Constipation pains in early pregnancy

Constipation in pregnancy - HSE.ie

Constipation is very common in pregnancy. It means that your bowel motions (poos) are very hard and may be painful to pass. You may also be doing a poo less often than usual.

There are things you can do to help deal with constipation and prevent it.

Symptoms of constipation

Symptoms include:

hard stool (poo)
less frequent bowel motions (pooing less)
pain on passing a bowel motion (when having a poo)
passing wind (farting)
cramp-like pains in your tummy

Causes of constipation

Constipation can be caused by:

not drinking enough water
not eating enough fibre
pregnancy hormones - these can make your poo move more slowly through your intestine
your growing baby and womb putting extra pressure on your intestines
taking iron supplements

How to ease constipation

You can ease constipation by:

drinking plenty of water - try to have 10 glasses of water a day, about 2. 3 litres
eating foods that are high in fibre every day - vegetables, wholegrain breads, porridge, fruit, dried fruits, vegetables, beans and lentils
staying active - try walking, swimming, pregnancy yoga or pilates
going to the toilet when you first feel the urge to have a bowel motion (do a poo) - give yourself plenty of time and take some deep breaths to help relax the pelvic floor

Only take iron supplements if your GP or midwife has said you need them.

Healthy eating during pregnancy

Your position on the toilet

Having a good position on the toilet can help when you are emptying your bowels.

Use a small step or footstool under your feet. This helps you to get into the best position.
Lean forward, as much as your bump allows. Put your elbows on your knees. Try and keep your back straight.
Do not strain, and do not hold your breath. Taking long, slow, deep breaths through your mouth will help your tummy muscles relax.

Correct toilet position for pregnant women with constipation

When to get medical help

Non-urgent advice: Talk to your GP, midwife or obstetrician if:

making diet and lifestyle changes does not work
you have blood in your stools (poo)
you have pains in your tummy
you are vomiting

They may prescribe a high fibre drink, or other types of laxative to help you have a bowel motion.

This project has received funding from the Government of Ireland’s Sláintecare Integration Fund 2019 under Grant Agreement Number 8.

Page last reviewed: 27 March 2019
Next review due: 27 March 2022

Abdominal Pain During Pregnancy: Causes and Treatment

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Medically reviewed by Debra Rose Wilson, Ph. D., MSN, R.N., IBCLC, AHN-BC, CHT — By Annette McDermott on June 18, 2015

Pregnancy abdominal pain

Abdominal pain during pregnancy isn’t unusual, but it can be scary. The pain may be sharp and stabbing, or dull and achy.

It can be challenging to determine if your pain is serious or mild. It’s important to know what’s normal and when to call your doctor.

Pregnancy gas pain

Gas can cause excruciating abdominal pain. It may stay in one area or travel throughout your belly, back, and chest.

According to the Mayo Clinic, women experience more gas during pregnancy due to increased progesterone. Progesterone causes intestinal muscles to relax and extends the time it takes food to get through the intestines. Food remains in the colon longer, which allows more gas to develop.

As your pregnancy progresses, your enlarging uterus puts extra pressure on your organs, which can slow digestion further and allow gas to build up.

Treatment

If abdominal pain is caused by gas, it should respond to lifestyle changes. Try eating several small meals throughout the day and drink lots of water.

Exercise may also help aid digestion. Identify foods that trigger gas and avoid them. Fried and greasy foods, as well as beans and cabbage, are common culprits. Avoid all carbonated beverages, too.

Many women write off abdominal pain during pregnancy as gas, but there are other benign reasons for pain to occur.

Round ligament pain

There are two large round ligaments that run from the uterus through the groin. These ligaments support the uterus. As the uterus stretches to accommodate your growing baby, so do the ligaments.

This may cause sharp or dull pain in the abdomen, hips, or groin. Shifting your position, sneezing, or coughing can trigger round ligament pain. This usually occurs in the last half of the pregnancy.

Treatment

To reduce or eliminate round ligament pain, practice getting up slowly if you’re sitting or lying down. If you feel a sneeze or cough coming on, bend and flex your hips. This can help to reduce the pressure on the ligaments.

Daily stretching is also an effective method for reducing round ligament pain.

Constipation

Constipation is a common complaint among pregnant women. Fluctuating hormones, diet that’s short on fluids or fiber, lack of exercise, iron pills, or general anxiety can all lead to constipation. Constipation may cause severe pain. It’s often described as cramping or sharp and stabbing pain.

Treatment

Try increasing the amount of fiber in your diet. Increasing fluids may also help. Pregnant women should drink at least 8 to 10 glasses of water each day. Talk to your doctor before taking a stool softener. Some stool softeners aren’t recommended during pregnancy.

Braxton-Hicks contractions

These “practice” or “false” contractions occur when the uterine muscles contract for up to two minutes. The contractions aren’t labor and are irregular and unpredictable. They may cause pain and uncomfortable pressure, but they’re a normal part of pregnancy.

Braxton-Hicks contractions often occur in the third trimester of pregnancy. Unlike labor contractions, these contractions don’t get progressively more painful or more frequent over time.

HELLP syndrome

HELLP syndrome is an acronym for its three main parts: hemolysis, elevated liver enzymes, and low platelets. It’s a life-threatening complication of pregnancy.

It’s unclear what causes HELLP, but some women develop the condition after receiving a preeclampsia diagnosis. According to the Preeclampsia Foundation, of the 5 to 8 percent of women in the United States who develop preeclampsia, it’s estimated that 15 percent will develop HELLP.

Women without preeclampsia may also acquire this syndrome. HELLP is more common in first-time pregnancies.

Right upper-quadrant abdominal pain is a symptom of HELLP. Other symptoms include:

headache
fatigue and malaise
nausea and vomiting
blurry vision
high blood pressure
edema (swelling)
bleeding

If you have abdominal pain accompanied by any of these additional HELLP symptoms, seek medical advice right away. Dangerous complications or even death can result if HELLP isn’t treated immediately.

Other reasons for concern

Abdominal pain during pregnancy may also be a sign of other, more serious conditions. These include:

miscarriage
ectopic pregnancy
placental abruption
preeclampsia

These conditions require immediate medical attention.

Conditions not directly related to pregnancy may also cause abdominal pain. These include:

kidney stones
urinary tract infections (UTIs)
gallstones
pancreatitis
appendicitis
bowel obstruction
food allergies or sensitivities
peptic ulcer disease
a stomach virus

Call your doctor immediately if your pain is accompanied by any of the following:

fever or chills
vaginal bleeding or spotting
vaginal discharge
repetitive contractions
nausea or vomiting
lightheadedness
pain or burning during or after urination

When considering if abdominal pain is gas or something more serious, keep all of this information in mind. Though at times severe, gas pain usually resolves itself within a short period of time. It’s often relieved when you burp or pass gas.

You may be able to connect an episode to something you ate or a period of stress. Gas isn’t accompanied by fever, vomiting, bleeding, or other serious symptoms. Gas pains don’t get longer, stronger, and closer together over time. That’s likely early labor.

Whenever in doubt, call your doctor or go in and seek treatment at your birthing center. It’s always better to err on the side of caution.

Last medically reviewed on August 18, 2017

Parenthood
Pregnancy

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Gas. (2016).
marchofdimes.org/pregnancy/gas.aspx
HELLP syndrome. (2015).
preeclampsia.org/health-information/hellp-syndrome
Murry MM. (2013). Pregnancy week by week: Pregnancy and you blog: Gas in pregnancy: Why it happens, what to do.
mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-blog/gas-in-pregnancy/bgp-20055810
Murry MM. (2014). Pregnancy week by week: Pregnancy and you blog: Round ligament pain: Understanding this pregnancy complaint.
mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-blog/round-ligament-pain/bgp-20111536
Pregnancy: Body changes and discomforts: Constipation.
womenshealth.gov/pregnancy/youre-pregnant-now-what/body-changes-and-discomforts
Pregnancy: Staying healthy and safe: When to call the doctor. (2017).
womenshealth.gov/pregnancy/youre-pregnant-now-what/staying-healthy-and-safe
Tobah YB. (2017). Pregnancy week by week: Pregnancy and you blog: Is it safe to take stool softeners to treat pregnancy constipation?
mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/pregnancy-constipation/faq-20058550
True vs false labor. (2016).
my.clevelandclinic.org/health/articles/true-vs-false-labor

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Aug 18, 2017

Medically Reviewed By

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

Jun 18, 2015

Written By

Annette McDermott

Edited By

Frank Crooks

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Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — By Annette McDermott on June 18, 2015

Manifestations of constipation in pregnant women - signs and symptoms

Co-author, editor and medical expert - Klimovich Elina Valerievna.

