Constipation in a pregnant woman - causes, treatment, prevention

Difficulty defecating is a very common problem during pregnancy. Constipation in pregnant women occurs due to various factors. These include hormonal changes, a growing uterus, and an increase in the sensitivity threshold of intestinal receptors. Changes in the body weaken intestinal function and slow down the digestion process.

Constipation during pregnancy is not just a delicate problem. It can affect the well-being of the expectant mother and the health of the baby. Retention of stool leads to pain in the lower abdomen, which can be confusing, as they are easily confused with unpleasant sensations due to hypertonicity of the uterus. Chronic constipation often leads to changes in the psycho-emotional state and makes a woman irritable. It causes increased fatigue, which is already common to many women who are awaiting replenishment.

To get rid of discomfort and avoid complications, you need to carefully consider this problem and start treatment on time.

Symptoms of constipation during pregnancy

The main signs of constipation during pregnancy include:

lack of stool for more than three days in a row;
incomplete bowel movement;
discomfort and feeling of fullness during bowel movements;
increased stool density;
reduction in the number of acts of defecation.

Stagnation of intestinal contents is often accompanied by flatulence, a feeling of bitterness in the mouth, nausea, and increased gas formation. Experts distinguish between chronic and acute constipation. The acute form is temporary and most often occurs under the influence of provoking factors. For example, severe stress or changes in diet.

Constipation in a pregnant woman can manifest itself not only as stool retention. Thus, constipation is considered to be daily bowel movements if dense, fragmented stool is observed in a small volume, and the woman notes a feeling of incomplete bowel movement.

However, most often constipation is the absence of stool for 2-3 days. Normally, bowel movements should occur daily, in rare cases it is permissible up to once every 2 days, if the expectant mother notes good health and the absence of unpleasant symptoms.

In addition to rare bowel movements, the following signs may indicate constipation: +

abdominal pain due to the accumulation of feces and gases;
false urge to defecate, in which a visit to the toilet ends without result;
the need for strong straining to empty the bowel;
dense, dry feces

Companions of constipation are hemorrhoids, anal fissures and other proctological diseases. The likelihood of developing hemorrhoids during pregnancy increases, and if stool retention also occurs, the risk of such a pathology increases several times.

Severe constipation during pregnancy is sometimes accompanied by symptoms of general intoxication: dizziness, excessive sweating, weakness, headaches, fatigue and sleep disturbances. This is due to the developing intoxication of the body due to stagnation of feces. In case of prolonged constipation lasting 3 days or more, a slight rise in temperature, nausea and even vomiting may be observed. Such symptoms cause difficulties in diagnosing toxicosis, anemia and other diseases that may accompany pregnancy.

Candles

For constipation after childbirth, suppositories with glycerin or sea buckthorn oil are used. Rectal suppositories soften stool and prevent the formation of plugs. Glycerin, acting as the main element, has laxative properties and accelerates the healing of microcracks around the anus. Suppositories with sea buckthorn oil are used for stool retention accompanied by the formation of hemorrhoids.

Suppositories can be used for constipation after a caesarean section, while the stitches are still healing. The insertion of rods into the anus is carried out while lying on your side. Suppositories are placed in a cool place 5-7 minutes before intended use. Before and after the procedure, hands must be disinfected.

No more than 1 candle is placed per day. Suppositories for constipation after childbirth are used for 7-10 days. In case of relapse, treatment is repeated after the prescribed time.

Causes of defecation delay

Constipation is a condition characterized by a decrease in the number of bowel movements, difficult bowel movements, and hard stools. The disorder is often accompanied by a decrease in the volume and consistency of stool.

Constipation during pregnancy occurs for several reasons:

Violation of the motor-evacuation and rhythmic function of the intestines, caused by compression from the growing uterus.
Relaxation of intestinal smooth muscles, impaired peristalsis due to increased progesterone levels.
Unbalanced diet, insufficient water intake.
Drug therapy, the presence of chronic gastrointestinal diseases.

Also, gestational constipation is often associated with a lack of physical activity, taking certain vitamins and minerals, and emotional stress. In the early stages, problems with stool occur due to toxicosis. General malaise, nausea, loss of appetite - all this affects digestion and causes dehydration and a decrease in the volume of feces.

The most common cause of colonic stasis in pregnant women is a decrease in the production of substances that activate intestinal motility. A decrease in the amount of these compounds is normal. This is a kind of protective reaction of the body that prevents the threat of miscarriage.

Physical inactivity can be the main mechanism for the development of constipation during pregnancy and an aggravating factor. Insufficient physical activity is usually associated with a woman’s unsatisfactory well-being, the risk of miscarriage, and a doctor-recommended reduction in activity. And during a multiple pregnancy, even simple exercises can be difficult for a woman due to the increased load on the musculoskeletal system.

