow, but I still go to the bathroom 2-3 times a day.
Plus, I have fixed-point tenderness in my upper right abdomen, and recently, the pain has started in my upper left abdomen as well (I also have a protruding belly button postpartum and some abdominal distension).
I recently visited an obstetrician-gynecologist and was diagnosed with pelvic infection and vaginal pain.
I have been taking antibiotics and using vaginal suppositories! Since the end of April, I have had pain near the lower ribs on both sides close to my belly button.
Around May 1st, the pain moved to the upper left rib area...
This has been happening for the past few days! Additionally, I still have 2-3 soft bowel movements daily, with stool colors ranging from deep brown to occasional yellow, sometimes with mucus.
Could you please help me understand what might be wrong? I'm really confused.
Thank you very much!

MINISHIUAN, 30~39 year old female. Ask Date: 2017/05/04

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Dear Minishiuan: Your condition is relatively complex.
Generally, diverticulitis may lead to your current symptoms; of course, a pelvic infection combined with mild peritonitis can also present in this manner.
It is advisable for you to seek evaluation from a gastroenterologist at a nearby hospital, as this would be safer and more likely to resolve your issues.
Changhua Hospital cares about your health.

Reply Date: 2017/05/04

More Info

After giving birth, many women experience gastrointestinal issues that can be quite distressing. Your symptoms, including abdominal pain, changes in bowel habits, and the presence of blood in your stool, warrant careful consideration and management. Here’s a comprehensive guide to understanding these issues and potential solutions.

Understanding Your Symptoms
1. Bowel Changes: It’s not uncommon for postpartum women to experience changes in bowel habits. The frequency of bowel movements can increase, and the consistency can vary from hard to soft stools. The presence of deep coffee-colored stools may indicate the presence of bile or could be related to dietary changes, particularly if you have been consuming rich or fatty foods.

2. Abdominal Pain: The pain you’re experiencing, especially if it is localized to the right upper abdomen, could be related to several factors. It might be due to gastrointestinal issues such as gastritis or gastroesophageal reflux disease (GERD), which you mentioned was diagnosed during your endoscopy. The pain could also be related to the healing process after childbirth, especially if you had a cesarean section or significant tearing during delivery.

3. Blood in Stool: The presence of fresh blood on toilet paper can be alarming. It could be due to hemorrhoids, which are common postpartum, or it could indicate more serious conditions such as anal fissures or even diverticular disease, especially given your mention of diverticula. It’s essential to monitor this symptom closely.

4. Dietary Factors: Your diet plays a crucial role in your gastrointestinal health. The consumption of rich foods, especially during the postpartum period when you might be focusing on recovery, can lead to digestive discomfort. Foods that are high in fat or fiber can sometimes cause gas and bloating, which may explain the increased flatulence you’re experiencing.

5. Infections and Inflammation: The pelvic infection you mentioned could also contribute to your abdominal pain and discomfort. Infections can lead to inflammation in the gastrointestinal tract, potentially exacerbating symptoms like diarrhea or constipation.

Recommendations for Management
1. Dietary Adjustments: Consider keeping a food diary to identify any specific foods that may trigger your symptoms. Focus on a balanced diet rich in fruits, vegetables, whole grains, and lean proteins. Avoid overly rich, spicy, or greasy foods that could exacerbate your symptoms. Staying hydrated is also crucial, especially if you are breastfeeding.

2. Probiotics: Since you’ve had some relief with probiotics, continuing to incorporate them into your diet may help restore a healthy balance of gut bacteria. Look for high-quality probiotic supplements or fermented foods like yogurt, kefir, and sauerkraut.

3. Regular Check-ups: Given your complex symptoms, it’s vital to maintain regular follow-ups with your healthcare provider. If your symptoms persist or worsen, further investigations such as imaging studies or additional gastrointestinal evaluations may be necessary.

4. Pain Management: For abdominal pain, over-the-counter medications may provide relief, but consult your doctor before taking any new medications, especially while breastfeeding.
5. Mental Health: Postpartum adjustments can be stressful. If you find that anxiety or stress is contributing to your gastrointestinal symptoms, consider speaking with a mental health professional. Stress management techniques such as mindfulness, yoga, or gentle exercise can also be beneficial.

6. Seek Specialist Care: If your symptoms do not improve, consider consulting a gastroenterologist for a more in-depth evaluation of your gastrointestinal health. They can provide targeted treatments based on your specific condition.

Conclusion
Your gastrointestinal issues postpartum can be multifaceted, involving dietary habits, physical changes after childbirth, and potential infections. It’s essential to work closely with your healthcare providers to monitor your symptoms and adjust your treatment plan as necessary. Remember, your health is paramount, and addressing these issues will not only improve your quality of life but also support your overall well-being as a new mother.

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