ABSTRACT
Prolonged vomiting may lead to Mallory-Weiss tears of the oesophagus and episodes of haematemesis. Flexible sigmoidoscopy or colonoscopy and mucosal biopsy are safe in pregnancy and may confirm mucosal inflammation and allow histological examination to differentiate ulcerative colitis and Crohn's disease. Irritable bowel syndrome (IBS) is common, and most sufferers encountered in pregnancy will already be aware of their diagnosis. Crohn's disease (CD) affects the terminal ileum alone in 30%, the ileum and colon in 50% and the colon alone in 20% of cases. CD may affect any part of the gastrointestinal tract from the mouth to the anus. Since it is a diagnosis of exclusion, new onset of symptoms in pregnancy are more likely to be attributed to the pregnancy than to IBS. The commonest causes of abdominal pain in pregnancy are constipation, urinary tract infection and uterine contractions.
