CONSTIPATION in Pregnancy
A resume of the evidence compiled by Neil Pattison
Constipation is one of the most common symptoms in pregnancy. It is thought that in order to improve absorption of foods for mother and baby, pregnancy hormones reduce bowel motility. Constipation is further aggravated by reduced physical activity, iron supplements, poor diet and dehydration.
Constipation tends to worsen during pregnancy so once it has begun it is sensible to address your diet and treat if necessary. Constipation can lead to colicky abdominal pain and hemorrhoids.
How to manage constipation in pregnancy:
- Diet. A diet suitable for pregnancy is five small meals per day which spread your intake and avoid the one large evening meal. Also one should increase fluid, fruit and vegetables and reduce high calorie foods. But it is important you do "not eat for two".
- Fluid intake. You should drink 2+ litres of water per day. Avoid dehydrating fluids such as coffee.
- Fibre. The mainstay of treatment of constipation is increasing the fibre content of your diet. Fibre acts as a bulking agent which retains fluid in your gut (assuming you drink it) thus softening your stool. Variety is beneficial and include high fibre foods such as wholegrain cereals, breads, fruit.
- Exercise. Cardiovascular exercise such as swimming, walking and cycling are helpful.
- Laxatives. There are three types of medical laxatives:
Bulking agents such as Metamucil are the best treatment for constipation in pregnancy as it is so easy and effective. Take half and increase to one teaspoon every morning (in yoghurt or sprinkled over and mixed with milk into a cereal but be warned it congeals if you don't eat it soon after it is moistened. Proceed or follow this by a large glass of water. This can take a week to work and should be continued throughout your pregnancy.
- Osmotic agents
such as Lactulose also hold water in your stool. Should only be used for an extreme condition.
These are not usually required in healthy pregnant women. Senna etc increases the activity of bowel muscles. Best only used after stool has been softened.
An easy change which works for most women is to add both extra fluid and Metamucil to your breakfast. Start with half a teaspoon in yoghurt or sprinkled over any cereal and mixed with extra milk (it congeals if you don’t eat it soon after it is moistened). Proceed and follow this with extra fluid, tea, juice water etc. This will take up to a week to work at which time you can increase to a whole teaspoon if needed. This should be continued throughout your pregnancy.
N.B. sudden or excessive fibre in your diet and dehydration aggravate constipation causing colicky pains.