Why do you get constipation during pregnancy
Constipation during pregnancy | Pregnancy Birth and Baby
Constipation during pregnancy | Pregnancy Birth and Baby beginning of content5-minute read
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What is constipation?
'Normal' bowel function differs from person to person, although some people find it difficult to pass soft stools (poo) regularly. Constipation means having fewer than 3 bowel motions per week and with stools that are hard to pass. If you suffer from constipation, it may be difficult or painful to pass stools, and you may find you need to push or strain. Some people with constipation feel they have not fully emptied their bowels and that even after passing stools, they feel the need to pass more.
Up to 1 in 4 women experience constipation during pregnancy. However, constipation will often resolve itself as pregnancy progresses.
What causes constipation during pregnancy?
Low levels of dietary fibre in your diet can contribute to constipation during pregnancy – as they can at any other time. There are, however, reasons why constipation is more common during pregnancy.
An increase in the pregnancy hormone progesterone can cause your gut to work less efficiently and your food to move more slowly through your intestines. This is known as reduced gastric motility.
Another cause of constipation is the medicines and supplements that some women take during pregnancy. Medicines prescribed for nausea and vomiting, antacids for heartburn, and some strong pain medicines can induce constipation in some women. Supplements like iron and calcium, as well as some multivitamins can also trigger constipation.
If you take any of these during your pregnancy and are troubled by constipation, speak with your doctor about whether a change in the formulation of your medicine or supplement can help. Sometimes a simple change of brands or dose can reduce constipation.
However, everyone is different and a formulation that causes constipation for one person might work well for another.
Am I more likely to experience constipation if I had it before pregnancy?
Women who have had constipation before pregnancy are, unfortunately, likely to experience worsening of symptoms during pregnancy.
If you have constipation and are planning a pregnancy, try to get into good habits before you become pregnant. Keeping to a healthy diet, drinking plenty of fluids, and doing regular exercise may help you maintain regular bowel motions.
It is better to prevent constipation early on rather than wait to treat it later.
How is constipation treated during pregnancy?
The first step in treating constipation is to increase the fluids and fibre in your diet. Eating wholegrain foods, fruit and vegetables can often resolve constipation. If symptoms continue, then fibre supplements or laxatives may be a short-term solution – however, it is always better to stimulate the bowel with a healthy diet rather than take medications.
Taking laxatives can sometimes result in side effects such as abdominal pain and diarrhoea.
While most cases of constipation are not a sign of illness, sometimes there are complications such as haemorrhoids, faecal impaction or rectal prolapse. In rare cases, constipation can be caused by more serious conditions such as tumours.
Speak with your doctor if you are concerned, and especially if you notice blood in your stools.
Will it affect my baby?
If you’re pregnant, you don’t need to worry that constipation will affect your baby since the discomfort occurs in the mother’s gut and bowels and isn’t passed on to the baby. Most laxatives are not well absorbed into the bloodstream and can be taken during pregnancy and breastfeeding, but always check with your pharmacist before taking a medicine while pregnant.
Will it continue after I’ve had the baby?
There are several reasons why constipation may continue after birth. Women who have had a caesarean often experience constipation for a few days until their regular bowel movements return.
Women who have stiches after a vaginal birth may hesitate on the toilet, which can cause a build-up in their bowels.
If you’ve taken strong pain medication after having your baby this may also cause constipation.
New mothers are often busier than usual in the first few weeks and months of motherhood. It may seem like taking care of yourself has become less of a priority, but your health is no less important now than it was during your pregnancy. Be sure to have plenty of fibre-rich fruit, vegetables, and wholegrains as well as increase your fluid intake while breastfeeding to encourage healthy bowel movements, even when you are busy.
Where to get help?
Constipation can vary in severity and if changes to your diet do not help relieve your symptoms, ask your midwife, doctor or pharmacist for guidance on choosing and using a laxative.
Sources:
Australian Government Department of Health (Common conditions during pregnancy: constipation), Better Health Channel (Constipation), The Royal Hospital for Women (Constipation in pregnancy and breastfeeding)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: January 2021
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Constipation in Pregnancy: 5 Fool-Proof Remedies
If you’re pregnant, you’ve probably experienced these symptoms of constipation: infrequent bowel movements, abdominal pain, and hard stools.
Hormonal changes, pressure on the uterus, and iron in prenatal vitamins are to blame.
Read on to learn more about constipation in pregnancy, why it happens, and what you can do to relieve it.
Why Am I Constipated?
An increase in the progesterone hormone during pregnancy causes the relaxation of your body’s muscles. That includes your intestines. And slower moving intestines means slower digestion. This can lead to constipation.
Constipation is common during pregnancy. Almost three out of four pregnant women will experience constipation and other bowel issues at some point, according to a study published in Acta Obstetricia et Gynecologica Scandinavica.
From over-the-counter pills to natural cures, there are a whole host of remedies available for relieving constipation.
But when pregnancy’s involved, the number of solutions shrinks.
These five remedies are pregnancy-safe.
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A diet high in fiber helps prevention constipation.
It also supplies pregnant women with vitamins and antioxidants.
Pregnant women should try to consume 25 to 30 grams of dietary fiber each day to stay regular and healthy.
Good choices include fresh fruits, vegetables, beans, peas, lentils, bran cereals, prunes, and whole-grain bread.
