Increased bile secretion during pregnancy: Cause for concern or temporary condition?

Pregnancy brings many changes to a woman’s body, from hormonal adjustments to physical transformations. One such change that often goes unnoticed until it manifests with symptoms is increased bile secretion. This occurrence can cause concern for expectant mothers. In this blog, thanks to experts from the IntroLab laboratory, we explore what increased bile secretion during pregnancy means, its implications during pregnancy, and when it may signal the need for medical attention.

What is bile and what is its role?

Bile is a digestive fluid that plays an important role in our body, especially in the digestion process. It is produced by the liver and stored in the gallbladder between meals. When we eat, bile is released from the gallbladder into the small intestine, where it helps break down and absorb fats. Besides emulsifying fats, bile also aids in the absorption of fat-soluble vitamins such as A, D, E, and K. Therefore, regular monitoring of vitamin and mineral status during pregnancy is extremely important, especially if there is an increased secretion of bile.

Trudnica u beloj majici
Increased secretion of bile during pregnancy does not always have to be dangerous

In addition to its role in digestion, bile also helps eliminate certain waste products from the body, including red blood cells and bilirubin, a breakdown product of hemoglobin. This is important for maintaining healthy liver function and the overall detoxification capacity of the body.

Why does increased bile secretion during pregnancy occur?

During pregnancy, changes in a woman’s hormonal state, particularly the increased production of progesterone, can slow down the process of gallbladder emptying and increase bile concentration. These changes can lead to the formation of gallstones, a condition medically known as cholestasis. The excess bile production can cause discomfort, including abdominal pain and digestive issues. Additionally, as the pregnancy progresses, the growing uterus exerts pressure on the abdomen, which can affect the normal flow and function of the bile ducts. The increased concentration of bile acid can accumulate in the liver and bloodstream, potentially complicating the condition further.

Symptoms to look out for

Although increased bile secretion is relatively common, it can sometimes lead to symptoms that require careful pregnancy monitoring. The most significant of these symptoms are:

  • jaundice
  • itching
  • pain in the upper right part of the abdomen
  • nausea or vomiting

These symptoms may indicate intrahepatic cholestasis of pregnancy (ICP), a liver condition that disrupts the flow of bile. ICP is relatively rare but requires medical attention.

Jaundice

Jaundice manifests as visible yellowing of the skin or the whites of the eyes. This symptom occurs when bilirubin, a bile pigment that is usually processed in the liver and excreted through bile, accumulates in the blood. Jaundice can indicate that the liver is not adequately processing all the present bile acids, which is common during pregnancy. For this reason, a blood test for total bilirubin is performed as soon as the first symptoms appear.

Itching

Intense itching, especially at night, can be very uncomfortable and often occurs without visible rashes on the skin. Itching is a typical symptom of bile acid accumulation in the skin and can be quite severe. It is often the first sign that pregnant women notice, prompting them to seek medical attention.

A woman in pain holding her stomach because she is suffering from increased bile secretion during pregnancy
If you feel pain in the abdomen, consult a doctor

Pain in the upper right part of the abdomen

Ovaj bol može varirati od blagog do jakog i često se javlja u predelu ispod desnih rebara. Bol može biti posledica pritiska koji rastuća materica vrši na žučnu kesu ili može indikovati prisustvo žučnih kamenaca, koji su češći tokom trudnoće zbog hormonskih promena koje utiču na sastav žuči.

Nausea or vomiting

Nausea and vomiting, although common in pregnancy, when associated with other symptoms such as pain and jaundice, may indicate more serious problems with the gallbladder or liver.

Intrahepatic cholestasis of pregnancy (ICP)

When these symptoms become evident, it may be a case of intrahepatic cholestasis of pregnancy, a condition characterized by reduced bile flow within the liver. ICP can increase risks for the fetus, including preterm birth and fetal distress, so it is vital that the condition is diagnosed and treated promptly. This condition requires detailed monitoring by the healthcare team, and treatment may include medications that improve bile flow and often planning for early delivery to minimize risks for the baby.

Diagnosis and treatment of hypersecretion of bile

If you experience any of the above-mentioned symptoms, it is important to consult your doctors. They may recommend blood tests to measure liver function and bile acid levels. An ultrasound may also be performed to check for the presence of gallstones.

Managing increased bile secretion usually involves dietary adjustments. Eating smaller, more frequent meals can help manage symptoms. Limiting fats and including fiber in your diet can also help improve digestion and reduce bile concentration. Additionally, maintaining adequate water intake is important to support normal liver function and reduce the risk of gallstone formation.

Besides dietary adjustments, your doctor may recommend the use of certain medications. For example, ursodeoxycholic acid is often prescribed to reduce the concentration of bile acids in the blood and facilitate their excretion, which can significantly alleviate symptoms such as itching and jaundice. These medications are generally safe to use during pregnancy, but they should be used under the supervision of a doctor.

For pregnant women with extremely high levels of bile acids, early induction of labor may be considered to protect the baby’s health, as ICP can increase the risk of fetal distress and preterm birth. Regular monitoring of the pregnant woman’s condition, including proper medical examinations and laboratory tests, is crucial for timely intervention and management of the condition.

What pregnant women can do

When bile secretion is increased during pregnancy, in addition to medical treatment, supporting and educating pregnant women on how to recognize and monitor their symptoms also plays an important role. Education can include information on the importance of proper nutrition, physical activity, and how to manage symptoms at home. Additionally, pregnant women can be advised to keep a symptom diary to more easily track their condition and the effectiveness of the treatments applied.

A pregnant woman sitting on the bed
With regular check-ups and adherence to the doctor’s advice, increased bile secretion during pregnancy can be controlled

Increased bile secretion during pregnancy does not have to be a cause for concern

Although increased bile secretion during pregnancy can cause concern, most conditions can be successfully managed with proper diagnosis and management. Adequate nutrition, regular medical check-ups, and cooperation with the healthcare team are key to maintaining the health of both the mother and baby. It is important to recognize symptoms in a timely manner and consult a doctor to ensure safety and well-being during pregnancy.

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