Constipation and Pregnancy: Tips to Keep Things Flowing

Constipation and Pregnancy: Tips to Keep Things Flowing

If you are pregnant and feel constipated, you are not alone.  Constipation is one of the most frequently reported gastrointestinal (GI) complaints in pregnant women.1 At some point during a pregnancy, up to 40% of women feel uncomfortably constipated.1,2,3,4 Usually, constipation occurs in the first and second trimesters, and then diminishes in the third trimester.1,2,4

What is constipation?

Constipation is a GI (gastrointestinal) symptom, that is described as either infrequent bowel movements – less than three stools per week — or difficulty passing a stool due to straining, hard stools, or incomplete stool evacuation.1,2,4

Why are you constipated?

There are multiple theories for why pregnant women are frequently constipated.  Not surprisingly, the hormone progesterone plays a role in pregnancy-related constipation.1,2 Progesterone can contribute to constipation as it slows down stool motility as it passes through the intestines.4,5,6   Other factors that can cause constipation include a low liquid intake and reduced physical activity.1,4 Constipation is also a side effect that can occur from iron supplements, which some pregnant women take to treat anemia.1,6

Are there natural ways to treat constipation while pregnant?

Ideally, the best way for a pregnant woman to manage constipation is through lifestyle changes, which can include an increase in liquid and fiber intake.1 Fiber is used to increase stool bulk and defecation frequency.  Too much fiber can also lead to cramping or bloating.4,5 Some pregnant women find that daily light to moderate exercise also helps to prevent constipation.1,5

Are there medications for constipation while pregnant?

If dietary and physical activity changes are unable to provide constipation relief, then a medication may be required.  Of note, osmotic and stimulant laxatives should not be taken for constipation without a doctor’s consent,4,5 since, these laxatives may cause dehydration and are usually only taken for a short period of time.5,6  Medications commonly used during pregnancy for constipation include:1,4,5

  • Osmotic agents: lactulose, polyethylene glycol, sorbitol
  • Bulk-forming agents: psyllium, bran
  • Stool softeners: docusate
  • Stimulant laxatives: bisacodyl, senna

Summary

Constipation is a common symptom during pregnancy – second only to nausea among pregnancy-related GI complaints.1,4,5  Over time, pregnant women can improve their GI symptoms with certain lifestyle modifications.  For pregnant women with persistent constipation, medications are available to provide help.  Always consult your health care provider before starting a new medication if you are planning a pregnancy, pregnant, or breastfeeding.

References
  1. Zielinski R, Searing K, Deibel M. Gastrointestinal Distress in Pregnancy Prevalence, Assessment, and Treatment of 5 Common Minor Discomforts. J Perinat Neonat Nurs. 29; 1: 23–31.
  2. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterol. 2006;130:1377–1390.
  3. Johnson P, Mount K, Grazian S. Functional bowel disorders in pregnancy: effect on quality of life, evaluation and management. Acta Obstetricia et Gynecologica Scandinavica. 93: 2014; 874–879.
  4. Cullen G, O’Donoghue D. Constipation and Pregnancy. Best Practice & Research Clinical Gastroenterology. 2007. 21: 807–818.
  5. Trottier M, Erebara A, Bozzo P. Treating constipation during pregnancy. Can Fam 2012; 58:836–838.
  6. Longo SA, Moore RC, BJ, et al. Gastrointestinal Conditions during Pregnancy. Clin Colon Rectal Surg. 2010 Jun;23(2):80-9.

 

 

Jacqueline Kostick
Jackie Kostick PharmD is a pharmacist, medical/science writer, and mother of two children. She has written and researched pharmacy-related material --medical newsletters, drug monographs, medical/science website content-- for organizations including Medscape, the American Society of Health-System Pharmacists (ASHP), CVS/Caremark, and United HealthCare.

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