Constipation and Pregnancy

Pregnancy is a wonderful time in a woman’s life, but it may also come with its lot of not-so-wonderful side effects. Constipation is a good example of a common pregnancy ailment. Fortunately, there are various ways to prevent and treat it.

How is constipation defined?

  • 3 bowel movements or less per week or a decrease in frequency
  • Straining during defecation
  • Pain during defecation
  • Hard and dry stool
  • Sensation of incomplete bowel evacuation

Contributing factors to constipation during pregnancy:

  • Compression of the intestines by the uterus
  • Hemorrhoids
  • Insufficient intake of liquids due to nausea/vomiting
  • Vitamin supplements containing iron and calcium
  • Hormonal changes that slow down digestion
  • Stress/anxiety caused by the arrival of the new baby
  • Decreased physical activity (especially at the end of the pregnancy)

RECOMMENDED TREATMENTS

Nonpharmacologic measures

  • Progressively increase daily fibre intake up to 25 to 30 g per day
  • Drink between 6 to 8 glasses of water per day (1.5 to 2 litres) if no fluid restriction applies
  • Exercise regularly (walking, swimming, etc.)
  • Set aside a specific time to go to the bathroom during the day
  • Do not suppress the urge to have a bowel movement

Sources of dietary fibre

  • Fruits : apples (preferably with the skin), pears, dates, figs
  • Vegetables: Brussel sprouts, raw carrots, spinach, corn, broccoli, lettuce
  • Legumes: chickpeas, Lima beans, lentils, kidney beans
  • Whole grain cereal: wholewheat, bulghur wheat, oatmeal, barley, brown rice
  • Nuts and seeds: soybeans, sesame seeds, flaxseed, almonds, pistachios

HINTS AND TIPS

Preparation of a gentle purée laxative:

(Not recommended for diabetics due to high sugar content)

  • 1 cup of dates
  • 1½ cups of prunes
  • 1 cup of raisins
  • 3 cups of water
  • 2 tsp of lemon juice (for taste and as a preservation agent)

Heat for 30 minutes until smooth consistency is obtained. Put in mixer as needed.
Keeps for 1 month in the refrigerator.
Spread onto toast in the morning.

If the nonpharmacologic measures fail to work...

Pharmacologic measures:

  1. Glycerin suppository (effective in less than 1 hour)

    1 rectal suppository as needed. Keep for 15 minutes if possible (maximum of 2 per day).

  2. Psyllium (MetamucilMD or BenefibreMD) (effective after 1 to 3 days)

    5.8 g 1 to 3 times a day with lots of liquids (water, fruit juice, etc.)

    *** can interfere with the absorption of other medications. Space out the time you take your medication by 2 hours)

  3. Docusate sodium (ColaceMD) (effective after 1 to 3 days)

    1 tablet twice a day, morning and night. If this is ineffective, increase to 2 tablets twice a day.

  4. If the agents above fail:

  5. Lactulose (effective after 1 to 3 days)

    15 ml twice a day, morning and night. Increase to 30 ml twice a day if necessary.

  6. Sennosides (SenokotMD) (effective after 8 to 12 hours)

    2 tablets at bedtime (occasional use only)

Natural health products

These products may contain high doses of stimulant laxatives and are not recommended to treat constipation for pregnant women. When the first resort agents fail, talk to your pharmacist who will be able to recommend another treatment option.

When to see a doctor

  • No bowel movement for 5 consecutive days
  • Presence of blood in the stool
  • Presence of fever (≥38,5 °C)

Don’t hesitate to talk to your pharmacist at any time for additional information!

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Constipation and Pregnancy

Pregnancy is a wonderful time in a woman’s life, but it may also come with its lot of not-so-wonderful side effects. Constipation is a good example of a common pregnancy ailment. Fortunately, there are various ways to prevent and treat it.
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