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Dealing with Discomforts (part 1) - Managing Morning Sickness, Gastrointestinal Complaints

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1. Managing Morning Sickness

Even though that nagging feeling of nausea (and the vomiting that sometimes accompanies it) is commonly known as “morning sickness,” it can occur at anytime of the day. Morning sickness is a very normal part of pregnancy, and its severity differs from woman to woman. It is thought to simply be a side effect of hormonal changes, particularly the pregnancy hormone HCG (human chorionic gonadotropin) and the change in estrogen. A woman’s lifestyle can also affect the severity with which she experiences morning sickness. Women who do not get enough rest or are under more stress may experience more severe morning sickness. Though the experience differs greatly from woman to woman, for most, morning sickness begins in the fifth to sixth week from the first day of the last menstrual period (about the third week of pregnancy). For most women, morning sickness begins to subside at around fourteen to sixteen weeks.

When morning sickness becomes severe, it is called hyperemesis gravidarum. It can cause weight loss, dehydration, ketone production (which is toxic to a fetus), and potassium deficiency. When a woman experiences severe morning sickness, testing may be done to rule out possible health conditions such as gastroenteritis, thyroid disease, cholecystitis (gall bladder), pancreatitis, hepatitis, ulcer, kidney disease, and fatty-liver disease as well as obstetric conditions such as multiple births and molar pregnancies. Notify your doctor if your morning sickness becomes severe.

Follow these suggestions to help decrease your symptoms of nausea and vomiting:

• Stay away from foods with strong odors or flavors that may trigger nausea. Women who are pregnant sometimes find that they have an exaggerated sense of smell, which makes common odors seem unappealing.

• Keep your kitchen well ventilated during cooking and meal times.

• Let someone else do the cooking for you.

• Go easy on spicy foods, such as those cooked with pepper, hot chili peppers, and garlic.

• Before getting out of bed in the morning, eat a starchy food such as dry crackers, graham crackers, melba toast, dry toast, pretzels, or dry cereal to help absorb and neutralize stomach acid. Carbohydrate-rich foods can help to slowly elevate your blood-sugar levels and help prevent symptoms of nausea.

• Get up out of bed slowly. Abruptly standing up from a prone position can increase feelings of dizziness and nausea.

• Instead of three large meals, eat five to six small meals or snacks per day every two to three hours. Don’t allow yourself to become hungry. Nibble on carbohydrate-rich foods such as crackers, dry cereal, pretzels, and rice cakes.

• Drink beverages between meals, not with meals, and stay well hydrated.

• Limit fried, greasy, and other high-fat foods that may be hard to digest. Stick to easy-to-digest foods such as plain pasta, potatoes, rice, fruits, vegetables, lean meats, fish, poultry, and eggs.

• Eat your meals and snacks slowly.

• Before going to bed at night, eat a light snack such as peanut butter on bread and a glass of milk, yogurt, or cereal.

• Try beverages that may help settle a queasy stomach such as lemon or ginger tea, ginger ale, lemonade, peppermint tea, or water with a slice of lemon. Experiment with beverages. Some women do better with hot liquids, while others do better with cold.

• Choose foods that agree with you, and stay away from those that don’t. Even if they aren’t perfectly nutritious, it is better to get something in. If the problem persists, though, and you have a hard time eating nutritious foods for long periods of time, speak to your doctor and a dietitian.

• Take advantage of the times that you do feel good, and eat nutritious foods then, while you have the chance.

• Iron supplements and prenatal vitamins can sometimes intensify nausea. Make sure to take them with food. Do not stop taking them if you find they are adding to your nausea! Speak with your doctor first.

• Some women find relief by sucking on “fireballs,” those intense cinnamon jawbreakers.

• Speak with your family and explain how important their support is for you during this time.

2. Gastrointestinal Complaints

Several gastrointestinal complaints can strike during your pregnancy. Knowing how to deal with them can help to decrease your discomfort. The way you eat and the lifestyle you live can go a long way in relieving some of these problems.

