Dear Doctor,

Is it normal to be gassy during pregnancy?  I constantly feel bloated, gassy, and sometimes, it is hard to control which can be embarrassing. What causes this? Will it stop eventually?

Hanifah

Dear Hanifah,

Is this your first pregnancy? If not, did you have a similar problem in the previous pregnancy as well?

Flatulence during pregnancy is normal, like morning sickness. It occurs due to the effect of the hormone, progesterone. As pregnancy continues, the body produces more progesterone to support the growing baby. Progesterone also relaxes the muscles, including those of intestines, thus causing gas to build up.  These add up, causing uncomfortable flatulence. This is manifested as a sense of bloating of the abdomen after food, and passing gas after meals. There may be associated burning sensation in the chest, with or without nausea and vomiting. In advanced pregnancy, the growing foetus directly compresses the abdomen internally, thus causing gas.

Carbonated beverages like sodas, alcohol, and fatty food like frites, vegetables like broccoli, beans cabbage, cauliflower, radish, and et cetera, also contribute to a sense of feeling "gassy” during pregnancy.

If one is constipated, it adds to the problem. Some individuals also experience flatulence when stressed. Women who become very anxious during pregnancy usually fall in this category.

If it is the first time to have so much flatulence, it would be prudent to exclude any underlying medical disorder, which can cause digestive disturbances. Diabetes, hypothyroidism, diseases or tumours of intestines, are some of these medical problems which can be diagnosed and treated.

Though causing much discomfort and being embarrassing, it is not a sinister problem. Moreover, it does not affect the in-utero baby in any way. In most of the women who develop this "gas” issue during pregnancy, it subsides after child birth.

Drinking enough water, 8 to 10 glasses per day, helps to prevent constipation by enhancing intestinal motility. It also prevents the stools from become dry, factors that lead to bacterial action on the faecal matter, causing flatulence and uncomfortable bloating sensation in the abdomen.

High fibre food containing fresh green vegetables, citrus fruits can help in this regard. It is also useful to avoid fatty food and sodas. Alcohol is harmful during pregnancy in more than one way, hence, best avoided.

Food should be eaten slowly, taking small bites to avoid "gas”. Because while eating hurriedly or taking big bites, one can swallow air, a factor contributing to flatulence.

It is also important to remain stress free and adopt relaxation techniques. Role of physical exercise is also very important in keeping a pregnant woman comfortable and free from flatulence. Physical exercise should be enjoyable, done regularly and as per the physical ability of the person.

A word of caution here, if during pregnancy one experiences severe persistent bloating, with or without abdominal cramps, nausea, vomiting, or symptoms, it is better to consult in a hospital straight away.

Dr. Rachna   Pande is a  specialist in internal medicine.