The food preferences of the expectant mother also change. Often, the diet is completely revised some time after conception. The digestive system may need some time to get used to increased amounts of food and changes in the daily menu.

Diagnosis of constipation

Diagnosis is based on complaints that a woman voices to the doctor. As a result, a diagnosis of chronic constipation may be made. However, identifying the causes is important here, since stool retention is only a symptom. It is important to establish the development mechanism to eliminate the causes.

What to do about constipation during pregnancy? First of all, tell the gynecologist who is treating you about this. If necessary, he will refer you to specialized specialists if there is reason to suspect diseases of the gastrointestinal tract or other pathologies. It is important to tell about how long ago the retention of stool began, and whether the problem was observed before conception.

Complex diagnostics usually includes laboratory and instrumental methods, taking into account the duration of pregnancy and the individual characteristics of its course.

The doctor excludes serious pathologies based on the results of routine examinations: assessment of the level of glucose in the blood and thyroid hormones, conclusions of a therapist, etc. In addition, at certain times, the patient undergoes routine examinations by specialized specialists. If she does not have chronic diseases that can lead to constipation, the doctor will explain the reasons for the difficulty in defecation and talk about how to deal with it.

Duphalac

Duphalac is available in the form of an emulsion for oral administration. The medicine has a sweet taste and plum aroma. It is completely safe for health, no side effects are observed even with long-term use. The dosage form contains lactulose - 667 mg/100 ml.

The principle of action of Duphalac for constipation after childbirth is to stimulate the peristalsis of the large intestine. At the same time, the volume of digested food increases, and the density of feces decreases.

Dangers and complications

Constipation disrupts the intestinal microflora and promotes the proliferation of opportunistic microflora, which can negatively affect the health of the expectant mother and baby. The accumulation of fecal matter is dangerous due to complications such as:

weakening of the protective functions of the mucous membrane of the digestive tract;
reabsorption of toxins and metabolic products;
imbalance of intestinal microflora.

With constipation, an increase in the permeability of the intestinal walls develops, and their protective function is disrupted. In late gestation, persistent constipation can cause premature rupture of amniotic fluid, as well as endometritis. In addition, problems with stool cause heaviness and pain in the abdomen, burning in the rectum, and irritation in the anus. Normalizing stool consistency will help avoid injury to the rectum during bowel movements.

Proctological diseases often accompany stool retention. The risk of developing hemorrhoids, anal fissure, and proctitis increases. And abdominal pain can result in an incorrect diagnosis - the doctor will assume a threat of miscarriage, and the woman will undergo treatment that is unnecessary in this particular case.

Intoxication associated with constipation can aggravate toxicosis. In this case, there is a decrease in appetite and sleep disturbance. All this has an adverse effect on the overall health of a woman and may cause a deficiency of vitamins and minerals.

conclusions

Glycerin suppositories for constipation for pregnant women are a safe laxative, when used for medicinal purposes there are almost no side effects. Compliance with the gynecologist's instructions guarantees the absence of characteristic symptoms of overdose. The medication interacts well with other drugs; suppositories do not increase or decrease the bioavailability of drugs.

Proper storage preserves the healing properties of rectal sticks with glycerol. Opened boxes must be stored in the refrigerator without deforming the original packaging. Shelf life - no more than 36 months from the date of manufacture. Hemorrhoids are a relative limitation to the use of suppositories. To lubricate the sphincter, it is prohibited to use mineral, aromatic oils and oil-based massage products - this increases the risk of developing allergic reactions.

Features of treatment and laxatives

Treatment of constipation during pregnancy requires an integrated approach. The doctor’s first recommendation will be to adjust your lifestyle and diet. In case of ineffectiveness or poor effectiveness of such measures, symptomatic therapy is prescribed. The doctor will not wait for results from the diet if constipation causes severe discomfort, there is a risk of complications, and urgent help is required.

When choosing a laxative, it is important to pay attention to the safety of the drug for both the expectant mother and the baby. There are several groups of laxatives:

Osmotic (macrogol, lactulose). Products based on macrogol (polyethylene glycol) help soften stool and increase its volume. As a result, the walls of the colon are stretched, which stimulates their contraction and bowel movements. Lactulose preparations are laxatives with prebiotic action. They also increase the volume of intestinal contents, increase osmotic pressure, dilute stool and stimulate peristalsis. In addition, lactulose stimulates the growth of lactobacilli and inhibits the growth of ammoniogenic microorganisms and salmonella.
Softening. Such products are represented by oils and glycerin, they promote the penetration of water into the stool. These drugs can only be recommended for the treatment of occasional constipation, since vegetable oils interfere with the absorption of fat-soluble vitamins (A, ED, K). They are prescribed to pregnant women with great caution to avoid complications such as hypovitaminosis.
Bulk laxatives: vegetable - bran, plantain seeds, flax, etc.; synthetic - preparations based on cellulose. Promotes fluid retention in the intestines, increases the volume of feces, and gently stimulates peristalsis. Suitable for continuous use for constipation with normal transit time.
Anthraquinone derivatives, stimulant laxatives. Preparations based on buckthorn, rhubarb, and senna are absolutely contraindicated during pregnancy. They have a teratogenic effect and can cause severe pathologies in fetal development. In addition, such laxatives are addictive and are fraught with irreversible consequences for a woman’s digestive system.

The doctor may prescribe other groups of drugs to relieve constipation. If means for regulating intestinal motility are in most cases contraindicated for the expectant mother, then pre- and probiotics can be recommended to restore the intestinal microflora. This is especially true in cases where stool retention has been observed for a long time and there is a possibility of an imbalance in the microflora.

What to do at home

Traditional medicine helps with postpartum constipation. In order to decide on the choice of laxative recipe, it is necessary to determine the type of pathology: for spastic and atonic constipation, different ingredients are used on the basis of which the remedy is prepared.

Plant materials that are useful for the spastic type can harm a woman with the atonic form.

Stool retention caused by spastic constipation is treated with figs and potatoes:

30 g of figs are brewed with boiling water (250 ml). You can use boiled milk. The container with the infusion (preferably a thermos) is hermetically sealed. The product is taken warm, 15 ml (1 tablespoon) after each meal.
Potato tubers (2-3 pieces) are peeled and crushed in a blender. The pulp is squeezed through gauze. The resulting juice must be mixed with water (1:1). Drink 25 ml (5 tsp) three times a day after meals.

Infusions that normalize stool in atopic form:

The fruits of cumin, anise and fennel, taken in equal parts, are mixed with medicinal preparations (leaves, stems) of the same plants (10 g each) in one container. Pour boiling water (250 – 300 ml). Allow the product to cool. Strain the warm infusion, take 30 ml half an hour before each meal.
Rowan and fennel berries, leaves of stinging nettle, blackberry and oregano, taken in equal parts (1 tablespoon each), mix thoroughly in one container. Pour 30 g of the prepared collection with boiling water (250 ml). The product must be infused in a thermos for at least 90 minutes. Take 30 ml on an empty stomach before meals.

For severe constipation lasting 4-5 days, take a decoction of flaxseeds. 100 g of flax seeds are placed in an enamel container, pour 250 ml of hot water. The product is brought to a boil and left for 2-3 hours. Consume after dinner, once - no more than 200 ml.

The use of plant materials is possible if the woman has no contraindications.

What can pregnant women eat and drink if they are constipated?

A pregnant woman experiencing constipation needs to carefully monitor her diet. It is important to understand what you can eat if you have problems with bowel movements, and what foods you should avoid. If you have a bowel movement disorder, you should follow some rules:

Drink at least 1.5–2 liters of clean water daily. You should drink water in small sips. In this case, the liquid should not be too cold. In addition, it is useful to drink herbal teas, natural yoghurts, and kefir. In the third trimester of pregnancy (after 20 weeks), it is necessary to reduce the amount of fluid you drink to 1–1.5 liters per day.
Cook dishes by steaming or in the oven. Eliminate fatty and fried foods from the menu.
Make sure that meals are fractional. You need to eat often, in small portions. The interval between meals is no more than 4 hours.

To normalize stool, it is important to form a correct nutritional system. Your daily menu should include fresh vegetables and fruits that are high in fiber. A large amount of healthy dietary fiber is found in apples, sauerkraut, green salad, apricots, artichokes, raspberries, and black currants.

You can eat wheat bran, almonds, hazelnuts, and green peas. Dried fruits, stewed vegetables, as well as buckwheat and oatmeal facilitate bowel movements. It is better to choose coarse bread, it has more benefits for digestion.

Fermented milk products are important. They are rich in beneficial bacteria and help improve microflora and eliminate constipation. It is better to choose kefir, yogurt, and yogurt. So, one of the proven folk remedies for constipation is a glass of yogurt + 20 pieces of dried apricots at night. If you have this problem, it is better to avoid whole milk. It stimulates increased gas formation and can cause increased abdominal pain.

Of the juices, it is better to give preference to apricot, pumpkin, plum, carrot, peach, and you should give up apple and grape for a while.

The list of prohibited products includes:

chocolate, baked goods;
cocoa, black tea and coffee;
rice, pasta;
radishes, garlic, onions, mushrooms;
fatty meats, spicy dishes;
canned food, smoked meats.

