What is constipation?
Constipation is the term used to describe difficulty in emptying the bowels, and usually infrequent and/or inadequate bowel movements, generally associated with feces being hard and compact. Constipation can be a component of irritable bowel syndrome (IBS), a disorder that often includes some episodes of diarrhea and other episodes of constipation, or constipation developing because of dehydration due to diarrhea. Constipation during pregnancy frequently results from pressure caused by the growing uterus on the intestines. This interferes with the movement of the bowel so that too much water is removed from the feces and it gets stuck or slows down considerably. Inadequate intake of dietary fiber also contributes greatly to constipation, whether or not you are pregnant. Constipation can also result from eating certain foods, as a side effect of certain medications, from lack of physical activity, and as a physical effect of stress or other emotional disturbances. Finally, constipation can develop as a symptom of obstruction of the bowel, due to a serious disease process such as cancer.
How common is constipation during pregnancy?
Most pregnant women will experience some kind of gastrointestinal discomfort during pregnancy. Occasional constipation is one of the most common types of gastrointestinal discomforts.
How is constipation diagnosed?
Constipation is not a medical condition, but rather a symptom. If you report having fewer than three stools per week, or you are frequently straining, if you need to push on your abdomen or pull stool with your finger from the rectum, this is enough for the doctor to conclude that you are constipated. If your constipation happens very frequently or continues for many days, and if it does not respond to dietary changes and laxatives, its possible that it is the result of a more serious underlying problem. In such a case, your family physician or obstetrician may first perform a digital rectal exam to look for signs of gastrointestinal bleeding. You also will be asked to recall the last bowel movement that you had and whether the stool was very dark, which could suggest the presence of blood. Your family physician or obstetrician may then refer you to a gastroenterologist to evaluate you for gastrointestinal diseases. Tests could include colonoscopy and/or upper endoscopy (both involve use of a tube that carries a camera and instruments) and imaging of the abdomen.
Does constipation cause problems during pregnancy?
Constipation makes you extremely uncomfortable and often you will develop gas, because of the stool not moving and trapping some gas when you defecate. Straining to defecate can both cause and exacerbate hemorrhoids, a condition that is common during pregnancy because of hormonal changes making rectal veins more flexible.
Does constipation during pregnancy cause problems for the baby?
Constipation has no direct effects on the baby, but indirectly it can have an effect by increasing your stress level and possibly keeping you on the toilet for long periods of time at night, thereby shortening your sleep.
What to consider about taking medications when you are pregnant:
- The risks to yourself and your baby if you do not treat the constipation
- The risks and benefits of each medication you use when you are pregnant
- The risks and benefits of each medication you use when you are breastfeeding
What should I know about using medication to treat constipation during pregnancy?
Treatments for constipation include bulk-forming agents (natural fibers), stool-softeners such as docusate sodium, lubricants such as mineral oil, macrogol (polyethylene glycol, PEG), osmotic laxatives (mixtures of sugars and sugar alcohols, which retain water in the stool and draw water from outside the gut), anthraquinones, and stimulant (diphenolic) laxatives. All of these agents are considered safe for the developing baby, as there is little or no absorption from the intestines into the body and no evidence of birth defects.
Bulk laxatives also are useful when constipation is part of IBS, which also features diarrhea because the addition of bulk to your diet keeps stool fairly solid.
Who should NOT stop taking medication for constipation during pregnancy?
As noted above, the agents that are given to treat constipation are generally pregnancy-safe. Consequently, there is no reason to stop taking them.
What should I know about choosing a medication for my constipation during pregnancy?
You may find Pregistrys expert reports about the individual medications to treat constipation here, and a report about laxatives here. Additional information can also be found in the sources listed at the end of this report.
What should I know about taking a medication for my constipation when I am breastfeeding?
All of the types of laxatives and stool softeners mentioned above are safe in mothers who are breastfeeding.
What alternative therapies besides medications can I use to treat my constipation during pregnancy?
Increasing your consumption of dietary fiber and water, and engaging in aerobic exercise a few times per week can help to alleviate, or even eliminate constipation.
What can I do for myself and my baby when I have constipation during pregnancy?
Maintain adequate hydration by drinking plenty of liquids, especially plain water. Eat high fiber foods, engage in exercise that is appropriate for pregnancy, such as long-distance walking or swimming. See your doctor if you have other gastrointestinal symptoms, such as bleeding, or if you feel extreme fatigue.
Resources for constipation in pregnancy:
For more information about constipation during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles: