Bisacodyl is one of the "stimulant laxatives". The orally taken stimulant laxatives have no known harmful effect on the fetus. However, there is a theoretical possibility that they could stimulate the uterus and precipitate a miscarriage or preterm labour. They are generally avoided in pregnancy. An exception to this is the rectally administered suppository (Glycerine). The action of this is mild and is confined to the rectum. There is no danger of miscarriage or preterm labour. It can therefore be used safely in pregnancy.
Phosphate enema will be used in pregnancy when the situation gets desperate. Its action is local and there is no danger of causing damage to the baby. By its very nature, an enema cannot be used on a regular basis. Use in early pregnancy may cause slight concern of the theoretical risk of precipitating miscarriage. This is highly unlikely but in the presence of several and arguably more user-friendly alternatives, its use at this stage of pregnancy is rarely justified.
Picolax represents a group of the powerful laxatives used in preparing the bowel before surgery. It is not used in pregnancy.
Again, the initial advice for heartburn should be conservative management. This should take the form of small frequent meals, preferably rich in carbohydrates. The expectant mother should also avoid lying flat or prolonged stooping. She may also try to lie in a propped-up position at night. If all these do not work, then medication may have to be tried.
There is lingering concern about safety of antacids (such as magnesium- or aluminium-based preparations) in early pregnancy (the first eight to ten weeks). This is based on reports of occasional congenital defects in the past which have not been fully disproved. In this phase of pregnancy, therefore, they are best avoided. There is certainly no risk to the fetus in the second or third trimester of the pregnancy and, when required, they can be taken with peace of mind.
Common brand names of antacids include Gaviscon®, Peptac®, Rennie®, Maalox®, and Mucogel®.
If one has been on specific treatment for peptic ulcers, what then?
The general rule is that peptic ulcers tend to improve in pregnancy. It is exceptionally unusual for peptic ulcers to start or be diagnosed for the first time during pregnancy.
For somebody who has been on specific treatment for the ulcers, the medication is likely to be one of the drugs known as H2-receptor antagonists. These work by inhibiting the secretion of acid in the stomach. They are also called acid reducers.
The most common are Cimetidine (Tagamet®) and Ranitidine (Zantac®). Other similar drugs include Nizatidine (Axid®) and Famotidine (Pepcid®). The body of data available indicate that Ranitidine (which is the one most commonly used) is safe to use in pregnancy and there is no evidence that it will increase risk of fetal abnormalities. If required, it should be prescribed and can be used.