The Low FODMAP Diet During Pregnancy

Have you started having different gastrointestinal symptoms and recently become pregnant? 

Are you wondering if it is IBS?  Let’s talk about it. 

Unfortunately, a lot of women experience changes in their gastrointestinal tract (GI tract) during pregnancy. You could have symptoms ranging from nausea, reflux, occasional bloating, constipation, and diarrhea. 

These symptoms can come and go and they can alternate.

One week you may feel constipated and the next you can’t get off the toilet. 

Research has suggested that hormone changes are mainly responsible for these gastrointestinal symptoms as well as intra-abdominal pressure (your baby growing and pushing all your organs around). A review by Moosavi et al. highlights potential factors that are affecting IBS symptoms in pregnancy:

• Luteal hormones - can increase constipation and slow the movement of food through the GI tract
• High progesterone levels- slows movement of food through the GI tract by slowing peristalsis (muscle contractions that move food along in the gut)
• High estrogen levels - affects communication from the brain to the gut - your gut and brain are not communicating as well
• Sex hormones - may increase hypersensitivity in the GI tract- certain foods may cause sensitivities compared to others
• Relaxin - relaxes your muscles to help your body prepare for the delivery of the baby but this also can slow peristalsis leading to constipation or it can weaken your anal muscles leading to diarrhea and uncontrolled bowel movements
• Sex steroids - can affect gut permeability - possibly leading to leaky gut
• Mast cell activation - related to heightened stress it can be associated with increasing or exacerbating IBS symptoms

Currently, there is limited research on diet and treatment for IBS during pregnancy. Most studies exclude pregnant subjects because of safety issues.

However, elimination diets pose a risk due to the increased risk of nutritional deficiencies. Pregnancy is a time when all nutrients are vital for the development of the baby and certain nutrients like folate cannot be avoided. 

If you suspect you have IBS and recently became pregnant it is best to talk with your provider about the management of symptoms but it might be best to hold off on strict diet interventions like the Low FODMAP diet until after the pregnancy. 

If you are already following a Low FODMAP diet and have been able to alter your diet to meet nutritional needs it is safe to continue but make sure to consult with a registered dietitian/nutritionist (RD/RDN) if you have any concerns or questions. They can help make sure you get all the nutrients needed for the proper development of the baby.

Here is a list of several low-risk interventions you may try to help alleviate symptoms:

• Drink plenty of water- at least 64 oz of hydrating fluids per day

• Limit sugar and artificial sweeteners

• Reduce foods that typically cause gas and bloating - beans, broccoli, cabbage, garlic, and onion
• Add probiotic-rich foods to your diet- yogurt, kefir or talk to your provider about adding a daily probiotic to your regimen
• Get regular physical activity to help promote digestion- go on a walk or you can also continue your pre-pregnancy exercise regimen as long as it is safe and clear with your Obstetrician 

_{Moosavi S, Pimentel M, Wong MS, Rezaie A. Irritable bowel syndrome in pregnancy. American Journal of Gastroenterology. 2021;116(3):480-490. doi:10.14309/ajg.0000000000001124} 

These ancient grains are healthy additions to your meal rotation:

Whole Grain Farro (24 oz)

Gluten-Free Amaranth (2.2 lbs)