The consumption of dairy products with a high percentage of fat should be greatly limited - it is better to eat cream, full-fat sour cream, and ice cream less often. You will also have to temporarily give up hard-boiled eggs. Rusks, rice water, strong black tea, berry jelly, astringent fruits, pomegranates and infusions of pomegranate peels, unripe pears, black grape varieties have a strengthening effect.

For constipation, it is advisable to exclude from the diet foods that cause fermentation and flatulence. It is better to completely remove white and brown sugar, store-bought juices and carbonated drinks from the menu. Legumes and vegetables with a lot of essential oils also stimulate increased gas formation, so limit their consumption or eliminate them from your diet altogether.

A review of the usual diet is the first thing an expectant mother who is experiencing constipation needs to do. In addition, pregnant women should not eat salty dishes and foods, as they retain fluid in the body and can cause swelling.

The diet and fluid intake, as well as the daily diet, must be selected individually. It is best to do this together with the doctor monitoring the pregnancy.

It is important to understand that some dishes and products cause individual reactions in us, and the effect of their consumption largely depends on the characteristics of the gastrointestinal tract. For example, semolina porridge can have a fixing effect in your case and not affect the functioning of the digestive system of another person.

It may be useful to keep a food diary, where you record your observations, which will allow you to identify certain patterns: how certain foods affect your stool. This will help develop the most effective diet, taking into account the needs of the body and personal characteristics.

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Severe constipation after childbirth

Severe constipation after childbirth occurs if a woman has not visited the toilet for 4-6 days. Digested food forms a rough lump in the intestines, which can damage the mucous membrane and cause bleeding.

The pathology is accompanied by cutting pain in the CT area. Partial defecation is accompanied by strong straining, and there is blood in the stool. It is extremely difficult to get rid of the problem at home; in this case, going to a medical facility is mandatory.

Laxatives

All medications that a doctor prescribes for a pregnant woman have certain instructions in the instructions. Medicines undergo a series of tests, based on which researchers conclude whether they penetrate the fetoplacental barrier and what effect they have on fetal development and maternal health.

The FDA, or Food and Drug Administration, has several safety categories for drugs during pregnancy:

A: long-term studies of the drug’s effect on the body of pregnant women have revealed no risk to the fetus in the 1st trimester; there is no evidence of risk in later stages.
B: no established risk to the fetus in the 1st trimester, no evidence of risk later.
C: The benefits of the drug may outweigh the risks/there are no clinical studies in humans.
D: There is evidence of risk to the fetus, but the potential benefit outweighs the possible risk.
X: studies have identified fetal abnormalities/adverse reactions that pose a risk that outweighs the potential benefit.

However, the instructions for not every laxative drug contain instructions for permission or prohibition of use in pregnant women. For example, researcher Sokolova (Sokolova M. Yu., 2013, p. 29).

It is known that the list of laxatives approved for use in pregnant women is quite small. Irritating laxatives often lead to prolonged diarrhea and electrolyte disturbances, and also have a mutagenic effect.

Increased intestinal motility from stimulant drugs also stimulates uterine contractions. Their long-term use provokes degenerative changes in the intestinal nervous system. These drugs are genotoxic and mutagenic.

Osmotic laxatives may be recommended for constipation during pregnancy. But it is important to take into account the peculiarities of using such drugs: they require drinking a large amount of liquid. This can cause a shift in water balance and the development of edema. If you do not consume more than 1.5 liters of fluid per day, there is a possibility of developing disorders.

That is why a laxative must meet three important conditions:

safety for the fetus;
safety for women's health;
safety for the course of pregnancy itself.

There is a category of women who enter pregnancy with a history of constipation. Among them there are also those who already use certain medications to solve their problem. During pregnancy, it is important to adjust the approach to getting rid of defecation retention. You should tell your doctor what medications you have been taking and for how long. Self-medication in this case is unacceptable, since it is often necessary to abandon habitual laxatives in order to avoid complications.

Instructions for use

Suppositories with glycerin during pregnancy (regardless of the period) are used according to the instructions. Transparent dense torpedo-shaped rods have a recess at the bottom. The top of the suppository is round. Suppositories are sold in soft foil blisters (10 pcs). The medication does not require a prescription. After opening the package of glycerin suppositories for constipation, the instructions for use are carefully studied, especially the tab regarding pregnancy.

The dosage form is injected into the rectum. Suppositories are placed at the same time. Preferably in the morning, 25-30 minutes after eating. An adult dose of glycerol is indicated for pregnant women, which is equivalent to 2.25-2.11 g. The use of glycerol-based drugs is carried out after a complete examination of the woman and the fetus in the womb in the absence of absolute and relative contraindications.