Fecal impaction pregnancy

Expert Tips to Relieve Constipation During Pregnancy

For all the bowel movement talk we do, there’s one area we seem to neglect—our own.

By Diana Spalding, CNM January 29, 2018

If you hang out with moms, you are probably aware just how much they (ahem, we) talk about our children’s poop. How much, how often and of course, all those badge-of-honor-poopslosion-up-the-onesie stories.

Yet for all the bowel movement talk we do, there’s one area we seem to neglect—our own… or rather, our own lack thereof. But we should! Up to one-third of pregnant women suffer from constipation. And if you are one of them, you understand what an impact it can have on you.

So! Let’s discuss.

Constipation is when you have three or less bowel movements (poops) in a week. You may also experience small or hard bowel movements and feeling the need to strain when you are in the bathroom.

Why does it happen in pregnancy?

The hormones of pregnancy slow everything down, including your GI tract
Your changing diet and the way your body utilizes the food you eat
Not eating enough fiber or drinking enough water
A decrease in exercise.
Iron in your prenatal vitamins can lead to constipation as well
Pressure from your growing uterus

Is constipation dangerous?

Rarely. The two main things to look out for are fecal impaction and hemorrhoids.

Fecal impaction occurs when the feces gets so hard that it gets stuck in your rectum or colon. This requires immediately medical attention, so if you are constipated, reach out to your provider right away.

Hemorrhoids are swollen veins in your anus or rectum that occasionally protrude out of your anus. They are more common during pregnancy, and can occur with constipation as well, since you may be straining/pushing extra hard while having a bowel movement.

If you have hemorrhoids you may notice bleeding, swelling, pain or itching, or a lump near your anus. While they are often nothing to worry about, don’t hesitate to reach out to your provider just to make sure.

The biggest problem with constipation is that it’s just plain uncomfortable.

So what can you do about constipation?

The first thing I’ll say is please, please don’t be embarrassed to call your OB or midwife. I promise you, we are so unfazed by stuff like this. Chances are you will be the third “constipation call” of the day. We are here to help you, call us!

To prevent or alleviate constipation, you might try:

Increasing foods with fiber, like whole grain cereals and breads, almonds, beans, popcorn, oranges, and oatmeal.
Eat smaller meals more frequently instead of three big meals a day.
Drink plenty of fluid (about 10 glasses/day).
Exercise
Talk to your doctor or midwife about laxatives, stool softeners and other medications

Hang in there, mama. This is rough for sure. Please just reach out for help, and know that you’re not alone—except for when you’re in the bathroom. We wont follow you in there.

Can pregnancy cause FAECAL IMPACTION and CONSTIPATION?

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Can pregnancy cause FAECAL IMPACTION and CONSTIPATION?

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Hello, I am 36 weeks pregnant and have had difficulty passing stools. I've been to the my doctor at the hospital where I'm receiving prenatal care and he says that constipation is common in pregnancy, and prescribed a magnesium based laxative.
However I'm worried that this is a fecal impaction - I ate some pumpkin seeds at the weekend, and a few hours later is when the trouble began. I passed some bright red AND dark red blood from the rectal area but couldn't pass any stools except a couple of very small ones. I had the feeling that I had to pass more but I couldn't even after
straining for a long time.
Now for three days I haven't had a proper bowel.
How likely is this to be a fecal impaction? I have read cases about seeds causing blockages. If it is at all likely, should I be searching out a specialist doctor rather than going to my ob/gyn? (I'm based in South Korea). Thanks for your help.

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Expert: Dr. Aarti Vazirani

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Hello. Thank you for posting your query at DoctorSpring.com
Constipation is actually quite common in pregnancy, and fecal impaction is not.
Fecal impaction is preceded by a history of chronic constipation, which is absent in your case.
Fecal impaction is common in morbid patients, not in healthy young women.
I would say you are not likely to have fecal impaction.
How long have you taken the laxative, and have you been passing small amounts of stool, or not at all?
Have you been having pain, because fecal impaction is painful too.
Painless bleeding from the rectal area is more indicative of a haemorrhoid, which are more common in pregnancy.
I would ask you to consult a specialist- a general or a colo-rectal surgeon, if your OB - GYN is not conclusively able to rule out fecal impaction on a per rectal exam.
All the best
Please feel free to discuss further.
Regards.

