During her first pregnancy, New Bloomfield resident Katie Berry experienced some of the usual symptoms, like fatigue and nausea. But at six months, she started experiencing symptoms that were more concerning. Berry noticed blood in her stools, sores in her mouth and an increase in stomach pain and bowel movements.
“I just assumed it was my body reacting to the next stage of the pregnancy, and my obstetrician had no serious concerns at the time,” she said.
The symptoms progressed quickly, and she became dehydrated and violently ill. She was admitted twice to the hospital in order to receive fluids. Diagnosed with a virus, she brushed it off until she delivered her daughter, Eleanor, in April 2019.
“The nurse on duty after I had my baby got me to take the symptoms seriously,” Berry said. “She told me that I really needed to go to my primary care doctor as soon as possible so I realized that maybe I shouldn’t be ignoring this.”
After she met with her primary care doctor, she was referred to a gastrointestinal specialist and was scheduled for a colonoscopy in May 2019. Leading up to the procedure, she experienced severe rectal bleeding, lost 17 pounds in a week and became dizzy and lightheaded easily.
The night before her colonoscopy, Berry became extremely ill. She was taken to MU Health Care’s University Hospital with a heart rate between 140 and 150 beats per minute. She was admitted for seven days at the hospital.
She had her colonoscopy and met with Yezaz Ghouri, MD, a gastroenterologist at MU Health Care’s Missouri Digestive Health Center, at the end of her hospital stay.
“Her entire colon had ulcers, inflammation and redness,” Ghouri said. “Biopsies confirmed that she had aggressive ulcerative colitis.”
Ulcerative colitis, or UC, is an inflammatory bowel disease disorder that causes chronic inflammation and ulcers in the lining of the large intestine and rectum. Symptoms include diarrhea, bloody stools, abdominal pain, loss of appetite, weight loss, nausea, vomiting, fever and fatigue. It even causes symptoms outside of the GI tract — such as joint pain, vision problems and mouth blisters — that can cause permanent damage if left untreated.
“She needed a long-term treatment plan,” Ghouri said. “She had been treated with steroids, which may lessen the pain initially, but they aren’t meant to be taken for continued management of UC symptoms. She was afraid to take anything because she was breastfeeding so I worked with her until she was finally ready to start treatment.”
Ghouri prescribed a biologic therapy with an immunosuppressant drug. Unlike steroids, which are anti-inflammatory drugs that affect the entire body, biologics are antibodies created in a lab to block specific proteins that cause UC inflammation.
“Ulcerative colitis happens because of a number of factors working together to cause a reaction. Things like genetics, autoimmune diseases and diet can create the perfect storm. Her immune system was overreacting to natural microbiomes and bacteria in her gut,” Ghouri said. “We use biologics to either neutralize inflammation-causing molecules generated in our body or to prevent too many inflammation-causing cells from entering the GI tract. These mechanisms help control inflammation and reduce symptoms of UC.”
Berry received three IV infusions over the first eight weeks, and since then has received an infusion once every eight weeks for maintenance.
“It was a night and day difference after being on the medication,” Berry said. “I didn’t realize how sick I was until I got better. Now, I even notice that my vision gets blurred before I need my next infusion.”
For people experiencing symptoms of UC, Ghouri recommends seeking care from a gastroenterologist. He said pregnancy or breastfeeding shouldn’t be a deterrent from seeking treatment for UC. Treating the issue will actually help people have a healthier pregnancy.
Berry is proof of that.
Now 28, she is pregnant with her second child and feeling great.
“Dr. Ghouri has been amazing,” she said. “Once I told him I was pregnant, he immediately started working with my OB to develop a plan and even provided me with research to put my mind at ease about the medication.”
Berry encourages others to have an open dialogue with their doctor to ensure the best outcome.
“Share every detail and don’t be embarrassed about the topic,” she said. “Your doctor wants you to feel better, so it’s good to listen to their advice and work together.”