
Constipation is a common issue during pregnancy, affecting up to 38% of pregnant women. It is mainly caused by hormonal changes that slow down the movement of the digestive system. While increasing fibre and fluid intake, as well as physical activity, are recommended first steps to relieve constipation, these methods are sometimes ineffective. In such cases, laxatives can be considered.
Laxatives such as bulk-forming agents, lubricant laxatives, stool softeners, osmotic laxatives, and stimulant laxatives are generally considered safe during pregnancy. However, osmotic and stimulant laxatives should only be used occasionally or in the short term to avoid dehydration and electrolyte imbalances.
It is always recommended to consult a healthcare professional before taking any medication during pregnancy, including over-the-counter laxatives.
Characteristics | Values |
---|---|
What to do when constipated during pregnancy | Drink more water, eat more fibre, exercise |
First-line therapy for constipation | Increasing fibre, fluids, and exercise |
Laxatives that can be considered | Bulk-forming agents, lubricant laxatives, stool softeners, osmotic laxatives, stimulant laxatives |
Laxatives that are considered safe during pregnancy | Bulk-forming laxatives, Milk of Magnesia, Polyethylene glycol, Glycerin suppositories, Docusate, Lactulose, Macrogols |
Laxatives that should be used with caution during pregnancy | Osmotic laxatives, Stimulant laxatives |
What to do before taking any new medications during pregnancy | Talk to your healthcare provider |
What You'll Learn
Safe laxatives to take during pregnancy
Pregnancy predisposes women to constipation due to physiological and anatomical changes in the gastrointestinal tract. It is estimated that 11% to 38% of pregnant women experience constipation. Hormonal changes, reduced motilin hormone levels, increased water absorption from the intestines, decreased maternal activity, and increased vitamin supplementation can all contribute to constipation during pregnancy.
While natural remedies such as increasing fibre and fluid intake, as well as regular exercise, are recommended as the first line of therapy, these methods may not always provide relief. In such cases, laxatives may be considered.
Bulk-forming laxatives
Bulk-forming laxatives, also known as bulk-forming agents, are considered the first-choice treatment option for constipation during pregnancy. They add fibre to the digestive process, helping the intestines absorb more water. This results in larger, softer stools that are easier to pass. Examples of bulk-forming laxatives include psyllium, methylcellulose, and polycarbophil (FiberCon). It is important to note that these laxatives can take 48 to 72 hours to achieve their desired effects and may cause side effects such as gas, bloating, and cramping.
Stool softeners
Stool softeners, such as docusate (Colace), moisten the stool, making it easier to pass. Docusate has been studied and is considered safe to use during pregnancy, but it is recommended only as a short-term option for occasional constipation.
Lubricant laxatives
Lubricant laxatives, such as glycerin suppositories, add a slippery coating to the stool or the inside of the intestinal tract, aiding the passage of stool out of the body. It is important to speak to a healthcare professional before using suppositories, especially during pregnancy.
Osmotic laxatives
Osmotic laxatives are considered second-choice treatment options for constipation during pregnancy. They work by keeping water in the intestines instead of being absorbed by the body. Polyethylene glycol (Miralax) is recognised as safe during pregnancy by the American College of Obstetricians and Gynecologists. Osmotic laxatives can be used when bulk-forming laxatives are ineffective. However, they may cause side effects such as bloating, gas, and nausea, and prolonged use may lead to electrolyte imbalances.
Mild laxatives
Mild laxatives, such as Milk of Magnesia (magnesium hydroxide), are generally considered safe to take during pregnancy. However, some healthcare providers prefer to avoid magnesium-containing products during pregnancy, so it is important to consult your care team before using this laxative.
While these laxatives are generally considered safe during pregnancy, it is always recommended to consult your doctor or healthcare provider before taking any medication, including over-the-counter products. Additionally, it is important to be cautious during the first trimester, a crucial time for your baby's development.
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Natural ways to relieve constipation
Constipation is no laughing matter. It can leave you feeling bloated and miserable, and it can lead to more serious problems like hemorrhoids or rectal tissue prolapse. While laxatives may seem like the quickest solution, they are not always the best idea as they can lead to physical dependence. Instead, try these natural ways to relieve constipation:
- Stay hydrated: Drink at least four to six glasses of fluids per day, with water and fruit juices being the best options. Limit caffeinated drinks like coffee and soda, which can dehydrate you further.
- Increase your fiber intake: Aim for at least 25 grams of fiber per day from foods like Brussels sprouts, apples, figs, bran cereal, and black beans.
- Get on a daily schedule: Try to have a bowel movement at the same time every day, preferably after a meal when the emptying reflex works best.
- Avoid straining: Straining can lead to hemorrhoids, anal fissures, or rectal prolapse. Instead, add more fiber and fluid to your diet or use a stool softener to make bowel movements easier.
