Which laxative to choose during pregnancy in the first, second and third trimester

Co-author, editor and medical expert - Klimovich Elina Valerievna.

Number of views: 109 807

Last updated: 02/16/2022

Average reading time: 8 minutes

While causing discomfort to the woman herself, constipation can also have a negative impact on both the course of pregnancy and the development of the fetus. Therefore, their timely and correct treatment is a priority. And one of the most important stages of therapy is diet.

Can pregnant women take laxatives?

When carrying a child, you must be especially careful when taking medications that can harm both mother and baby. Laxatives during pregnancy are prescribed only by a gynecologist or attending physician.

The wrong medicine can cause bleeding, miscarriage and premature birth. It is better to prevent constipation than to treat it.

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.

What laxatives can you take during pregnancy?

To relieve constipation, laxatives are prescribed to promote bowel movements. While carrying a child, your attending physician or gynecologist will provide a list of medications and what laxatives you can use during pregnancy in a particular trimester.

• Osmotic laxatives
  . Medicines increase salt levels in the esophagus and retain water there. The process dilutes the excrement and allows it to be removed from the body. The list of such drugs includes Forlax, Magnesium Sulfate, Sodium Sulfate, Laxomag, Karlavy Vary and Morshyn salt.
• Prebiotics
  . The category of laxatives is not absorbed in the thin part of the esophagus, moves to the intestines in the same form and pushes feces. Prebiotics normalize the functioning of the digestive system due to the appearance of lactic acid bacteria and activation of their growth. These are Lactovit, Lactulose, Inulin, Duphalac, Normaze.
• Medicines for softening stool
  . This group consists of oils that improve the sliding of processed food and remove it from the body. These are sunflower, olive, castor, corn and almond oil. Medicines can be found in everyone's home.
• Means for irritation of the mucous membrane of the esophagus
  . Their components act on organ receptors and stimulate the process of peristalsis. These are Kafiol, Regulax, Picolax, Guttalax, senna leaves, buckthorn bark.
• Contact laxatives
  . They have a local effect and are presented in the form of suppositories and enemas. Medicines act on the receptors of the intestinal mucosa, provoking rapid and gentle excretion of feces. These are Bisacodyl, Norgalax, suppositories with glycerin or castor oil.
• Drugs to increase the volume of feces
  . You can take them with water; with this combination, they swell, dilate the intestines, and thanks to this, feces are easier to excrete. These are flaxseeds, Laminaride, Angiopax, wheat bran, Fiberlex, Mucofalk.

Before choosing which laxative is suitable for pregnant women, it is worth considering the presence of concomitant ailments.

Attention! Osmotic laxatives have an antitoxic effect, ridding a person of waste and toxins that are formed due to poor metabolism.

Treatment

Diet helps cope with constipation. As much fiber as possible should enter the intestines. It is not digested, but only swells, increasing the volume of feces and promoting bowel movement. Therefore, your diet should include carrots, cucumbers, tomatoes, beets, zucchini, pumpkin, apples, as well as wholemeal bread and dried fruits. Often fermented milk products have a good laxative effect: kefir, yogurt, as well as kvass and sour cabbage soup. Vegetable fats are useful: when broken down, they form fatty acids that stimulate peristalsis.

It is better to use prunes as an infusion: pour 100 g of fruit with two glasses of boiling water, add a little sugar, cover with a lid and leave for 10-12 hours. It's better to do this in the evening. The next day, drink half a glass of the infusion before meals, and eat the plums. Another remedy for constipation is to drink a glass of cold water on an empty stomach. You can add a spoon of honey to it.

You should not get carried away with strong tea, black coffee, cocoa, chocolate, white bread, flour and slimy soups, semolina, blueberries. All these products, as well as dry food, have a fixing effect.

In case of severe bloating, it is allowed to take infusions of chamomile flowers, mint leaves, caraway seeds, dill, as well as carbolene (activated carbon). But only in quantities recommended by your doctor.

You should also try not to stand for long periods of time, do not lift weights, and do gymnastics to strengthen the pelvic floor muscles. By the way, physical exercise will enhance intestinal motility.

