Constipation During Pregnancy And After Childbirth - What To Do?

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

What to do with constipation during pregnancy?

Description of the disease

Content:

• Description of the disease
• Causes of constipation during pregnancy
• Why are constipation dangerous during pregnancy?
• What to do with constipation?
• Constipation after childbirth

Constipation during pregnancy is slow or difficult bowel movement.

In a healthy person, defecation normally occurs from 3 times a day to 3 times a week. Stool retention can be considered constipation if it:

• occurs less frequently than every 24 hours;
• accompanied by strong pushing while going to the toilet;
• leaves a feeling of incomplete emptying of the intestines.

People of any age and lifestyle are prone to constipation. However, there are conditions in which the risk of developing a defecation disorder is increased. One of them is pregnancy. Gynecologists consider constipation as an inevitable companion of any expectant mother.

Disorders of bowel movement in pregnant women can manifest with the following symptoms:

• a feeling of pressure, fullness in the rectum;
• rumbling, feeling of "transfusion" along the intestines;
• increased gas production, bloating;
• pain in the sacrum, buttocks;
• feeling of weakness, malaise, decreased appetite, unpleasant taste in the mouth, plaque on the tongue, nausea, headache, nervousness.

Causes of constipation during pregnancy

Changes in a woman's body during pregnancy can lead to disturbances in the proper functioning of the intestines. These include:

1. Hormone progesterone

   Progesterone is the main pregnancy hormone. One of its biological actions is to relax the smooth muscles of the internal organs. This is necessary in order to reduce the tone of the uterus and prevent the threat of miscarriage. Since the intestinal wall also consists of smooth muscle fibers, under the influence of the hormone, its activity decreases.

2. Pressure of the uterus on the intestines

   The growing uterus pushes the intestines back and up. This leads to a slowdown in the passage of its contents towards the anus

3. Low physical activity

   The work of the intestines and the act of defecation are closely related to the condition of the muscles of the abdominal and perineum. Sedentary work, bed rest with the threat of miscarriage, stretching of the anterior abdominal wall by the growing uterus, refusal of physical activity for fear of damaging the unborn baby lead to a decrease in the motility of the digestive organs.

4. Inaccuracies in diet, low water intake

   The best intestinal stimulant is dietary fiber. Their source is vegetables, fruits, bran, some cereals (buckwheat, oats). Unfortunately, in big cities, most expectant mothers lack these products.

   In order for the intestinal contents to have the desired consistency and be easily transported towards the anus, it is necessary to consume at least 1.5-2 liters of water daily. This factor plays an important role in the development of constipation in pregnant women for whom the attending physician has restricted their drinking regime due to high blood pressure, kidney disease or edema.

5. Impact of stress

   The work of the intestine, like the whole organism, is regulated by the nervous system. If it fails, the digestive organs begin to contract chaotically. The so-called spastic constipation occurs. Clinically, this is manifested by severe abdominal pain, colic, the stool takes on the characteristic appearance of "sheep droppings". Very often during pregnancy, excessive excitability of the nervous system is observed, which can lead to impaired bowel movements.

6. Some drugs: calcium and iron

   Constipation is common among pregnant women taking iron or calcium supplements. This effect is most noticeable when using monopreparations and is almost not observed when using multivitamin complexes. The injected form of iron does not affect intestinal motility.

7. Diseases of the anal area (fissure, hemorrhoids)

   Compression of the veins of the abdominal cavity by the growing uterus, a sedentary image leads to congestion in the small pelvis. This contributes to the expansion of the venous plexus around the anus and the occurrence of hemorrhoids. One of its symptoms is pain during bowel movements. It can be so strong that women subconsciously postpone going to the toilet in order not to experience unpleasant sensations.

Why are constipation dangerous during pregnancy?

Constipation has two types of influence on the body of the expectant mother:

1. Local impact

   Impaired motility leads to stagnation of contents in the intestinal lumen. Digestive gruel, rich in nutrients, is an ideal environment for the development of microorganisms that normally inhabit the human digestive tract. This can lead to inflammation of the upper colon - the appendix, the sigmoid colon. Permanent trauma to the wall of the rectum and the tissues of the anus with solid feces can cause the development of proctitis, anal fissures, inflammation of hemorrhoids.

2. Overall impact

   Under the influence of microflora, the stagnant contents of the intestine undergo decay processes. At the same time, toxic substances are released - indole, skatole, ammonia, hydrogen sulfide, methanol. Being absorbed into the blood, they cause chronic poisoning of the whole organism. This is manifested by weakness, loss of appetite, headaches, nervousness, and bad mood. In pregnant women, under the influence of toxic products, violations of the uteroplacental blood flow, delayed fetal development, early aging of the placenta, and premature birth can be observed.

Many pregnant women wonder: is it possible to push for constipation during pregnancy? There is no definite answer to it. It all depends on the duration of the violation of bowel movement, the duration and course of pregnancy.

If constipation is of a short-term nature, then straining is not dangerous in the 1st and 2nd trimesters. However, by the end of pregnancy, the need to empty the bowels for a long time can stimulate labor.

In chronic constipation, constant straining leads to overstretching of the muscles and ligaments that support the abdominal organs. This can negatively affect the effectiveness of the persistent period and lead to prolapse of the vagina, uterus and bladder after childbirth.

Any straining is contraindicated in pregnant women with:

• threatened miscarriage;
• late toxicosis, accompanied by high blood pressure;
• eye diseases, including severe myopia;
• diseases of the cardiovascular system.

