Friday, June 6, 2008

The Pregnancy and Constipation

The Constipation occurs when there is abdominal pain or discomfort, difficult and infrequent bowel movements, and the passage of hard stools. Unfortunately, constipation affects approximately half of all women at some point during their pregnancy.

What causes constipation during pregnancy?
In general, worry, anxiety, minimal physical exercise, and a low-fiber diet may cause constipation. Constipation in pregnant women is thought to occur due to hormones that relax the intestinal muscle and by the pressure of the expanding uterus on the intestines. Relaxation of the intestinal muscle causes food and waste to move slower through your system.

Sometimes iron tablets may contribute to constipation. Make sure you are drinking plenty of water if you are taking iron supplements. You may need to switch to a different type of iron tablet, but it is important to talk to your health care provider first.

How can I prevent or treat constipation during pregnancy?
Prevention and treatment of constipation involve much of the same thing. Here are a few things that you can do to help prevent constipation from occurring or treat it if you are already experiencing it:

Eat a high fiber diet: Ideally, you will consume 25 to 30 grams per day of dietary fiber from fruits, vegetables, breakfast cereals, whole grain breads, prunes and bran.
Drink a lot of fluids: Drinking plenty of fluids is important, particularly with your increase of fiber. Drink 10 to 12 cups of fluids each day. It is the combination of a high fiber diet and lots of liquid that best help you eliminate your waste. Sweat, hot/humid climates, and exercise may increase your need for additional fluids.
Exercise routinely: If you are inactive, you have a greater chance of constipation. Walking, swimming and other moderate exercises help the intestines work by stimulating your bowels. Schedule exercise three times a week for 20-30 minutes each.
Over-the-counter remedies: There are over-the-counter products such as Metamucil (Catergory B) which may help soften your bowel movements and reduce constipation. Always speak to your health care provider before using over-the-counter medications.
Reduce or eliminate iron supplements: Iron supplements may contribute to constipation. Good nutrition can often meet your iron needs during pregnancy. Taking smaller doses of iron throught the day rather than taking it all at once can reduce constipation. Talk to your health care provider about checking your iron levels and recommendations to manage iron intake during pregnancy.
What remedies should not be used for constipation during pregnancy?
Laxative pills are NOT recommended for the treatment of constipation during pregnancy because they might stimulate uterine contractions and cause dehydration.

Mineral oils should NOT be used during pregnancy because there is an increased reduction in nutrient absorption.

sources:

Mayo Clinic Guide To A Healthy Pregnancy Harms, Roger W., M.D., et al, Part 3.

William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 8.