Laxative during early pregnancy

The first trimester is the most dangerous time of pregnancy, because many people experience increased uterine tone. At the initial stage, gentle medications for constipation are prescribed.

1. Duphalac
   . A laxative for pregnant women in the early stages solves the problem thanks to lactulose, which is part of the medicine. The substance is an artificial analogue of lactose present in breast milk.
2. Export
   . The powdered medication is similar to the previous drug in its operating principle and is used in the first trimester. The active substance is lactitol.
3. Microlax
   . Microclysters quickly soften stool. Used as an emergency aid, not prescribed for chronic constipation.
4. Mucofalk.
   A dietary supplement obtained from plantain seed, presented as a powder. The granules must be dissolved in liquid. Do not take in the third trimester of pregnancy. An analogue of the product is Fibralax.
5. Phytomucil.
   A dietary supplement that dissolves in water, yogurt or kefir. It has no contraindications when carrying a child.
6. Glycerin suppositories
   . Suppositories can be used during early pregnancy, but not on an ongoing basis. Decreased esophageal tone leads to chronic constipation.

It is worth noting that when using the above medications in the 1st trimester, flatulence may occur in the first 2 days of taking them.

Diet for spastic constipation in pregnant women

With such constipation, the diet should be gentle. This avoids overstimulation of intestinal receptors responsible for peristalsis. When creating a menu, all products from the recommended list can be used, but their preparation is of great importance. Thus, vegetables and fruits should be consumed in the form of purees, cream soups, baked and boiled. You should also eat porridge cooked with plenty of water, milk or broth so that its consistency is slimy. The presence of fats of animal and plant origin in a pregnant woman’s diet is mandatory.

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Laxatives during pregnancy in the 2nd trimester

In the middle of the term, the absence of stool is treated comprehensively. If there is no result when changing your diet and physical activity, then drug therapy is prescribed.

1. Candles.
   Not all suppositories are safe while pregnant. During this period, it is allowed to use sea buckthorn and glycerin suppositories. The second type is not used in the presence of cracks or hemorrhoids.
2. Microclysters.
   Only in exceptional cases is an enema performed, which often causes uterine contractions. It is better to use a microenema with a ready-made solution.
3. Medicines.
   When the 2nd trimester of pregnancy begins, it is allowed to take Duphalac, Tranzipeg, Defenorm for difficult bowel movements.

All of the above methods are effective, but before using them, mandatory consultation with a specialist is required. Some of them may be contraindicated based on the individual characteristics of the body and the presence of concomitant diseases.

General information about constipation

Constipation or constipation is a very common bowel movement disorder that makes it difficult to have bowel movements.
Individual episodes are often associated with dietary errors or functional disorders, while chronic constipation often indicates diseases of the gastrointestinal tract or other organs and systems. The key symptoms of constipation are:

• Defecation less than 3 times a week.
• Passage of dry, hard stool, which often looks like separate lumps.
• The need for additional straining to defecate.
• A feeling of “blockage” in the rectum.
• Feeling of incomplete bowel movement.
• The need for assistance with defecation (hand pressure on the abdomen and manual manipulation to remove stool from the rectum).

Laxative for late pregnancy

The third trimester of pregnancy is characterized by excessive swelling, so experts try not to prescribe laxatives that retain fluid in the torso. During such an important period, medications are used that do not harm the mother, baby and do not provoke premature birth. For the 3rd trimester the following are most often prescribed:

• medications with bifidobacteria;
• suppositories;
• microenemas;
• products with lactulose.

These are the safest medications. In some situations, pregnant women, despite the late date, are prescribed other methods to combat constipation, but this depends on the condition of the expectant mother.

Basic menu for constipation in pregnant women

1st breakfast.

A serving of oatmeal or muesli with the addition of a baked or finely grated fresh apple, a glass of yogurt.

2nd breakfast.

Weak green tea with crispy bread and a slice of cheese.

Dinner.

Vegetable puree soup, buckwheat porridge with stewed meat and vegetable salad, milk dessert.

Afternoon snack.

