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Pregnant and stopped IBS medication with flare up of symptoms

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Hi Doctor

My name is Edgar and my wife is 7 weeks pregnant. We are concerned about the well-being of our child and the medications that have been suggested

My wife is suffering from chronic IBS over many years and was on medication and antidepressants from various doctors, which have kept things under control (MEDICATIONS: Complete td, Lonazep, Longifene, Pariet, Librocol). However due to the discovery of her pregnancy, all these medications were immediately asked to be stopped.

Within a few days the IBS symptoms flared up and she was suffering from abdominal cramps and pain, loss of appetite, nausea.

Now the doctors are unsure why the pain is happening, is it due to the pregnancy or is it the IBS, whatever the cause the extreme pain and suffering is causing my wife a lot of hardships

Now the doctors have done some tests (which i am subsequently uploading) to check for urine infections, they have also done two scans (due to the constant pain my wife was suffering from) I have attached those reports too

The doctor has put my wife on the following medication

1. Duphaston 10 mg 1-0-1 for hormones and save pregnancy
2. Folic acid 0-0-1
3. Zantac 1-0-1 antacid
4. Scopinal painkiller as and when needed

Now the most important aspect of all of this is the doctor believes that my wife should take a PRIMOLUT DEPO injection. Now here is my major concern, i am unsure if this injection is necessary or important, but the doctor says it may / will help with the pain. Can you please advice if this is true and if this injection is safe to take?

Also, my wife is unable to sleep well, and now is starting to suffer from a lot of anxiety due to the constant pain (the pains currently on the left side of her stomach)

Additional Conditions:

My wife does not have any vaginal bleeding

Pinching pain which comes and subsides and comes again

She constantly feels the onset of periods

Her last period was on the 11th of August 2013

Please advice the road ahead and what is the best course of action for her?

Category: OBGYN

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Category: Infertility Specialist
 23 Doctors Online

Hello Edgar
Thanks for writing to us with your health concern.
IBS is underlined by basic anxiety and depression which contribute greatly to the symptoms of IBS.
Pregnancy in itself is a condition of increased stress for women, due to hormonal effects, and hence many women undergo worsening of IBS symptoms during this phase.
As you rightly pointed out, most of the medications used to treat the condition are contraindicated due to adverse fetal effects.
I have gone through your reports.
The ultrasound scan is perfectly normal.
I would recommend an internal ( vaginal ) examination by an obstetrician as that would easily tell you if the pain is due to pregnancy related complications like an impending miscarriage.
In that case, the cervix ( mouth of the uterus ) would be shortened in length and would be dilated and loosened.
Since your wife does not have any spotting / bleeding and the pain is characteristically that associated with IBS, I suspect that it is indeed a flare up of IBS as opposed to pregnancy related event.
The mainstay of therapy for your wife is - to consult a good psychiatrist and undergo behavioural therapy, deep breathing exercises and relaxational techniques.
There is no scope for antidepressant and anti anxiety drugs during pregnancy.
Yoga / meditation / mild exercise will also benefit your wife.
The medications sound all fine.
Duphaston contains progesterone which will support the growing pregnancy , and Primolut Depo injections also contain progesterone in oil.
Some kind of progesterone is essential in your case to reduce risk of miscarriage as well as reduce any pain which might be due to subtle undetected uterine contractions.
There is no need of taking Primolut depo injection in my opinion, as you are already taking progesterone in duphaston.
Primolut Depo injections are based in oil and are extremely painful ( the injection site itself will cause pain and thrombosis and lump formation, risk of abscess etc ).
Hence your apprehension is justified, and you can go ahead and tell your treating doctor that progesterone has already been supplemented in your case via duphaston.
One word of caution, though.
Duphaston is banned in the US, UK and Canada - risk of fetal birth defects exist with its use in pregnancy.
The safest and most preferred progesterone preparation is vaginal natural micronized progesterone suppositories ( oral progesterone also causes side effects such as dizziness, nausea, drowsiness ).
Many excellent brands of natural micronized progesterone are available, such as Susten , Neogest, Microgest, Gestone etc.
Newer vaginal progesterone gels are also available ( Crinone gel, Susten gel ) which are easy to use vaginally and have excellent results with no side effects.
I hope this answer helped you
Please feel free to discuss the issue further with me anytime.
All the best with your pregnancy, Edgar and Namitha.
Take care.


As a postscript, dietary modification is a big component of managing pregnancy and IBS both.
Eat small frequent meals instead of binge eating twice or thrice a day.
Take lots of liquids such as soups, juices, dal, buttermilk, coconut water, water etc.
Stick to fresh, non spicy, non greasy home made food.
Avoid eating outside.
Avoid gas forming foods like cabbage, broccoli, rajma , chana, leftover food kept in the refrigerator, beans etc.
Take lots of natural digestives like saunf , zeera, heeng etc in your food.
All the best.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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