Constipation during pregnancy: what to do?

It must be remembered that only a doctor can diagnose constipation. Even if the symptoms of the disease completely coincide, only a specialist should make the final decision on the appointment of one or another treatment.

The following methods can be used to normalize bowel function:

• diet;
• physical activity;
• medications.

1. Diet for constipation during pregnancy

All products, according to their action on intestinal motility, can be divided into:

• enhancing peristalsis;
• weakening peristalsis.

In order to normalize stool, it is necessary to increase the consumption of foods from the first group and try to avoid foods from the second.

Have a positive effect on intestinal motility:

• vegetable fiber, which is found in carrots, beets, zucchini, pumpkin, wholemeal bread, buckwheat, oatmeal, pearl barley;
• foods with a high content of organic acids (apples, prunes, figs, dried apricots, dates);
• lactic acid products (unsweetened natural yogurt, kefir, low-fat fermented baked milk).

See the article - what you can and cannot eat for constipation

Slow down digestion:

• fatty red meats;
• sweets;
• pastry products;
• White bread;
• rice and semolina porridge;
• smoked meats;
• chocolate;
• drinks containing caffeine - strong tea and coffee;
• canned food;
• semi-finished products and fast food (fast food);
• pasta;
• potatoes.

Eating bran or wholemeal bread is one common treatment for constipation. In pregnant women, this method of stimulating digestion is unacceptable. Due to the physiological characteristics of the body of the expectant mother, coarse plant fiber, lingering for a long time in the intestinal lumen, releases a large amount of gases during digestion. This leads to bloating, pain, and negatively affects the well-being of the pregnant woman.

Instead, products containing more delicate plant fibers are recommended: figs, dried apricots, prunes, oatmeal.

For the same reason, you should avoid eating foods that contribute to gas formation, such as cabbage, legumes, apples with peels, grape juice, radishes, garlic, turnips.

Pregnant women who have no contraindications in terms of the volume of fluid taken should drink 1.5-2 liters of clean drinking water per day.

There are also many special foods that can help normalize stool, see the article - What helps with constipation?

2. Physical activity

   Expectant mothers should remember that pregnancy is not a disease, but a normal physiological state. Therefore, if it proceeds without complications, then there is no need to give up physical activity. You can attend gymnastics or yoga courses for expectant mothers, or practice special programs at home, or you can just walk for at least 1 hour a day. It is best if the walks will take place away from roads and crowds.

3. Medications

   All laxatives can be divided into four groups:

• drugs that increase the volume of feces. Facilitate bowel movements due to the "lubrication" effect. In the form of suppositories (glycerin suppositories) can be used during pregnancy only in extreme cases, when other methods and drugs do not help. For drugs intended for oral use (liquid paraffin), pregnancy is a contraindication.
• drugs that slow down the absorption of water from the intestine and cause an increase in the volume of intestinal contents. Drugs of this group are not absorbed in the intestine, are not digested, do not act on the wall of the colon. Approved for use in pregnant and lactating women. These include: duphalac, forlax.
• drugs that enhance motor skills. Their action is based on stimulating the nerve endings of the intestinal wall. Contraindicated in pregnancy at all stages. These include: guttalax, dulcolax, senna-based preparations (senalex), zhostera fruits, buckthorn bark.
• preparations that soften stool. Laxatives of this group do not irritate the rectal mucosa, are not absorbed and are not addictive. Allowed during pregnancy at any time and during breastfeeding. These include: plantain seeds, phytomucil.

Constipation after childbirth

Constipation often complicates the postpartum period. Intestinal motility disorders in the first weeks or months after the birth of a child can be caused by:

• unbalanced hormonal background, when biological substances circulating in the blood have an inhibitory effect on intestinal activity;
• the stretched walls of the anterior abdominal wall and the muscles of the perineum, which cannot create effective intra-abdominal pressure;
• a sharp mixing of the intestines after the birth of the fetus and a decrease in the size of the uterus;
• disruption of bowel function after cesarean section;
• psychological reasons, when women are afraid of defecation because of pain at the stitches after episiotomy, suturing of perineal tears, aggravated hemorrhoids;
• lifestyle changes associated with responsibilities for caring for the newborn: lack of sleep, chronic fatigue, eating disorders.

What to do? It all depends on the factor that underlies constipation.

If intestinal lethargy is due to overstretched muscles of the press and perineum, then diet and special exercise complexes for women who have given birth will help.

With sutures after tears, episiotomy and caesarean section, softening of the stool consistency comes to the fore. This can be achieved through diet or plantain-based preparations.

In order to restore bowel function on the first day after a cesarean section, early physical activity is necessary: turning in bed, sleeping on the stomach starting from 2 days after the operation. Self-massage of the anterior abdominal wall gives a good effect. To do this, the peri-umbilical region is massaged with the right hand in a clockwise circular motion. Spend 20 massaging movements every 2-3 hours.

For women who are breastfeeding, you should be careful about eating foods that have a laxative effect. Many of them can cause gas production in a child. Approved for use during lactation:

• dried apricots;
• prunes;
• boiled beets;
• oatmeal and buckwheat porridge.

However, all children are individual, therefore it is necessary to monitor the overall reaction of the newborn to the introduction of any new product into the mother's diet.

The author of the article: Volkov Dmitry Sergeevich | c. m. n. surgeon, phlebologist

Education: Moscow State University of Medicine and Dentistry (1996). In 2003 he received a diploma from the Educational and Scientific Medical Center of the Presidential Administration of the Russian Federation.