Patient replied :

Thanks for your reply. I wanted to wait a few days to give you an update and then ask further advice.
I understand that fecal impaction is uncommon in younger patients where the cause is chronic,untreated constipation. This would clearly be unlikely in my case since I have never suffered with constipation before last Saturday, even throughout the entire course of my three pregnancies. However I have also read several studies (eg here, here and here) online about the potential of certain types of seed to form a lump (or bezoar) in the rectum, stomach or large intestine. It is this that concerns me since the day before eating the pumpkin seeds I had absolutely no symptoms of constipation, and within a few hours of eating them I was almost totally unable to have a bowel movement, and passing blood (I've never had haemorrhoids before either).
Also I am not really responding to the laxatives or suppositories as I am straining to produce even a small amount of stool. I have been taking the laxatives for six days now, and I have also used one bisacodyl suppository. I still feel that there is a large blockage that I cannot pass, however much I strain. I am able to pass gas and I have had on average one or two small bowl movements per day, but they are very much reduced in size and quantity compared to normal. Other symptoms: bleeding from the rectum after trying to pass stools, some muscular aching especially in the arms and shoulders, some itching on my arms and legs, minor headaches which seem to come and go. No pain or abdominal discomfort except when I am trying to pass a stool.
My obgyn has only prescribed laxatives and suppositories so far. He has not carried out a digital rectal examination or performed any kind of scan (I would have to go to see a specialist at another hospital for this). He says he could perform an enema, but warned me that this carried significant risk of inducing labor ( which I find unacceptable because I am only 37 weeks and wish to carry the baby to term unless it really is an emergency).
I have about three weeks left of the pregnancy if I go into labor close to my due date (as I did with my previous two pregnancies) .Should I just wait it out, using home remedies such as prune juice, a high fibre diet, and over the counter drugs such as Colace, and then have tests done after the baby is born? Or should I go to a larger hospital straightaway for further testing? I discussed this with my obgyn, who said that there would be very little they could do at a larger hospital- I can't have an Xray or CT scan since I'm pregnant, and even tests such as as a sigmoidoscopy typically require an enema to be carried out beforehand. I'm concerned however that the waste building up in my body even from a partial impaction could lead to serious consequences.
I'd like to know your opinion on this. If I went to a larger hospital, would there actually be anything that they can do (given that I don't want to risk inducing labor at 37 weeks by having an enema).Are there any scans or tests that can be used safely in pregnancy to check whether there is a fecal impaction?I'd also like to know how serious you think my situation is, based on the description I have provided.Could I be in danger of developing a complication such as sepsis or peritonitis due to fecal build up, despite the fact that I am passing small amounts of stool every day. In that case maybe the benefits of having a CT scan, X ray or enema outweigh the risks.
Thanks very much for your advice.

Expert: Dr. Aarti Vazirani

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Thank you for the detailed and insightful and well - read follow up.
It is rare to interact with patients who are so intelligent, interactive and vigilant.
Seeds are associated with fecal impaction, but in cultures where they are routinely consumed or in patients who have eaten quite a bit of them, exceeding what is normal intake.
I am sure you did not binge out on the pumpkin seeds.
To me, the association between your constipation and the pumpkin seeds seems incidental, though I can very well understand your concern regarding it.
You are also passing small amounts of stool, which would not happen in a fecal impaction.
Straining at stools, the bleeding and the reduced volume of stools points to constipation per se, and I still do not think you are having fecal impaction.
Diagnostic and therapeautic options involve enemas, which I would strongly recommend against at 37 weeks.
However, I fail to understand why a simple digital exam is not carried out, by a Specialist, it would clinch the diagnosis almost.
A CT could be done to support it , and at 37 weeks, is perfectly safe.
Also, I would say that do not go for enemas or other drastic measures, just seek a Specialist opinion, a per rectal exam is the next logical, safe step.
Carry on with the home remedies also.
You do not have any fever, pain , distension, bloating - I think you absolutely need to stop worrying about septicemia due to fecal build up as you are evacuating small amount of stools.
Again, from your history and clinical details, fecal impaction seems to be far fetched, but the constipation is severe, and necessitates a Specialist opinion and digital rectal exam, at the very least.
All the best
Will look forward to hearing from you again.
Hope this helped.
Regards