Controlling Constipation

Constipation can be a very common problem during pregnancy. Hormonal changes relax muscles to help accommodate your expanding uterus. In turn, this can slow the action in your intestines and the movement of food through your digestive tract. If you are taking iron from either an iron supplement or a prenatal vitamin, this can also cause constipation. Increased pressure on your intestinal tract as the baby grows can also cause hemorrhoids. Preventing constipation (as much as possible, anyway) can help you to avoid hemorrhoids. Some circumstances, such as hormonal changes and the growing baby, can’t be helped, but there are plenty of dietary and lifestyle changes you can make that will make a difference.

Never discontinue your prescribed supplements. If you feel they are causing constipation or other problems, speak with your doctor before you stop taking them. Your doctor can recommend a different brand, maybe with a stool softener, or break up your iron dosages throughout the day.

A high-fiber diet can help to relieve constipation, but you must drink plenty of fluids or this option can make your constipation worse. Women under fifty should shoot for 25 grams of fiber daily. Make sure you are drinking eight to twelve cups of fluid daily. The majority of your beverages should be water, but you should also include fruit juice and milk in your total fluid intake. Include high-fiber foods to help alleviate your symptoms, such as whole-wheat breads and pastas, high-fiber breakfast cereals, bran, vegetables, fruits, and legumes. Some foods are known to act as natural laxatives, such as prunes, prune juice, and figs; other dried fruits may help as well. It is also essential to be physically active each day. Regular activity can help to stimulate normal bowel function. If nothing seems to help, speak to your doctor about possibly taking a fiber supplement such as bran, Metamucil, or a similar product mixed with water or juice once a day.

Do not use over-the-counter laxatives or stool softeners while you are pregnant to help relieve your constipation unless you have talked to your doctor first. Some may not be safe to use during pregnancy. Before relying on medications to relieve your symptoms, first make sure your diet, fluid intake, and activity level is adequate. Avoid castor oil as a remedy because it can interfere with your body’s ability to absorb some nutrients.

Taming Gas

The same changes in a pregnant woman’s body that cause constipation can also cause excess gassiness. Increase your fiber intake slowly and drink plenty of fluids each day. Increasing fiber too quickly, especially when you are used to a lower-fiber diet, can cause gas and other gastrointestinal problems. Some foods can exacerbate gas problems, such as broccoli, beans, cabbage, onions, cauliflower, and fried foods. Carbonated drinks can also cause problems with gas. All women are different as to what foods they can tolerate, so keep track of what bothers you so that you can cut back on those things.

Oh, the Heartburn

In the beginning stages of pregnancy, heartburn is usually due to hormonal changes. Heartburn has nothing to do with your heart but everything to do with your stomach and esophagus. The irritation you feel and the sour taste in your mouth comes from acidic stomach juices that back up into your esophagus. As your pregnancy progresses, your growing baby puts more and more pressure on your stomach and other digestive organs, which can cause heartburn. Although this problem can happen at any time during your pregnancy, it is more prevalent during the last three months when the baby is rapidly growing.

To help relieve symptoms, take the following steps:

• Eat small, frequent meals throughout the day, every hour or two if possible.

• Avoid known irritants that cause heartburn, such as caffeine, chocolate, highly seasoned foods, high-fat foods, citrus fruits or juices, tomato-based products, and carbonated beverages.

• Keep a food diary to track foods that might be triggering your heartburn. Everyone is different, so what bothers someone else may not bother you.

• Eat slowly and in a relaxed atmosphere.

• Do not lie down right after eating a meal. Instead, remain seated upright for an hour or two after eating. Even better is to walk after you eat to help your gastric juices flow in the right direction.

• Avoid large meals before bedtime.

• Limit fluids with meals, and drink them between meals instead.

• Sleep with your head elevated to help prevent acid backup.

• Wear comfortable, loose-fitting clothing.

• Talk to your doctor before taking any over-the-counter medications, such as antacids. Your doctor can advise you on what is safe to use.

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