Pregnancy and inflammatory bowel disease
Women with IBD (ulcerative colitis and Crohn’s disease) who want to become pregnant should firstly discuss this with their gastroenterologist primarily to ensure that the drugs you are taking are safe during pregnancy (most are). Additionally it is important to make sure that your disease is under control (in remission) and to continue your IBD drugs throughout the pregnancy to ensure that you stay well.
In women who become pregnant whilst their disease is in remission only about one-third will relapse. Whereas in those who become pregnant with active disease two-thirds will have continuing active disease and two-thirds of these patients will get worse. Some studies have reported that in patients with active disease up to one-third of women will have a miscarriage. In those where the disease is in remission
It is important to appreciate that during pregnancy the biggest risk to the baby is active disease (which in itself may even mean that surgery is needed) and stopping your medicines may make you more likely to develop active disease (most IBD medicines are safe during pregnancy).
The following advice is based on the European Crohn’s and Colitis organisation (ECCO) guidelines.
Drugs that CANNOT be taken during pregnancy
-Metronidazole (SAFE after the first 12 weeks)
Drugs which should ideally be avoided
Drugs that are safe to take during pregnancy
-5-ASA drugs (Asacol, Ipacol, Mezavant, Pentasa, Octasa, Salofalk)
-Infliximab (generally best avoided in the last few weeks before giving birth)
Drugs that cannot be taken during breast feeding
Flexible sigmoidoscopy is considered safe during pregnancy, colonoscopy should be avoided unless absolutely necessary.