Ulcerative colitis in pregnancy can bring many questions, especially when you want a calm and healthy journey for both you and your baby. It is common to worry about flare-ups, medicines, and how your body will respond during these months.



Ulcerative colitis is a chronic inflammatory bowel disease (BID) that causes sores on the inner lining of your large intestine, and your symptoms can change over time. During pregnancy, your hormones rise, your digestion slows, and your body needs more support. These shifts can influence how you feel. When you understand what is happening, you gain more clarity and confidence.



How To Plan Pregnancy With Ulcerative ColitisIf you have ulcerative colitis, it helps to start thinking about pregnancy a little early.



Step 1: Wait for RemissionGive your body a calm starting point. Try to conceive only when your ulcerative colitis has been in remission for at least 3 to 6 months. No flare-ups. No active symptoms. This gives you safer ground to begin your journey.



Step 2: Meet Your Doctors EarlySit down with your gastroenterologist and obstetrician as soon as pregnancy is on your mind. Share your plans and ask all your questions. They may guide you to a high-risk pregnancy specialist too, which is common for ulcerative colitis.



Step 3: Review your MedicinesYour doctors will look at the medicines you take and adjust anything that is not safe for pregnancy. Do not change things on your own. Let your doctor handle it.



Step 4: Work on a Healthy WeightAim for a healthy weight before you start trying. Being underweight can raise the chances of miscarriage or a premature baby. Think of this step as building a strong base for your pregnancy.



Step 5: Check Fertility Concerns EarlyMost people with ulcerative colitis have normal fertility. The only time it may drop is after certain surgeries. If you have had your large intestine removed, scar tissue can form in the pelvic area and affect conception. In such cases, doctors often suggest a partial removal first, with an external pouch that does not affect fertility. You can complete the full surgery later.



Step 6: Avoid Trying During a Flare-UpDo not plan a pregnancy when symptoms are active. Flare-ups can continue or worsen, and they can lead to nutrient shortages that affect both you and the baby. Give your body time to settle first.



Step 7: Build a Nutrition PlanWork with your doctor or a dietitian to keep your nutrients in balance. Your body needs steady fuel to support a healthy pregnancy.



Step 8: Make a Mental Health Plan TooPregnancy brings strong emotions, and so does living with ulcerative colitis. Talking to a counsellor or joining a support group can help you stay calm.



What Foods Support Pregnancy With Ulcerative ColitisEating right becomes even more important when you are pregnant with ulcerative colitis. Your body may not absorb every nutrient the way it should, so you need to give it a little extra care. Work closely with a dietitian who understands this condition. You and your dietitian can put together a plan that keeps symptoms calm without cutting out the nutrition your body needs. Follow these tips to stay healthy:

• Fill half your plate with fruits and vegetables. Steam or bake them if raw ones upset your stomach because softer foods are easier to digest.
• Make at least half your grains whole grains. Choose brown rice, whole wheat chapati, oats, or daliya for steady energy.
• Go for low-fat or fat-free dairy. Curd, toned milk, and light paneer feel gentler on your stomach.
• Cut back on salt, sugary drinks, fried food, greasy food, and very spicy food because these can trigger more irritation.
• Skip nuts, popcorn, and corn if they cause bloating or discomfort since they are harder to break down.
• Drink plenty of water. Diarrhoea can dehydrate you fast, so keep sipping water or coconut water.
• Have five or six small meals instead of three big ones. Smaller portions like dal, rice, khichdi, or curd rice are easier on your gut.
• Add calcium-rich foods like yoghurt, hard cheese, fortified juices or cereals, tofu, soybeans, or black eyed peas to support your bones.
• Include low-mercury fish up to 12 ounces per week. You can choose options like rohu, catla, pomfret, or rawas.

Also, take your supplements daily, such as prenatal vitamins, iron, folic acid, and calcium with vitamin D, which are all important.



What Are Safe Treatment Options For Ulcerative Colitis In PregnancyMost treatments for ulcerative colitis are safe during pregnancy, but never stop or change your medication without your doctor’s advice. These are the safe options your doctor might suggest:

• Aminosalicylates (5-ASA compounds): These are the most common medicines for mild to moderate colitis. They reduce inflammation in your gut and help keep flare-ups away. They are usually safe in pregnancy.
• Corticosteroids: These are strong anti-inflammatory drugs used when your symptoms flare up. They work quickly to calm inflammation. But doctors try to avoid giving them in the early months of pregnancy if possible.
• Immunomodulators and immunosuppressants: These medicines slow down your immune system to prevent it from attacking your gut. These can often be continued during pregnancy under medical supervision.
• Certain biologics: Biologics are targeted medicines that block specific proteins causing inflammation. Your doctor will guide the timing carefully.

Important Precautions:

• Methotrexate and thalidomide: Must be stopped at least 3 months before trying to conceive, as they can cause birth defects.
• Steroids: Your doctor will aim to reduce them to the lowest effective dose or stop them safely.
• Biologics in the last two trimesters: Might affect your baby’s immune system.

Pregnancy with ulcerative colitis is definitely manageable, especially with careful planning and regular medical support. While there are slightly higher risks, most people with this condition have healthy pregnancies and babies!



Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.



FAQs on How Ulcerative Colitis Affects Your Pregnancy: Understanding This Chronic Bowel Condition

What tests are usually safe for monitoring ulcerative colitis during pregnancy?

Blood tests, stool cultures, and ultrasound-based imaging are considered safe during pregnancy.

Do ulcerative colitis flare-ups affect breastfeeding?

Flare-ups do not prevent breastfeeding, and most treatments used during this time are compatible with nursing.