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Constipation during pregnancy: causes, recommendations

In addition, constipation in pregnant women may be caused by changes in the nature of food, the use of smooth muscle-relaxing 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 .

In addition, constipation in pregnant women may be caused by changes in the nature of food, the use of smooth muscle-relaxing 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.

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 termination, 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'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 .

In terms of nutritional properties, wheat bran is considered the most acceptable for human consumption, which can be added 2-3 teaspoons to prepared meals 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 motor 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 . The drug Guttalax® Express enhances peristalsis, stimulates the natural process of bowel movement, and softens the stool. The development time of the laxative effect of the drug is 20 minutes (from 10 minutes to 30 minutes, in some cases - 45 minutes) ⁸ .

THERE ARE CONTRAINDICATIONS. IT IS NECESSARY TO CONSULT WITH A SPECIALIST.

Early pregnancy | Shchelkovsky perinatal center

Pregnancy is a wonderful period! However, the changes taking place in the body at this time can greatly frighten you. The phenomena characteristic of pregnancy are different for all women, and will not necessarily be repeated during each subsequent gestation. Let's analyze the most common symptoms, their causes and possible methods of correction.

1. Frequent urination.

Frequent, painless (!) urge to urinate is one of the signs of pregnancy. This is due to increased secretion of progesterone (pregnancy hormone), changes in metabolism and pressure from the growing uterus on the bladder.

Be sure to see a doctor if:

• urination is painful (this may be a sign of an infection)
• urine of strange color (stained with blood, brown)
• the amount of urine excreted per day is much less than the liquid drunk per day

Life hack! In no case should you limit your fluid intake! To alleviate the condition and reduce the frequent urge to urinate, it is necessary to exclude products that have a diuretic effect: tea, coffee, zucchini, watermelon; as well as salty, spicy and fried foods. It is better to drink water or juice. Wear comfortable cotton underwear that does not squeeze the lower abdomen.

2. Nausea, vomiting, heartburn, increased susceptibility to odors.

Nausea is one of the common symptoms of early pregnancy. The range of issues related to nausea and vomiting during pregnancy is quite wide. From "it's good, I don't even feel sick" (with relief), "I don't feel sick, what's wrong with me?" (with anxiety) to "when will this nausea pass" (with hope). Indeed, these symptoms are not at all a mandatory accompaniment of gestation, they can manifest at 7-8 weeks and last up to 12-14 weeks. The duration of this condition can sometimes be delayed, but rarely persists throughout pregnancy.

Life hack! For nausea, eat before you feel hungry. Solid, non-hot food and drinks at a cool temperature are best. With heartburn, you should eat small portions of food and often, and most importantly, sit, stand or walk for at least 30 minutes after eating, but do not lie down.

You should definitely consult a doctor if:

• vomiting occurs even after drinking water
• vomiting is exhausting, accompanied by dizziness, weakness
• dryness, jaundice and flaking of the skin appear
• nausea and vomiting impede proper nutrition, accompanied by weight loss

To reduce nausea and vomiting in the morning, try eating something before you get out of bed. It can be a cracker, a cookie, a piece of hard cheese. And salty food is preferable to sweet. You can have a snack in the same way at night when you get up to go to the toilet. Do not lie down immediately after eating, this will only increase nausea. Vitamins for pregnant women with nausea should be taken in the evening after meals. Cool water with lemon, ginger, mint tea, or ginger or mint candies can alleviate the condition. It is necessary to exclude those foods, drinks and smells that are unpleasant to you. Brushing your teeth and rinsing your mouth often can also reduce nausea.

