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Intestinal obstruction and pregnancy

Hi all, I have a beautiful 2-year old daughter, and have been trying to conceive another for about 6 months now. I have CD and have been feeling well for about 6 months with just weekly Humira. I had a surgical consult earlier in the year, but never acted on surgery because I started feeling well.

Now my GI is recommending that I have a bowel resection before pursuing pregnancy. I am confused about this because I have been feeling okay for awhile. I am having MRE next week to see if the area is truly looking better, but I have a feeling he is still going to push me toward surgery

My question is, does anyone know if there is something about pregnancy that actually makes it more likely that you will have an obstruction, even if you are in remission prior?

And has anyone else had a similar experience? I am so frustrated...IBD has already gotten in the way of a lot of things, and now it's interfering with our family planning! I hate it! Plus, I'll be 37 soon, so that is making me nervous, too.
 
Hmmm. That’s a good question. I didn’t get diagnosed with crohn’s until after I had my three children so I didn’t face any decisions about crohn’s and pregnancy. Your guts do get squished a lot during the third trimester. Was the area in question bothering you before you had your first child? Or is your GI just thinking that since you had a consult 6 months ago you should just get it done? Personally I think I’d want to go through a second pregnancy before doing a resection, but it all depends on how you are feeling and how much inflammation/scarring/stricturing you have. Wishing you well for when you have your second child.
 

Lisa

Adminstrator
I would get a second opinion, why would the GI be pushing surgery if you are doing better and he hasn't seen evidence your issues are getting worse?

For many women, me included, I was actually HEALTHIER while pregnant - I did end up flaring after I had my daughter, but during the pregnancy itself I did very well.

I personally would be concerned about recovery time after surgery and trying to conceive - and what a pregnancy could affect with the recovery from surgery....
 
I would get a second opinion as well. It seems that gastro's get nervous when you want to get pregnant. It was that way with my three pregnancies. I had two pregnancies that I was way healthier (crohn's-wise) while pregnant. My third was a different story, but I was flaring when I got pregnant. I was incredibly sick and ended up with an intra-abdominal abscess. BUT, again I was flaring when I got pregnant. Not exactly in the plans, but we now have a healthy 6 year old!

I would wait for the MRE results, but if all looks well I would question his recommendation for surgery anyway. Unless you have scar tissue that is not going to heal. But then I would assume you would have some symptoms? When I had scar tissue I was not feeling good at all and was unable to even eat anything. I was feeling horrible. So, there should be some signs if this is the case.

You do mention that you are on Humira every week? That is quite frequent, maybe he is concerned with that and the pregnancy? I was on Humira while breastfeeding and was fine, but it was every four weeks.

Crohn's is so frustrating and interferes with so much!
 
Thank you so much for your opinions. It helps a lot. During my first pregnancy the Crohn's was ok, but I had recurrent c-diff, which has been under control for a year now. I did have a bad flare after giving birth, but I think I know enough this time to catch it really early and get on top of things (and it was controlled medically, no surgery). I know one of the things he is advocating for is that I have to be healthy to care for a newborn, which I completely understand. Part of the big issue is that I started seeing a reproductive endocrinologist recently, and he needs a medical clearance from my GI. I will cross my fingers that he is happy with what he sees on the MRE next week.
 
Hi Frenchie mommie

I had to get a resection while pregnant but I also came off all my meds so I was kind of asking for trouble. If I was in your position and feeling well I would go ahead without a resection but be really careful with what I ate in regards to any kind of fibre. If you are feeling like a flare is coming on during pregnancy I would choose a liquid diet just in case. My Crohn's was really bad during the first four months but I felt brilliant after the resection. It could be the progesterone that suppresses your immune system and makes you feel well but on the other hand progesterone causes constipation which for anyone with a stricture is bad news.
 
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