- Exercise regularly: Physical activity helps stimulate your gut and get things moving. Walking in particular is a good, gentle exercise to help with constipation.
- Try an osmotic laxative: If you need immediate relief, osmotic laxatives like polyethylene glycol are a mild type of laxative that works by drawing water into your colon, softening the stool, and making it easier to pass.
If you're pregnant and experiencing constipation, the same natural remedies can help. However, it's important to talk to your doctor before taking any new medications, including laxatives. Bulk-forming laxatives and stool softeners are generally considered safe and effective options during pregnancy. Adequate fluid intake, exercise, and a high-fiber diet are also recommended to help relieve constipation while pregnant.
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When to consult a doctor
While laxatives are generally considered safe to use during pregnancy, it is still important to consult a doctor when dealing with constipation.
Firstly, it is vital that pregnant women speak with their doctor before taking any medication, including laxatives or other constipation remedies. This is because some laxatives have not been assessed for safety during pregnancy, and there is limited information about the effects of certain medications on pregnant women. Doctors can advise on which types of laxatives are safe to use and how often to take them.
Secondly, it is recommended to consult a doctor if you experience any of the following additional symptoms:
- Constipation that lasts for longer than one to two weeks.
- Bleeding from the rectum.
- No relief after using a laxative.
In addition, it is always important to mention any other symptoms or concerns to the doctor for more specific information and advice.
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Stimulant laxatives and their effects on pregnancy
Pregnancy predisposes women to constipation due to physiological and anatomical changes in the gastrointestinal tract. While laxatives are considered a second-line therapy for constipation, it is recommended to exercise caution when using stimulant laxatives during pregnancy.
Stimulant laxatives work by supporting the movement of the intestines, aiding stool passage through the digestive tract, and reducing water absorption from the large intestine. Examples of stimulant laxatives include bisacodyl (Dulcolax) and senna (Senokot, Ex-Lax).
Stimulant laxatives are generally recommended to be used with caution during pregnancy and nursing. Their use should be limited to short-term or occasional relief due to limited evidence regarding their effects on pregnancy. Prolonged use may lead to electrolyte imbalances and dehydration. Additionally, stimulant laxatives have been associated with side effects such as abdominal cramps, low potassium levels (hypokalemia), and low sodium levels (hyponatremia).
Before taking any new medications during pregnancy, it is crucial to consult a healthcare provider, especially during the first trimester when the risk of harm to the unborn baby is higher.
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The causes of constipation during pregnancy
Constipation is a common issue during pregnancy, affecting between 11% and 39% of pregnant women. It is caused by a combination of hormonal changes, lifestyle factors, and physiological changes in the body. Here are the main causes of constipation during pregnancy:
Hormonal Changes
The increase in progesterone during pregnancy relaxes the intestines, slowing down the movement of food and waste through the digestive tract. This delay leads to increased water absorption from the stool, making it drier, harder, and more difficult to pass. This is the primary hormonal cause of constipation during pregnancy.
Lifestyle Factors
During pregnancy, certain lifestyle factors can contribute to constipation. These include:
- Insufficient fibre intake: A low-fibre diet is a common cause of constipation. Pregnant women are often advised to increase their fibre intake to promote regular bowel movements.
- Inadequate fluid intake: Not drinking enough water can worsen constipation. It is recommended to drink 8 to 12 cups of water per day to keep the stool soft and easy to pass.
- Lack of physical activity: Reduced physical activity can lead to constipation. Regular exercise, even a gentle walk, can help stimulate bowel movements.
Physiological Changes
In addition to hormonal and lifestyle factors, there are some physiological changes during pregnancy that can contribute to constipation:
- Uterus enlargement: As the uterus grows, it can put pressure on the bowel, making it more difficult for waste to move through the intestines. This is more common in the later stages of pregnancy when the fetus is heavier.
- Iron supplements: Prenatal vitamins, especially those containing iron, can sometimes lead to constipation. Iron can make it harder for bacteria in the bowel to break down food. It is important to drink plenty of water when taking iron supplements.
- Vitamin and mineral intake: Increased intake of vitamins and minerals, such as calcium, during pregnancy can also contribute to constipation.
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Frequently asked questions
It is recommended that you consult your doctor before taking any new medication during pregnancy. However, glycerin suppositories are generally used for more severe constipation and are quite commonly used during pregnancy with no problems reported.
Eating high-fibre foods, drinking more water, and exercising regularly are some natural ways to relieve constipation during pregnancy.
Some safe laxatives to take during pregnancy include Milk of Magnesia, Metamucil, and stool softeners that contain docusate.
To prevent constipation, pregnant women are advised to eat a high-fibre diet, drink plenty of fluids, and exercise regularly from early pregnancy onwards.
Overuse of laxatives can cause diarrhoea, leading to fluid loss. It is also important to note that osmotic and stimulant laxatives should only be used in the short term or occasionally to avoid dehydration or electrolyte imbalances in pregnant women.