Constipation and pregnancy: What to know

By Nicola Galan

Reviewed by Holly Ernst, PA-C

Causes | Home remedies | Other treatments | Complications | When to see a doctor

Constipation is a very common symptom that many women experience during pregnancy.

Some women have constipation at an early stage of their pregnancy, while it does not affect other women until much later on.

In this article, we explain why constipation is common in pregnancy and discuss safe treatments and home remedies that women can use to relieve the discomfort.

Causes

The cause of constipation during pregnancy depends on the stage at which it occurs. Possible causes include:

• Hormones: Changing hormone levels in early pregnancy cause the intestines to slow down the movement of stool through the bowel. This delay increases the amount of water that the colon absorbs from the stool, which makes it more solid and difficult to pass.

• Prenatal vitamins: Prenatal vitamins are chock-full of iron, a crucial mineral that can sometimes be deficient during pregnancy. Iron can cause constipation and hard, black stools.

• Pressure from the uterus: In later pregnancy, the growing uterus can put pressure on the bowel, making it harder to move stool through the intestines.

In addition to infrequent bowel movements, constipation can cause bloating, stomach discomfort, and hard, dry stools that are painful to pass. It can also result in a feeling that not all the stool has passed.

Constipation can be particularly uncomfortable during pregnancy.

Home remedies

During pregnancy, women can often relieve constipation using gentle, safe home remedies:

• Fiber: Taking fiber supplements or eating more fibrous foods, such as fruits, vegetables, and whole grains, can increase the number of stools and facilitate their passage through the intestines. Adults should eat between 28 and 34 grams of fiber each day.

• Fluid: Drinking enough water is important to keep stool soft and easy to pass. If a person feels that water is not helping, they can try adding clear soups, teas, and naturally sweetened fruit or vegetable juices to their diet.

• Activity: Being active helps stool move through the intestines. Getting regular exercise, with a doctor's approval, can help relieve constipation. If exercising is not a priority or possibility, try to fit in a gentle walk each day.

• Probiotics: Millions of healthy bacteria live in the gut and help it function correctly. Probiotics may help repopulate the gut bacteria with healthy strains that encourage normal and regular bowel movements. Foods high in probiotics include yogurt, sauerkraut, and kimchi.

Other treatments

If the home remedies above do not work, it may be time to discuss other options with a doctor.

For women taking prenatal vitamins that are high in iron, doctors may recommend trying a vitamin that contains less iron.

The primary medical treatment for constipation in pregnancy is a medication called a laxative, which makes it easier and more comfortable to go to the bathroom.

It is generally safe to use gentle laxatives, but it is best to avoid stimulant laxatives because they can induce uterine contractions.

Although many laxatives are available over the counter, it is important to check with a doctor which one is safe to use. Limited information is available about using some of these medications during pregnancy.

Women can usually safely use the following types of laxative during pregnancy:

Bulk-forming agents

Bulk-forming agents mimic fiber by adding material to the stool and helping it absorb more water. By doing this, they make the stool larger, softer, and easier to pass.

These types of laxative can cause some cramping or discomfort, so people should start with the lowest dosage and ensure that they drink lots of water.

Examples of bulk-forming agents include psyllium, methylcellulose, and polycarbophil.

Stool softeners

Stool softeners add water to the stool to help make it softer and more comfortable to pass.

The stool softener that doctors most commonly recommend to pregnant women is docusate (Colace).

Lubricant laxatives

Lubricant laxatives add a slippery coating to either the stool or the inside of the intestinal tract to aid the passage of stool out of the body.

Glycerin suppositories are one type of lubricant laxative. It is essential to always speak to a healthcare professional before using suppositories, especially when pregnant.

Osmotic laxatives

By drawing more water into the intestines, these laxatives help soften the stool. They also allow the bowel to contract more to move the stool along. These types of laxative can also cause cramping and bloating in the abdomen.

Examples of osmotic laxatives include polyethylene glycol and magnesium hydroxide.

Complications

In most cases, constipation in pregnancy is short-lived and resolves with no or minimal treatment. In rare cases, however, prolonged constipation can cause fecal impaction, which may need removal by a doctor.

Continued use of certain types of laxative can cause the bowel to "forget" how to push stool through the intestines.

These drugs can also cause electrolyte or fluid imbalances in some people. Such issues usually affect people who have other health problems, such as diabetes or kidney disease.

It is best to speak to a doctor about the types of laxative to take and how often to take them.

When to see a doctor

It is vital that pregnant women speak with their doctor before taking any medication, including laxatives or other constipation remedies.

Seeing a doctor is also advisable if any additional symptoms occur, including:

• nausea
• stomach pain
• vomiting
• constipation that lasts for longer than 1–2 weeks
• bleeding from the rectum
• no relief after using a laxative

As always, mention any other symptoms or concerns to the doctor for more specific information and advice.

SOURCE: MEDICAL NEWS TODAY