Diarrhea is less common than constipation in pregnancy. However, it may occur for the same reasons as diarrhea in non-pregnant women as well as being a consequence of the elevated hormone levels associated with pregnancy. Diarrhea in pregnancy should always be monitored closely by a medical professional as it can lead to complications that may threaten the fetus and jeopardize the pregnancy if it persists beyond two days. The greatest danger in this regard is dehydration, however, with infectious causes there is also the risk associated with fever and a spread of the infection. Sometimes diarrhea occurs early in the first trimester along with nausea and vomiting (‘motion sickness) but should not be considered as a sign of pregnancy. However, diarrhea in later pregnancy may be a sign of impending labor.
Diarrhea is a symptom of underlying gastrointestinal dysfunction. It is defined as the passage of more than 200g or 200ml of stool in three or more bowel movements within a 24 hour period. Typically there is a large volume of watery stool especially in acute diarrhea. Sometimes changes in bowel habit and stool form may not fit into the definition of diarrhea yet it is not normal for the individual. Frequent bowel movements and loose stool are two more commonly used terms to describe these changes but may be used quite subjectively. Irrespective of the terminology, the changes are due to certain known mechanisms.
The bowels are made up of the small intestine and large intestine which are the longest parts of the digestive tract (alimentary tract or gut). The intestines are important sites of digestion and absorption of nutrients and the formation of waste material that is evacuated from the bowels as feces. Like the rest of the gut, it has a multi-layered wall that is somewhat similar in structure from mouth to anus. Within the bowels are massive populations of bacteria which help with digestion and absorption of nutrients but usually do not harm the bowels. This naturally-occurring ‘good’ bacteria is known as the normal intestinal flora. The bowels are affected by a number of insults, from infectious to mechanical and chemical, but is usually able to recover once the causative factor is removed.
Rhinitis is the inflammation of the nasal passages while sinusitis is the inflammation of the paranasal sinuses, the hollow air-filled cavities in the skull that drain into the nasal cavity. Both rhinitis and sinusitis are often related since these structures have a similar type of mucosal epithelial lining and communicate with each other. Pathology in one part can therefore extend and involve the other. The treatments for both rhinitis and sinusitis, although largely depending on the cause, are similar. Congestion caused by swelling of the epithelial lining coupled with excessive mucus production is the hallmark of both rhinitis and sinusitis. In rhinitis this is usually isolated to nasal congestion, whereas in sinusitis the congestion of the sinuses also extends to the nasal cavity and passages.