Cottage cheese with raisins and honey, fruit and berry compote.

Dinner

. Baked fish with mashed potatoes, vegetable salad, prune broth.

In addition to creating the right menu, you also need to take care of normalizing your nutrition schedule. This means that in order to avoid constipation, a pregnant woman should eat in small portions, but at least 4-5 times a day.

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List of all approved drugs

Regardless of the trimester, only a few laxatives for pregnant women can be used during pregnancy:

• Duphalac;
• Phytomucil;
• Senade;
• Microlax;
• Glycerin suppositories.

Other medications are selected only by the attending physician, based on the condition of the woman, the fetus, the presence of contraindications and concomitant diseases. Here is the main list of drugs, laxatives:

• Lactovit;
• Lactulose;
• Inulin;
• Dufalak;
• Normaze;
• Forlax;
• Magnesium sulfate;
• Exportal;
• Sodium sulfate;
• Laxomag;
• Carlsbad salt;
• Morshyn salt;
• Kafiol;
• Regulax;
• Picolax;
• Guttalax;
• Bisacodyl;
• Defenorm;
• Norgalax;
• Laminaride;
• Angiopax;
• Fiberlex;
• Transipeg;
• Mucofalk.

Anti-constipation pills allow you to get rid of feces before intoxication begins. There is no need to save money and buy an inexpensive, cheap laxative.

Diagnostics

The doctor makes a preliminary diagnosis based on the patient’s complaints. For the final conclusion, an examination, colonoscopy, and anorectal manometry are performed. If necessary, sigmoidoscopy, fibrocolonoscopy, abdominal radiography, irrigoscopy, electromyography of the pelvic muscles, ultrasound of the intestines, stomach, liver and pancreas, and enterocolonoscintigraphy are prescribed.

Laboratory tests require blood tests, coprogram, stool analysis for helminths and dysbacteriosis.

A differential diagnosis of spastic constipation with intestinal obstruction, anomalies and tumors of the large intestine, Crohn's disease, and diverticular disease is also carried out.

Natural laxatives for pregnant women

Constipation during pregnancy causes inconvenience, but not every laxative is reliable in this situation. During pregnancy, a hormonal imbalance occurs, the muscular structure of the esophagus weakens and cannot cope with the load. The laxative used should not irritate the digestive tract, so it is not recommended to drink synthetic products. It is especially dangerous to self-medicate, because some medications provoke uterine hypertonicity.

A woman should take a closer look at natural products that have a mild effect. You can use against constipation:

• whole grain porridge, bran;
• apples, figs, dried apricots, prunes;
• fresh vegetables;
• nuts;
• grapefruit.

At home, you can prepare your own natural laxative for pregnant women. Grinded steamed dried apricots are mixed with crushed carrot cake in a blender. If carrots are unavailable, they are replaced with pumpkin. The effect of eating the above foods will help strengthen the correct drinking regime. You need to drink at least 2 liters of clean water per day.

For a natural laxative to work, you must adhere to proper nutrition:

• five meals a day;
• a balanced diet consisting of vitamins, minerals, proteins, carbohydrates and fats;
• small portions;
• protein foods in the morning, and plant and dairy products in the evening;
• exclude walnuts, strong tea, rice and boiled eggs, which provoke the appearance of pathology;
• Every day you need to eat borscht, soups, broths;
• 2 hours before bedtime should be the last meal;
• fiber and plant fibers are added.

If a woman has suffered from constipation before, but her diet changes in the early stages of pregnancy.

Laxatives prohibited during pregnancy

Dangerous substances are divided into three categories:

1. Annoying
   . Laxatives during pregnancy sometimes cause reflex contractions. These are Bisacodyl, Carlsbad salt, castor oil, senna products. Medicines are toxic, mutagenic and lead to severe abnormalities of the enteric nervous system.
2. Detergents.
   This category consists of mineral oils that are deposited in the spleen, liver, and intestines. The drug interferes with the absorption of fat-soluble vitamins and causes an inflammatory process.
3. Bulk laxatives
   . The composition of such products includes hydrophilic colloids and dietary fiber. When taking them, you will need to drink a large amount of liquid, which causes severe swelling when carrying a child.