3. Pain or cramps in the lower abdomen, constipation, pain in the lumbar region.

The simplest and most easily controlled cause of pain is delayed and incomplete bowel movements. An increase in the concentration of progesterone relaxes the smooth muscles, which are located not only in the uterus, but also in other hollow organs. In this case, the correction of the diet and the restoration of the passage of feces will help. If the measures are ineffective, the doctor may prescribe safe drugs for you. A special type of pain that occurs during exclusivity in pregnant women is pain in the round ligament of the uterus. This acute, rather intense pain occurs, as a rule, on the one hand with a sharp change in body position (for example, when getting up from a chair or leaving a car). This pain occurs due to stretching, and then a sharp contraction, like a spring, of the round uterine ligaments. The pain quickly passes if you immediately take a comfortable position and does not require special treatment.

You should definitely consult a doctor if:

• pain is accompanied by spotting bloody discharge from the external genitalia
• increasing duration and intensity of pain
• abdominal pain accompanied by dizziness, fever, loss of consciousness

Life hack! To normalize bowel movements, eat more vegetables and fruits, drink water and move more during the day. Try to eat often and in small portions.

4. Enlargement and soreness of the mammary glands.

Hormonal restructuring of the body during gestation is accompanied, among other things, by an increase in the size of the mammary glands and an increase in their sensitivity. By the end of the first trimester, the soreness usually disappears, no additional methods of treatment are needed.

Life hack! Choose comfortable supportive underwear (it should not leave marks on the skin at the end of the day). You may need a larger size or a sports bra. Pain in the mammary glands is relieved by a warm shower at the end of the day.

You should definitely see a doctor if:

• the pain is severe
• mammary glands are very dense with redness and body temperature is increased
• discharge from the nipples appears (purulent, bloody)

5. Increased body temperature.

In early pregnancy, an increase in body temperature to 37.5 ° C is not necessary, but is possible due to the peculiarities of the action of progesterone. Because of this, it is difficult for pregnant women to endure stuffy, hot rooms. Self-medication is dangerous: an attempt to bring down the temperature even with a seemingly harmless folk method - tea with raspberries - can mask the true cause of hyperthermia and delay the diagnosis. Due to the increased body temperature, pregnant women should dress in layers and avoid stuffy and hot rooms and spaces so that they can always “adjust” their temperature on their own.

• temperature above 37.5 °C
• along with fever, any pain occurs
• runny nose, cough, body aches appear

6. Nasal congestion, difficulty breathing, nosebleeds.

These symptoms can be explained by the individual reaction of the vascular system to the increase in blood volume that occurs during pregnancy. Another possible reason is dry air in the room, the operation of central heating batteries.

Life hack! The easiest way to deal with nasal congestion is to use a humidifier. If you don't have one, you can put a damp towel on the battery - less effective, but better than nothing. It is possible to use sprays with sea salt, but you need to carefully read the instructions and especially the "Indications" section, it should contain information about the safety of the product during pregnancy.

You should definitely see a doctor if:

• symptoms of a cold occur
• nasal congestion accompanied by ear congestion
• these symptoms appeared after exposure to the allergen known to you

7. Blood pressure fluctuations.

An ideal option for the course of any pregnancy is the stability of the blood pressure throughout the gestation. However, this is extremely rare. A small (up to 10 units) increase in pressure from the usual reference may be due to an increase in the load on the cardiovascular system as a result of changes in body weight, hormonal changes, and uterine pressure on the vessels. Normal pressure: systolic below 130 mm Hg, diastolic no more than 85 mm Hg. Blood pressure in the range of 130–139/ 85–89 mm Hg considered high to be normal. High numbers are often observed in patients of older reproductive age, suffering from diabetes mellitus and kidney disease, obesity, etc. However, it is imperative to tell the doctor about all these concomitant pathological conditions at the first appointment and, if necessary, consult a neurologist, cardiologist, endocrinologist and other related specialists . Reasonable physical activity, adherence to sleep and wakefulness, a balanced diet, and the rejection of coffee and strong tea allow you to keep pressure within limits. Of the completely exotic for our days, but no less significant - the prevention of stress.

Life hack! If you first discovered that you have high normal pressure, repeat the measurement after 15 minutes. If the pressure remains elevated, see a doctor.

Be sure to see a doctor if: