Constipation in Early Pregnancy

By Dr. Vik, MBBS, MRCP(GB), PhD

Constipation in early pregnancy

Constipation is defined as a difficulty in evacuating one’s bowels or a reduction in the frequency in one’s bowel movements. 

There are a number of ways that pregnancy can cause constipation, even early on in the pregnancy. It is believed that up to 40% of pregnant women suffer from constipation.

Here are some factors that may contribute to constipation early in the pregnancy. 

In this article, we shall briefly look at constipation as a problem in early pregnancy.

Causes of Constipation

in Early Pregnancy

During pregnancy, a woman’s body undergoes a number of different physiological and anatomical changes.

These changes can impact different vital systems of the body.

1. Hormonal causes

To understand constipation in early pregnancy we must see that there is a rise in the serum progesterone levels in the early stages of the pregnancy.

This, accompanied by a reduction in the levels of a hormone called motilin (responsible for bowel movements) can increase the time it takes for stools to pass through the bowels.

This increase in bowel transit time gives the colon more time to extract water. The result is that stool dries out, making it hard and difficult to pass.

2. Increased water absorption

In addition to this, the physiological changes themselves result in an increased absorption of water from the bowel to be used elsewhere to accommodate the pregnancy.

When stool dries out, it loses its bulk, making it more difficult for the colon to move it along. A magnesium supplement, taken with plenty of water, is a good way to counter this difficulty. 

Magnesium is a natural osmotic laxative that pulls water into the colon, promoting a moist, soft and slippery stool.

The added moisture also increases the bulk of the stool, thereby helping the colon’s wavelike contractions (called peristalsis) to move the stool along.

Unlike most other laxatives, magnesium is non habit forming. For the 80% of Americans that don’t get enough magnesium in their diet, a magnesium supplement may result in numerous health benefits. 

3. Lack of fiber in the diet

This is a common cause of constipation, one that can be easily rectified by increasing the amount of fiber consumed.

Foods that are rich in fiber also tend to be rich in magnesium.

In other words, pregnant women who are unable to consume a sufficient amount of fiber should take a magnesium supplement to help in relieving constipation.

4. Lack of exercise

Many times, once a woman realizes she is pregnant, she starts being more careful in her activities so as not to harm her baby.

This can sometimes mean a reduction in physical activity. Exercise is a needed component for regular bowel movements, and a sedentary lifestyle is a recognised cause of constipation.

The lack of exercise in the first trimester (extending all the way through the pregnancy) can result in constipation.

5. Supplements

Pregnant women are usually put on a vitamin/mineral supplement by their doctor.

These supplements generally include iron and calcium, which can lead to constipation.

Taking a magnesium supplement will help to balance out the effects of iron and calcium.

• When the body doesn’t absorb iron and it travels to the colon, it causes feces to linger longer in the colon in an effort to better absorb the iron.
  
  Magnesium can help with the absorption of iron before it reaches the colon, thus reducing constipation. 
  
  
• Calcium tends to constrict muscles. Unabsorbed calcium that makes its way to the colon will cause the colon to tighten up, inhibiting peristalsis.
  
  Magnesium is a relaxant mineral that counters the effects of calcium. 

6. Pre-existing constipations

While constipation can develop as a result of pregnancy, there are patients who suffered from constipation prior to becoming pregnant, and this can be further complicated by pregnancy.

For this person, it may be a good idea for them to include in their diet foods that help to alleviate constipation. 

7. Other risk factors

Parity and a previous history of undergoing a caesarean section are recognised risk factors of constipation. Having an underactive thyroid gland is known to cause constipation as well. 

Other causes of constipation include pressure on the bowel loops from the enlarging uterus, but this is mainly a problem from the second and third trimester.

Treating Constipation in Pregnancy

Constipation in early pregnancy is a recognized yet is an under-appreciated problem. Natural remedies such as increasing fiber intake and increasing fluid intake are a good place to begin.

The use of laxatives has been mentioned but the safety of laxatives during pregnancy has not been well established. 

The use of a magnesium supplement can be extremely beneficial. Dosing is simple, the effects are almost immediate and side effects are minimal.

A magnesium supplement is one of the safer ways to prevent and treat constipation during pregnancy. For a pregnant woman, 350 to 400 mg. of total magnesium intake per day is recommended.

(Return from Constipation in Early Pregnancy to Pregnancy and Constipation)