Gastroenterology clinic

Pregnancy and inflammatory bowel disease: what to do with the medication?

Sally Bell



Inflammatory bowel disease (IBD) medications considered safe to use in pregnancy are the corticosteroids, sulfasalazines, 5-aminosalicylate preparations, thiopurines, antitumour necrosis factor agents and ciclosporin. The best pregnancy outcomes occur in women whose IBD is in remission at conception and remains so throughout the pregnancy. Most of these women will need to continue taking maintenance medication, and some will need extra treatment to control flares.

Article Extract


Fertility is usually normal

  • The fertility of patients with inflammatory bowel disease (IBD) is normal, with the exception of a small number of patients who have had pelvic surgery (proctectomy, J pouch formation) or who do not ovulate due to low weight or malnutrition.
  • There is no evidence that the oral contraceptive pill (OCP) affects IBD activity.
  • Although it is possible that women with significant small bowel disease or enhanced transit times due to active disease may malabsorb the OCP, this is rare. Women with vomiting or severe diarrhoea for more than 24 hours should follow the missed pill instructions for the OCP they are taking.

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