Dr. Aarti Vazirani

Category: Infertility Specialist

Experience:

Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B. J. Medical College, Ahmedabad, 2004

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Mucus plug | How does the mucous plug come off in pregnant women

Pregnancy

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Pregnancy and childbirth is an amazing process. After conception, a woman's body is rebuilt to bear a healthy child and protect him from all external threats. In particular, a small lump of mucus forms in the cervix - a mucous plug. It becomes an additional barrier that prevents infections from entering the cervical canal, and its release, along with other harbingers of childbirth, is evidence of the imminent birth of a baby. Let's see what a mucus plug is, when and how it leaves, and what difficulties this may cause. nine0003

6 min. for reading By Oksana Negrich Feb. 17, 2022

What is a mucus plug and why is it needed?

A mucus plug is a small clot that closes off the cervical canal during pregnancy. Together with the fetal bladder and fetal fluid, it protects the baby from infections and pathogens. nine0003

The mucous plug is formed at the beginning of pregnancy under the influence of special hormones. The cervix produces mucus, which subsequently thickens, turning into a clot. Usually, this clot protects the fetus for many months and leaves a few days before childbirth, when the hormonal background in the body of the expectant mother changes again and the whole body is actively preparing for the birth of the baby.

So, the mechanism is simple:

At 38 weeks, the level of progesterone - the hormone that is responsible for bearing the fetus - gradually drops. nine0022
The walls of the cervix smooth out, become softer, and the birth canal gradually expands.
The plug softens and falls off before childbirth, ideally 3-5 days before the start of the first period. Mucus can come out immediately in full or move away in parts within a few hours.

But this is not always the case. We described the average situation, and pregnancy is an individual process, which is influenced by the characteristics of the body of the expectant mother, her state of health, heredity and other factors. nine0003

Sometimes, after the release of the mucus clot, a woman can expect the birth of a child for another two to three weeks. And in some mothers, more often in primiparas, the cork comes out during childbirth along with the fetal fluid.

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How can you tell a mucus plug from other discharges? nine0013

During pregnancy, the amount of discharge may increase. This is due to an increase in the level of the hormones estrogen and progesterone, increased blood flow to the vagina, and is not a deviation from the norm.

To distinguish mucus plug from other secretions, pay attention to color and consistency. Cork is a small lump of mucus, similar to egg white, about the size of a walnut. Its hue can range from cream and brown to pink and yellow, sometimes streaked with blood. The usual discharge is clear or yellowish white, less thick and slightly sticky. nine0003

Time is also a very important factor. Normally, the discharge of the cork during pregnancy occurs on the eve of childbirth, at about 38-39 weeks. Normal discharge appears regularly, and is most abundant in the second trimester.

Amniotic fluid and mucous plug are also distinguished by appearance and frequency of discharge. Amniotic fluid is most often clear and more watery than cork. In addition, the mucous plug comes off in parts or immediately in full, and the fetal fluid leaks constantly, especially when coughing. nine0003

But even with all the characteristics, visually it can be difficult to distinguish between amniotic fluid and mucous plug or other secretions. Therefore, if something worries you, consult a specialist. For an accurate diagnosis, the doctor may use special tests for amniotic fluid leakage.

Early release of the plug: causes and dangers

In a normal pregnancy, the mucus plug comes out in the last weeks, when the body is already actively preparing for childbirth. But some external factors can provoke a premature departure of mucus, when there is more than one week before the preliminary date of the birth of the child. It can be:

training (false) contractions;
strong efforts;
external injuries, for example, during a medical examination in a gynecological chair;
violent contraction of the muscles of the vagina during sex;
excessive exercise.

After the plug has passed early, the cervical canal becomes open to bacteria, which weakens the protection of the fetus and increases the risk of infection. But this is not a reason to panic. If you do not have gynecological infectious diseases and leakage of amniotic fluid, then a sealed fetal bladder will protect the baby from troubles. nine0003

What to do when the cork is broken?

If you notice that the cork has broken and you are still far from your due date, we recommend that you consult your doctor. He will tell you how to proceed further in order to reduce the risks of infection. In addition, a number of precautions can help avoid complications:

avoid swimming in open water, pools and jacuzzis;
refusal to take a bath in favor of a shower;
strict observance of daily hygiene; nine0022
regular change of linen, including bed linen;
not having sex before childbirth, or at least using barrier methods of contraception.