Number of Views: 54,600

Last Updated: 12/27/2022

Average Read Time: 4 minutes

Constipation is a common problem during pregnancy. About 75% of women complain of problems with bowel movements during pregnancy. At the same time, these difficulties remain in about a third of women after childbirth.

Contents:

Detailed description of the symptoms
What can cause constipation in a pregnant woman

Our bodies constantly produce substances that stimulate bowel movements. During pregnancy, the susceptibility of the intestinal muscles to various kinds of irritants is significantly reduced. The change in the intensity of intestinal reactions is due to the fact that it has a common innervation * with the uterus, because of this, any excessive activation of peristalsis can provoke contractile activity of the uterus. This can be a threat to the child. Unfortunately, this defensive reaction has unpleasant consequences - constipation. Often they occur between 17 and 36 weeks of pregnancy.

Clinically, constipation in pregnant women is manifested by several main symptoms:

stool retention for more than 3 days and problems with passing gases, flatulence;
unpleasant feeling of incomplete emptying of the bowels;
the need to strain during bowel movements;
painful stools;
"sheep feces" (hard, dry, fragmented feces).

In the event of constipation, you should always seek medical advice, especially if you notice deterioration and pain.

Detailed description of symptoms

Constipation is characterized by decreased stool frequency. It happens that a pregnant woman manages to empty her intestines only once a week or less. The consistency of feces changes, discomfort and pain in the abdomen (often in its left half), there is a feeling of dissatisfaction after the stool.

Atonic constipation is characterized by very painful defecation, which occurs with great difficulty. Due to microscopic tears of the mucous membrane of the anus, streaks of blood may appear on the surface of the feces. Spasmodic constipation is characterized by fragmented stools ("sheep feces"). This condition is often accompanied by flatulence, a feeling of pressure, expansion, spasmodic pains in the abdomen. With prolonged constipation, there may be a feeling of lethargy, fatigue, a significant decrease in efficiency.

Pain in a pregnant woman occurs for no apparent reason or may be the result of excitement or physical exertion. Attacks of acute pain or exacerbation of constant discomfort, as a rule, are associated with negative emotions. The pain can be of varying strength, for example, in some cases it radiates to the lower back, leg, anus, and even the genitals. In some pregnant women, along with abdominal pain, there is a burning sensation in the rectum and itching in the anus. Nausea, bitterness in the mouth are often noted; passing gases is difficult.

Back to content

What constipation can cause in a pregnant woman

Feces in the rectum, which a pregnant woman cannot get rid of for a long time, bring her considerable discomfort. However, these are not the only consequences of constipation.

The large intestine mucosa is characterized by absorptive capacity; in case of constipation, not only water is absorbed into the blood, but also various toxic metabolic products. Intoxication of the woman and the fetus can lead to negative consequences and disrupt the development of the child in the future.
Due to overflowing with dense feces, the rectum presses on the uterus, which leads to irritation. Despite the fact that the sensitivity of the uterus during pregnancy is reduced, there is a certain risk of increased uterine tone and, as a result, premature birth.
With constipation, the intestines press on the uterus and pelvic vessels, which disrupts the outflow of blood from them. For this reason, hemorrhoids can occur, which is manifested by the appearance of blood in the stool.

Constipation in a pregnant woman is a serious problem. To solve it, contact your doctor.

*Innervation - the supply of organs and tissues with nerve fibers, which ensures their connection with the central nervous system (CNS).

Back to Contents

The information in this article is for reference only and does not replace professional medical advice. For diagnosis and treatment, contact a qualified specialist.

