Pregnancy and Constipation

By Dr. Julia Lizy, MBBS (KEMU)

Pregnancy and constipation

Constipation is a common problem in pregnancy. As much as 50% of women suffer from it at some point during pregnancy. Constipation tends to increase as pregnancy advances. 

Constipation is common in early pregnancy. It is considered to be one of the earliest signs of pregnancy, especially when it is accompanied by nausea, dizziness, mood swings and food cravings.

What causes Constipation during pregnancy

There are a number of contributing factors to constipation during pregnancy. 

Increased production of progesterone: This is a hormone which causes intestinal wall muscles to relax, making the colon less capable of peristalsis, the wave-like compressions that move along waste materials.

• Lack of exercise: Most women relax more during pregnancy. They tend to limit their physical activity to a minimum. This can lead to constipation, or make it worse if it is already present.
  
  
• Iron supplementation: During pregnancy its common to take iron supplements for treating anemia, the iron deficiency that is common during pregnancy. Iron supplements can cause constipation or can make existing constipation more severe. 
  
  
• An enlarged uterus: During pregnancy the uterus gradually expands. Later in pregnancy it can press on intestines and the rectum, restricting the movement of feces, which can lead to constipation.
  
  
• Dehydration: During pregnancy, it is important to drink an adequate amount of water. Decreased water consumption can lead to dehydration, a leading cause of constipation.
  
  
• Pelvic pain: Pelvic pain, which is common during pregnancy, can result in constipation, as there is a tendency to avoid defecation.
  
  
• Stress factors: For women, pregnancy can be stressful. Stress has a direct effect on the colon, causing a decrease in peristalsis. Stool moves more slowly through the colon, more water is extracted from it, and it becomes dry, hard and difficult to pass. 
  
  
• Low fiber diet: As her body changes, a pregnant woman tend to eat differently. Unfortunately, pregnant women eat less fiber rich foods and more foods that can cause constipation. 
  
  
• In General: Women who are prone to constipation find that, because of the above mentioned factors, they have an even greater problem with constipation during pregnancy. 

Symptoms of constipation during pregnancy

• Less than three bowel movements per week
  
  
• Hard, dry feces
  
  
• Difficulty in passing stools
  
  
• A feeling of incomplete evacuation, that some stool remains in rectum
  
  
• Occasional bleeding caused by dry, hard stools
  
  
• Rectal fullness due to impacted and dry stools in the rectum, which can also cause a sensation of blockage
  
  
• Abdominal bloating
  
  
• Abdominal cramps and pains
  
  
• Decreased appetite

Does constipation affect the baby?

Constipation usually doesn’t pose a problem for baby, although it may be a problem during delivery.

This is just another reason to find a way to successfully treat before delivery. 

Complications of constipation during pregnancy

Constipation can cause a number of health related issues to women during pregnancy, such as:

• Hemorrhoids: long term constipation during pregnancy can cause hemorrhoids, (also called piles) which can be troublesome and cause discomfort during the pregnancy and after childbirth.
  
  
• Rectal Bleeding: hard and dry stool which are withhold sometimes can cause rectal bleeding during the defecation process. 
  
  
• Anal fissures: Straining at defecation and dry hard stools can cause problem of anal fissures which become troubling after pregnancy. 
  
  
• Fecal Impaction: Dry and hard stools that stay in rectum for a long time can cause fecal impaction, making defecation difficult.  

How to deal with constipation

Since constipation is such a common condition during pregnancy, women should do their best to avoid it.

There are many safe ways to treat and get rid of constipation.

1.  Some Natural Remedies 

• Squeeze a lemon into a glass of water and drink the mixture every morning. This can prompt a bowel movement.
  
  
• Eat plenty of dry fruits, including dates, prunes and raisins. They are nutritious, and they are good for relieving constipation.
  
  
• Drinking fruit juices from citrus may help in improving bowel movements.

2.  Maintain regular bowel movements

Having a regular bowel movement is important for preventing constipation. It is beneficial to work at having a bowel movement at same time each day.

The body tends to adapt to the schedule. Do not ignore the urge to go when it comes, as this may result in less and less of an urge to go.

It will also mean that stool stays in the colon longer, which gives it more of a chance to dry out and become compacted.

Good sleeping and eating habits can also aid in preventing constipation.

3.  Maintain a daily exercise schedule

Being physical active is helpful. There are exercises that are well suited for pregnancy.

Getting into some simple exercises such as walking for 20 to 30 minutes daily or swimming can stimulate and regulate bowel motility.

Taking time to relax each day may help to reduce stress, a common factor of constipation. 

4.  Keep well hydrated

Drink an adequate amount of water, at least 6 to 8 glasses a day, to keep the body hydrated. Dehydration is a common cause of constipation.

5.  Eat a high fiber diet

A good goal is 25 g. to 35 g. of fiber each day. Fiber is helpful to keep bowel movements normal and regular. Include these high fiber foods:

• Fruits and vegetables
  
  
• Whole grain bread or cereals
  
  
• Bran cereals
  
  
• Beans, nuts and seeds
  
  
• Brown rice instead of white rice

6. Laxatives

Some laxatives are safe during pregnancy and can be used, including:

• Bulk forming laxatives: Psyllium or bran
  
  
• Stool softeners: Docusate sodium or calcium
  
  
• Lubricants: Mineral oil 
  
  
• Osmotic laxatives: Magnesium hydroxide, magnesium sulfate, lactose, sorbitol.

Magnesium for constipation

Magnesium is a mineral needed for many bodily functions. 

It is a mineral that tends to help muscles relax, and is known for its laxative and antacid effects.

Magnesium is found in fruits such as bananas and grapes, or vegetables such as spinach and cauliflower. Almonds, sunflower seeds and other nuts are rich in magnesium. 

Two ways that magnesium helps to fight constipation:

1. Magnesium is a muscle relaxant, which counters the muscle tightening effect of calcium.
   Balancing calcium with magnesium can help to enhance the rhythm of peristalsis that moves stool through the colon.
   
   
2. Magnesium is a natural osmotic laxative that draws water into the colon. This softens stool, making it easier for it to pass through bowels. 

Conclusion, pregnancy and constipation

Up to 50% of pregnant women experience constipation during pregnancy.

There are numerous ways that constipation may be avoided. Magnesium can be quite helpful when other methods fail. 

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