If the mucus plug came out at the end of the third trimester, then everything is going according to plan and your body has begun the final preparations for childbirth: the level of estrogen has increased and under its influence the cervix began to smooth and open. So it's time to pack your bag for the hospital. And if the water has broken along with the cork or you feel pain and labor pains, then the baby is already on the way and you need to go to the hospital as soon as possible. nine0003

Important!

If the discharge is bright red and profuse (more than 30 grams - about two tablespoons), you should immediately consult a doctor. A mucous plug with blood indicates the possibility of serious complications such as placenta previa or placental abruption.

Other harbingers of childbirth

The approaching date of childbirth is indicated not only by the discharge of the mucous plug, but also by other changes that the expectant mother may feel.

1. Abdominal prolapse

Not only the mother's body is preparing for the imminent birth, but also the child himself. Two or three weeks before the birth, the baby is pressed by the presenting part - most often the head - to the bottom of the uterus. The extra pressure causes the uterus to sink into the pelvic area. It ceases to crowd the chest and abdominal organs, so it becomes easier for a woman to breathe, and heartburn and belching decrease or disappear altogether. But at the same time, it becomes more difficult to walk and sit, urination becomes more frequent, as the uterus presses harder on the bladder. Also, the expectant mother may feel heaviness in the lower abdomen and slight pain in the inguinal ligaments. nine0003

2. Weight loss

A few weeks before giving birth, the hormonal balance in the body of a pregnant woman changes: the amount of progesterone decreases, but the production of estrogen increases. Due to this, the fluid accumulated during pregnancy begins to be excreted from the body. The expectant mother loses 0.5-2 kg of weight and suffers less from swelling - it becomes easier to wear shoes, rings and gloves.

3. False contractions

False contractions often appear after 38 weeks of pregnancy to train the uterus before childbirth. Unlike real labor pains, they occur irregularly and pass without pain. There is also no gradual decrease in intervals and an increase in the intensity of contractions. nine0003

The appearance of false contractions is not yet a reason to go to the maternity hospital, but a sure sign that the meeting with the baby is gradually approaching.

Read also: Packing a bag for the maternity hospital: a list of necessary things

So, if the cork has come off, false contractions have appeared, the stomach has dropped and weight has decreased, then the woman’s body is undergoing the final preparation for the birth of the baby. The body tells us that we need to be alert, listen to ourselves and collect everything we need on the road for the long-awaited baby. nine0003

Material approved by doctor Oksana Negrich

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What forms a fecal plug, how to get rid of it at home

Beauty secrets of the stars0002 The occurrence of such a problem is not too rare. It arises from many reasons. Another motivational point to start monitoring your diet and regimen. Unfortunately, there are many factors that can cause blockage.

Basic:

· abuse of fatty and smoked foods;

hemorrhoids and anal fissures due to fear of pain during defecation;

problems with bowel tone, which often causes problems such as fecal congestion during pregnancy, due to too high production of muscle-relaxing progesterone; nine0003

overeating;

any deformities of the colon, atony and hypotension;

· Fecal congestion in a child (most often) can also occur because of the love of persimmons.

Elderly or mentally ill people have a risk of building up a whole fecal blockage from a simple cork. This is a much more unfortunate complication. Often such people do not control the frequency of the defecation process and can simply forget about it. And in this case, in the intestines, which are not stimulated by the ardent desire of the carrier to be cleansed, more and more portions of feces will be stuffed. As a result, the closest area to the anus will begin to harden - and then it will need to be crushed. nine0003

Photo: Shutterstock/Fotodom.ru

How to get rid of a fecal plug

At the first manifestations of this problem, it is necessary to get rid of it. Otherwise, it can lead to intoxication, the formation of fecal blockage and other "pleasant" consequences. First of all, you should consult with your doctor. He, if the patient wishes, is able to deliver a cleansing enema in a hospital or at home. With the help of such an enema, you can cleanse the intestines. As a rule, this is done with the help of enemax, norgalax, or the like. Duphalac and glycerin suppositories are also often used. nine0003

But how to soften a fecal plug if there is no desire to pour chemicals into such a tender place? The natural composition will help:

3 tbsp.

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