Similarities Between Ulcerative Colitis and Pregnancy

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What is Ulcerative Colitis?

Ulcerative colitis is a type of inflammatory bowel disease that occurs when there is an abnormal activity of the mucosal immune system response resulting in chronic inflammations of the large intestinal lining. Unlike the other type (Crohn’s disease) of inflammatory bowel disease (IBD), ulcerative colitis may affect only the rectum-a condition known as proctitis or can also spread to the colon- a condition known as pancolitis. 

Ulcerative colitis has a distinctive pattern of activity known as remission (this is a period when the disease disappears) and relapse (a period when the disease reappears) of the mucosal inflammation. 

Ulcerative colitis symptoms usually differ from individual to individual and it may depend on the severity of the disease. The symptoms may include

  • Passing out blood with the stool
  • Diarrhea 
  • Abdominal cramp/pain
  • Tenesmus incontinence
  • Rectal pain

The cause of the disease could be said to be multifactorial as there has been no conclusive research to ascertain its primary cause. The multifactorial causes could be a result of the genetic predisposition of the patient, epithelial barrier defects, abnormal immune response-the immune cells overreacting or even attacking the intestinal lining, microbiome imbalance, or environmental factors.

Several pathways can be used by medical practitioners in the diagnosis of ulcerative colitis. Evaluation of the different clinical manifestations, laboratory results (blood test, stool test), endoscopy.

What is Pregnancy?

Pregnancy is the process of carrying a developing fetus that has been implanted in the uterus. Fertilization is the first step in the pregnancy process and it occurs during conception when an egg(s) and sperm(s) join together to form a single cell (or double cell in the case of twins) in the fallopian tube

Pregnancy periods can be divided into 3 stages/ trimesters and they can last up to 40 weeks when it is counted from a woman’s first day of a normal mensuration period.

Signs and symptoms of pregnancy

Pregnancy signs and symptoms may include;

  • Nausea which may or may not trigger vomiting
  • Breast tenderness and enlargement
  • Increased frequency of urination
  • Amenorrhea
  • Fatigue 


Several methods can be used to clinically ascertain if the signs and symptoms being experienced are an indication of pregnancy or any other medical condition. They include;

  • Serum pregnancy test
  • Beta-human chorionic gonadotropin (beta-HCG) test
  • Sonography 
  • Fetal heart tones

Pregnancy complications 

Pregnancy complications arehealth that may affect maternal or fetal health during pregnancy. They include;

  • Ectopic pregnancy
  • Miscarriage 
  • Preterm birth
  • Gestational diabetes
  • Anemia
  • Preeclampsia
  • High blood pressure
  • Ulcerative colitis(active case)
  • Urinary tract infections (UTIs)  

Similarities between ulcerative colitis and pregnancy

Iron-deficiency anemia

Iron deficiency anemia is the most common manifestation in both ulcerative colitis and pregnancy. 

Method of detection 

Both ulcerative colitis and pregnancy can be detected through ultrasound and blood tests.

Diet restriction

Avoidance of fatty food is usually one of the steps adopted for patients managing ulcerative colitis and also for a pregnant woman having issues with frequent nausea and vomiting (Hyperemesis Gravidarum), especially after the second and third trimesters. 

Frequently Asked Questions

How does pregnancy affect ulcerative colitis?

  • For some women without an initial diagnosis of ulcerative colitis, the onset of pregnancy can trigger the incidence of ulcerative colitis. 

What can be mistaken as ulcerative colitis?

Can pregnancy cause flare-up ulcerative colitis?

  • Yes, pregnancy can cause a flare-up of ulcerative colitis even when the patient has had a normal endoscopy result before the onset of pregnancy.

Is ulcerative colitis considered a high-risk pregnancy?

  • Yes, pregnancy with an active case of Ulcerative colitis has a higher risk of causing complications like premature childbirth, miscarriage, and also delivery of an infant with low-birth weight than those without ulcerative colitis disease.

What are 3 common complications of someone with ulcerative colitis?

  • Anemia
  • Colorectal cancer (especially when inflammation is left untreated for a long time)
  • Bone and joint problems

What gender is most affected by ulcerative colitis?

  • The disease affects both males and females equally before the age of 45 but from the age of 45 and above, the risk of developing ulcerative colitis is more associated with males than females.

Author: Jessica Damian

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References :

+ Rubin, D. T., Ananthakrishnan, A. N., Siegel, C. A., Sauer, B. G., & Long, M. D. (2019). ACG clinical guideline: ulcerative colitis in adults. Official journal of the American College of Gastroenterology| ACG, 114(3), 384-413.

+ Mahadevan, U. (2021). Overview of pregnancy in patients with inflammatory bowel disease. Gastroenterology & Hepatology, 17(2), 73.

+ Irwin M. Suzanne R. Rosenthal. (2015). Fact Sheet: Pregnancy. IBD Resource

+ Gomes, C. F., Sousa, M., Lourenço, I., Martins, D., & Torres, J. (2018). Gastrointestinal diseases during pregnancy: what does the gastroenterologist need to know? Annals of gastroenterology, 31(4), 385.

+ American College of Obstetricians and Gynecologists (ACOG). (2020). Patient education: How your fetus grows during pregnancy.

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+ Bernstein H.B., & VanBuren G (2013). Chapter 6. normal pregnancy and prenatal care. DeCherney A.H., & Nathan L, & Laufer N, & Roman A.S.(Eds.), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e. McGraw Hill.§ionid=41008595

+ Rustgi, S. D., Kayal, M., & Shah, S. C. (2020). Sex-based differences in inflammatory bowel diseases: a review. Therapeutic advances in gastroenterology, 13, 1756284820915043.

+ Manser, C. N., Borovicka, J., Seibold, F., Vavricka, S. R., Lakatos, P. L., Fried, M., Rogler, G., & investigators of the Swiss Inflammatory Bowel Disease Cohort Study (2016). Risk factors for complications in patients with ulcerative colitis. United European gastroenterology journal, 4(2), 281–287.

+ Keshteli, A. H., Madsen, K. L., & Dieleman, L. A. (2019). Diet in the pathogenesis and management of ulcerative colitis; a review of randomized controlled dietary interventions. Nutrients, 11(7), 1498.


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