West L, Warren J, Cutts T
Department of Internal Medicine, University of Tennessee, Memphis.
Gastroenterol Clin North Am. 1992 Dec;21(4):793-802.
Irritable bowel syndrome, constipation, and diarrhea may complicate a pregnancy. Complaints of IBS and constipation may be managed by nonpharmaceutical methods. A careful history should be conducted to determine whether these complaints are of an acute or a long-standing nature. Conservative treatment of IBS is recommended and may include stool-bulking agents, a high-fiber diet, elimination of offensive foods, and the behavioral treatment of passive muscle relaxation, biofeedback or supportive psychotherapy. Constipation is generally self-limiting. It also may be treated conservatively with stool-bulking agents, increases in dietary fiber, and the addition of pelvic muscle exercises, preferably using electromyographic biofeedback. Laxatives should be used judiciously (Table 1). Diarrhea is caused most often by infectious agents in pregnancy but may also be from food poisoning or a viral disease. Infectious diarrhea may be treated by mild antidiarrheal agents and safe antibiotics. Fluid replacement is the mainstay of treatment, and care should be taken, remembering that the treatment involves two patients. These complaints can generally be managed conservatively, but persistent cases should be investigated as in a nonpregnant patient.
肠易激综合征、便秘和腹泻可能会使妊娠复杂化。肠易激综合征和便秘的症状可以通过非药物方法进行处理。应详细询问病史，以确定这些症状是急性的还是长期存在的。推荐对肠易激综合征进行保守治疗，可能包括使用大便膨松剂、高纤维饮食、避免食用刺激性食物，以及采用被动肌肉放松、生物反馈或支持性心理治疗等行为疗法。便秘通常会自行缓解。也可采用保守治疗，使用大便膨松剂、增加膳食纤维摄入，并增加盆腔肌肉锻炼，最好采用肌电图生物反馈法。应谨慎使用泻药（表1）。腹泻在孕期最常见的原因是感染因素，但也可能由食物中毒或病毒感染引起。感染性腹泻可使用温和的止泻药和安全的抗生素进行治疗。补液是治疗的主要方法，要注意治疗涉及两名患者。这些症状通常可以通过保守治疗得到控制，但对于持续存在的病例，应像对非妊娠患者一样进行检查。