It is also prohibited to take medications based on seaweed, cellulose, agar-agar, or flax. These components help slow down the excretion of fluid in the female body. The most dangerous laxatives are considered to be saline laxatives, which have a laxative effect and disrupt the water-salt balance.

Uncontrolled use of such drugs leads to increased constipation. All of the above medications are prohibited for use during pregnancy.

Recommended and non-recommended foods on pregnant women's menus

Diet during pregnancy with constipation requires a responsible attitude to menu planning. Preference should be given to the following products and dishes:

• Carbohydrates
  . Oatmeal, buckwheat, corn porridge, bran bread, bananas, dates.
• Squirrels
  . Any lean meat, fish and seafood, cottage cheese, yogurt, whole milk, kefir, fermented baked milk.
• Fats
  . Sea fish of fatty varieties, vegetable oils, butter, nuts.
• Cellulose
  . Any vegetables and fruits (preferably seasonal), bran.

Food products such as canned food and sausage products, baked goods made from premium flour, sweets, dishes with the addition of mayonnaise or other fatty sauces, hot and spicy foods, pickles, smoked meats, carbonated drinks, strong tea and coffee should be excluded from the diet. What to eat for constipation during pregnancy is also determined by the type of constipation - spastic or atonic.

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Pros and cons of taking laxatives during pregnancy

Constipation is a disease characterized by the accumulation of stool in the esophagus. The pathology causes such unpleasant consequences as the development of hemorrhoids, increased uterine tone, and intoxication of the mother and child. To avoid complications, it is necessary to dispose of feces, but this does not mean that it is permissible to take all medications for constipation during pregnancy.

Some of these laxatives cannot be taken while carrying a child, while others are addictive and cannot be taken on an ongoing basis, and others dehydrate the body, removing the necessary salts for constipation.

Medications have one main advantage - they quickly combat the absence of bowel movements, preventing the development of intoxication of the body. Only in rare situations, when carrying a child, do they resort to this method of relieving constipation. But there are certain remedies that are allowed to be used throughout pregnancy without threatening the life of the fetus and mother.

The main disadvantage of laxatives is a quick solution to difficult bowel movements without eliminating the problem itself that caused constipation. In this case, pathology will occur regularly. Medicines cannot be used frequently; the intestines get used to artificial stimulation and after a while stop working on their own. During pregnancy, it is better to avoid such drugs and prefer natural products.

Problems with defecation are very common in pregnant women, the reason for this is hormonal changes, compression of internal organs, and unbalanced nutrition. Pathology poses a threat to women and children. At the first signs of constipation, you should inform your doctor, who will prescribe the optimal type of treatment. When carrying a baby, you need to listen to your body.

Causes

• During pregnancy, especially in the second half, the intestines are compressed by the enlarging uterus. This leads to disruption of blood outflow and the occurrence of venous stagnation in the pelvic vessels. As a result, hemorrhoids may develop - dilation of the veins of the rectum and, as a result, constipation.
• The human body produces special substances that stimulate intestinal contractions. During pregnancy, the susceptibility of the intestinal muscles to this kind of stimulants is significantly reduced. Nature “ordained” it very wisely - after all, the intestines and the uterus have a common innervation, therefore any excessive activation of intestinal motility can stimulate the contractile activity of the uterus, causing a threat of miscarriage. Unfortunately, this positive protective reaction also has undesirable consequences - constipation in pregnant women.
• The development of constipation is facilitated by hormonal changes that occur during pregnancy. In particular, the digestive process slows down under the influence of the pregnancy hormone progesterone.
• It is no secret that pregnant women are often emotionally unstable, prone to stress, and suffer from unreasonable fears. Modern medicine has come to the conclusion that constipation in general and, in particular, constipation in pregnant women is often caused by stress and other psychological factors. Women after childbirth are less likely to suffer from constipation - perhaps because their psycho-emotional state after childbirth quickly and significantly improves.
• Allergic and autoimmune processes also play a certain role in the development of constipation.