Try cutting up some raspberries, apples, bananas, figs, and strawberries for a refreshing fruit salad. Or roast some sweet corn, Brussels sprouts, and carrots for a delightful side dish.
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It’s important to stay hydrated during pregnancy. That might mean doubling your water intake.
Pregnant women should drink at least eight 12-ounce glasses of water a day. This will help keep your bowels soft and moving smoothly through your digestive tract.
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Try breaking up your daily food intake into five or six smaller meals to help with constipation relief. This will allow the stomach to digest food without having to work overtime, and allow it to transfer food to the intestine and colon smoothly.
Eating large meals can overload your stomach and make it harder for your digestive system to process what you’ve consumed.
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Regular physical activity can help reduce constipation. Exercise stimulates your bowels. Pregnant women should try to exercise three times a week for 20 to 30 minutes each.
The options for exercise are endless. Try walking down your favorite hiking path, swimming at your local gym, or practicing prenatal yoga on a relaxing afternoon.
Check with your doctor about what exercises are safe for you and your baby.
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If other natural options have failed, doctors will sometimes prescribe stool softeners like Colace on a short-term basis to help pregnant women with constipation. Colace stool softeners are available online. However, long-term use can lead to dehydration or change your electrolyte balance.
Stool softeners help moisten your bowels so they are easier to pass. They are especially useful for pregnant women taking constipation-causing iron supplements.
Doctors will often prescribe softeners along with iron pills. You can find a variety of iron supplements here.
Stool softeners are medications, so it’s best to check with your doctor if they are safe for you.
Takeaway
Constipation relief during pregnancy is common, and it can be remedied.
Just follow the steps above to help ease the discomfort of backed up bowels while you wait for your little one to arrive.
Tips for a Healthy and Happy PregnancyTreatments for constipation during pregnancy
What is the problem?
The term "constipation" is defined as difficulty in passing stools and reduced frequency of stools (defecations - bowel movements to empty it). Constipation is characterized by discomfort, excessive straining, hard or lumpy stools, a feeling of incomplete emptying, and infrequent bowel movements. Constipation is a common symptom during pregnancy. This may be the result of a combination of factors including hormonal changes (shifts) during pregnancy affecting the digestive system, physical inactivity, and dietary changes during pregnancy.
Also, as the fetus (baby) grows, it can compress the mother's intestines and thereby cause bowel delays/obstructions.
Why is this important?
Constipation during pregnancy is associated with impaired quality of life and distress for pregnant women, as well as physical problems, including the development of hemorrhoids. A number of treatment options have been suggested, including the use of medications, nutritional supplements, or dietary changes.
Non-pharmacological interventions (changes in diet, water intake and exercise) are generally recommended initially, and if these are ineffective or insufficient, medical (pharmacological) interventions are recommended. Medical interventions include a wide range of drugs: lubricants (lubricants), bulking agents, osmotic and stimulant laxatives, stool softeners (emollient laxatives), enemas and suppositories (laxatives in suppositories and enemas).
This review looked at the benefits of drug and non-drug interventions for constipation in pregnancy and whether they are safe for women and children.
What evidence did we find?
We identified four studies, but only two studies (a total of 180 women) provided data for analysis. These studies compared stimulant laxatives with bulk laxatives and dietary supplements (dietary fiber) with no intervention. The included studies were considered to be of moderate (moderate) quality.
We have looked at two main comparisons. In the first comparison, we found that stimulant laxatives may be more effective in treating constipation than bulk laxatives ( moderate-quality evidence ). However, it can also lead to more abdominal discomfort ( low-quality evidence ) and diarrhea ( moderate-quality evidence ). We found no difference in women's satisfaction ( moderate quality of evidence ). A second comparison between fiber supplementation and no intervention found that fiber supplementation may be effective in increasing stool frequency ( moderate-quality evidence ).
The use of dietary supplements (fibers) was associated with improved stool consistency as defined by the testers (hard stool frequency decreased by 11% to 14%, normal stool frequency increased by 5% to 10%, and loose stool frequency increased by 0% to 6 %).
There were no studies looking at other types of interventions such as osmotic laxatives, stool softeners (stool softener laxatives), lubricants (lubricating laxatives), enemas, and suppositories (suppositories).
What does this mean?
What little evidence exists suggests that dietary supplements rich in fiber (or fiber - bulk laxatives or fillers) may increase stool frequency. When choosing between stimulant or bulk laxatives: stimulant laxatives may provide better relief of constipation, but may be more likely to cause abdominal discomfort and diarrhea.
More research is needed in this area.
Translation notes:
Translation: Dzhumalieva Elnura Mukhodinovna. Editing: Ziganshina Lilia Evgenievna.
Project coordination for translation into Russian: Cochrane Russia - Cochrane Russia (branch of the Northern Cochrane Center on the basis of Kazan Federal University). For questions related to this translation, please contact us at: [email protected]
Constipation during pregnancy: causes, recommendations
In addition, the causes of constipation in pregnant women can be changes in the nature of food, taking drugs that relax smooth muscles (reducing 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, the causes of constipation in pregnant women can be changes in the nature of food, taking drugs that relax smooth muscles (reducing 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 dramatically 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 to prepared 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 . The drug Guttalax® Express enhances peristalsis, stimulates the natural process of bowel movement, and softens the stool. The time for the development of the laxative effect of the drug is 20 minutes (from 10 minutes to 30 minutes, in some cases - 45 minutes) 8 .