Constipation during pregnancy: causes, recommendations

In addition, constipation in pregnant women may be caused by dietary changes, smooth muscle relaxant drugs (lowering uterine activity, progesterone) ³ or mineral supplements containing iron and calcium4. Sometimes a woman has to lie down all the time, and at least minimal physical activity is necessary to maintain a normal bowel movement ³ . Another reason for the formation of constipation in pregnant women can be a decrease in fluid intake, starting from the earliest dates ⁴ .

Thus, low bowel tone during pregnancy is generally initially protective, but may result in constipation ¹ .

Possible complications of constipation in pregnancy

Gestational constipation can not only drastically reduce the quality of life, but also pose a certain threat to the well-being of the pregnant woman and the fetus.

Prolonged stagnation of feces can lead to a series of disorders, among other things, to the activation of opportunistic microorganisms. The penetration of microbes and their metabolic products through the intestinal wall can be at least a predisposing factor, and sometimes a direct cause of complicated pregnancy, problems in childbirth and the postpartum period ¹ .

Disruption of the normal balance of the colonic microbiota during constipation may later cause a change in the composition of the microflora of the cervical canal.

This condition can cause intrauterine ascending infection and the occurrence of various complications of the gestation period. The course of pregnancy against the background of stagnation in the large intestine can lead to the threat of interruption, untimely discharge of amniotic fluid, inflammation of the uterine mucosa ¹ .

The pathological increase in intestinal permeability caused by constipation impairs its barrier function, and even after childbirth it may not fully recover. That is why constipation is a situation that cannot be ignored and must be treated ¹ .

Disruption of the normal balance of the colonic microbiota during constipation may later cause a change in the composition of the microflora of the cervical canal.

The pathological increase in intestinal permeability caused by constipation impairs its barrier function, and even after childbirth it may not fully recover. That's why constipation is a situation that cannot be ignored and must be treated ¹ .

Treatment of gestational constipation

The main rules for the prevention and treatment of constipation in pregnant women are primarily diet and recommendations for increasing physical activity ⁴ . Treatment of constipation, especially in pregnant women, begins with dietary measures ⁴ .

For a laxative purpose, foods rich in indigestible plant fibers (fiber) are introduced into the menu. There are many such substances in raw fruits and vegetables, wholemeal bread ⁴ .

According to its nutritional properties, wheat bran is considered the most acceptable for human consumption, which can be added to ready-made meals by 2-3 teaspoons ³ .

Prunes, kefir, dried apricots are considered products that help relieve constipation. The menu is recommended to include beets, zucchini, cabbage, lettuce, cucumbers and tomatoes. It is recommended to limit the consumption of strong tea and coffee, sweets and cocoa, flour dishes in the diet ³.

It may also be necessary to correct the mode of physical activity, the amount of which is discussed with the doctor ³ . Gymnastics, walking or swimming in the pool may be recommended for a pregnant woman, if this is not contraindicated for health reasons ⁴ .

In some cases, despite following all recommendations, it may be necessary to use laxatives ⁴ . The choice of a possible drug cannot be made independently, because self-medication with laxatives during pregnancy is especially undesirable ¹ .

The use of any medicine during pregnancy carries certain risks that only a doctor can weigh.

Therefore, only with medical permission, laxatives may be recommended. One of the laxatives that can be prescribed by a doctor to pregnant women starting from the 2nd trimester is Guttalax®: in the 1st trimester of pregnancy, the drug is contraindicated, in the 2nd and 3rd trimesters of pregnancy it is used with caution. Guttalax® is available in drops and tablets5,6. In view of the lack of studies, the use of Guttalax® tablets during pregnancy is recommended only in cases where the potential benefit to the mother outweighs the possible risk to the fetus. During pregnancy, the drug can be used only after consultation with a specialist.

More about the drug

To increase the efficiency of preparation for the study, the individual functional state of the large intestine is also taken into account. If you have chronic constipation, you need to pay special attention to diet. In preparation for research, Guttalax® Express can be used in suppositories ⁸.
The active substance - bisacodyl - becomes active and acts only in the lumen of the large intestine, therefore it does not affect the digestion and absorption of nutrients in the small intestine ⁸ .