Constipation in Pregnancy

Pregnancy is undoubtedly a beautiful experience. But this unforgettable phase also comes with its own set of problems. While nausea and morning sickness are the most talked about pregnancy issues, it is the other problems which many find embarrassing, and that can be even more painful. Irregular bowel movements, gassy tummy or hardened stools are the symptoms of one such problem- constipation. Let us attempt to understand the ways to manage this tricky yet very common problem.

What is Constipation?

You are said to be constipated when bowel movement poses a challenge, and there is a noticeable gap between the intervals of passing stools. Even though normal bowel habits vary among women, it should become a concern if the infrequent bowel movements are characterised by less than three bowels per week.

Typically, the large intestine, or bowel, which includes colon and rectum, absorbs water from your digested food, changing it from liquid to solid, i.e., stool. Constipation occurs when the digested food remains in your colon for a long time and ends up absorbing too much water, making your stool hard and dry, which further poses a problem for the rectal muscles.

Causes of Constipation during Pregnancy

If you are prone to constipation, then there are chances that it could get worse during pregnancy. Let’s take you through some of the common reasons of constipation.

1. Hormones

One of the reasons for constipation, that also causes many other pregnancy issues, is hormonal fluctuation. Constipation is caused due to increase in the hormone progesterone, which relaxes the muscles throughout the body, including the digestive tract. It causes the food or waste to pass through the intestines more slowly.

2. Food

There are certain foods that cause constipation. You can try to ease the digestion process by cutting down on milk and dairy products such as ice-cream or cheese because of their high-fat and low-fibre content. Even cruciferous vegetable like broccoli, cabbage, and cauliflower, collard greens, etc., containing a sugar called raffinose should be avoided. Raffinose can trigger bloating and lead to gassiness in the stomach. Also, try to avoid eating excessive red meat since it might be more difficult to digest protein dense foods than fibre-based plant foods and cereals.

3. Anaemia

If you have irondeficiency anaemia, your body doesn’t have enough iron to produce haemoglobin, and as a result, lacks healthy red blood cells. You might be consuming iron tablets to counter this iron deficiency. The consumption of iron tablets has been linked to making constipation worse. This is because the iron from supplements is not as readily absorbed by the body as the iron from food sources

4. Less Physical Activity

If you are not physically active or are unable to exercise, you could be susceptible to constipation. This is because daily physical activity is essential for regular bowel movements. When you exercise, food moves through your large intestine more quickly. This reduces the amount of water that your body absorbs from the food and prevents stools from becoming hard and difficult to pass.

5. Stress

Besides physical activity, even stress could affect your digestion. Stress can be very damaging to your overall health, including your digestive health. When you are overly stressed, it is likely that your body will react by bringing down bowel movement, thus triggering constipation over time.

Causes of Constipation in Early Pregnancy

In the initial months, the extra iron from your prenatal vitamin supplements could cause constipation, and leave you bloated throughout the pregnancy. If you happen to take injections to increase the progesterone level in early pregnancy, then the muscles relax and slow down the digestion process.

Causes of Constipation in Late Pregnancy

During the later stages of pregnancy, increased water absorption in your body often leads to the hardening of stools. At this time, the release of progesterone shifts from the ovaries to the placenta. This increases secretion levels, which combined with hard stools, leads to serious constipation. The problem is further accentuated by the growing pressure of the uterus on the rectum which leads to gas formation that blocks the waste from being excreted. The symptoms of this constipation are belly pain, cramps, burping and passing gas.

Symptoms of Constipation during pregnancy

Some of the symptoms of constipation can leave you uncomfortable, so it is important to identify the signs:

1. Infrequent Bowel Movements

One of the first signs of constipation is bowel irregularity. If you have a daily bowel movement, but suddenly witness a decrease to once every other day, then you might be suffering from constipation.

2. Hard Stools

You may notice that irregular bowel movements are accompanied by hard stools, especially those that are painful to pass. You could even end up spending longer than usual to pass stool, while straining, which can lead to rectal bleeding and haemorrhoids. A haemorrhoid is a swollen and inflamed vein in the rectal tissues which could be painful and itchy. However, it may disappear for several days and reappear with every bowel movement. In case of a rectal bleeding, make sure you see a doctor.

3. Rectal Fullness

Some women may experience a sense of rectal fullness, a sensation of blockage in the rectum, which is felt when stools are hard. Even after you pass stool, there may still be a feeling of fullness, like an urge to defecate.

4. Abdominal Pain

If constipation persists, you may feel lower abdominal cramping while passing stool. You could experience lower abdominal bloating when you don’t pass any stool. This can be an indicator of waste getting backed up in your intestines.

5. Gassy Tummy

Constipation is a common cause of gas and bloating. Though at times severe, gas pain may be relieved with a burp or passing gas. At times, it might cause chest pain too.

6. Loss of Appetite

You could experience a loss of appetite because of gas and bloating. Since you are not able to pass stool, you will eventually lose interest in eating. This will, in turn, deprive the body of fibre-rich foods that help in easing bowel movements.

How One Can Prevent and Treat Constipation during Pregnancy

Consume a high fibre diet: You can best avoid constipation by increasing the intake of fibre-rich food or roughage because it helps to keep the intestinal system running smoothly. Soluble fibre permits more water to remain in your stool, making the waste softer, and easier to pass through intestines. Insoluble fibre adds bulk to your stool and speeds up its movement through your gut. It also prevents the feeling of constipation. Hence including fibre-rich foods in your diet can prevent constipation, and is the first advice to a woman who is wondering how to treat constipation.

1. Take Lots of Fluid

Water is crucial for digestion as it keeps the food moving along through the intestines. Double your water intake during pregnancy and stay hydrated.

2. Break Your Meals

You can try breaking up your meals into five or six smaller portions. This will allow the stomach to digest food, and allow it to transfer to the intestine and colon smoothly.

3. Exercise Regularly

Exercise helps in reducing the time taken to move the food through the intestine and further limiting the amount of water absorbed from the stool into the body and is an important part of constipation therapy. Hard, dry stools are harder to pass. When your intestinal muscles contract properly, it helps move stools out quickly. However, find out the exercises that are safe for you and your baby.

4. Pelvic Floor Relaxation

Most of the organs below the waistline are supported by the pelvic floor. If you are unable to relax or contract the pelvic floor muscles correctly, then it can lead to symptoms of constipation. Try to take deep breaths when you sit on the toilet and exhale to relax the pelvic floor muscles. Sitting in a squatting position is ideal, but remember not to strain.

5. Laxatives

You should consult your doctor to prescribe a laxative that’s safe to use in pregnancy.

Natural home remedies to get rid of constipation

Here are a few foods which you can include in your diet in addition to ensuring you get exercise to relieve constipation

1. Lemon

You can add a lemon in a glass of warm water because it helps flush out toxins and other undigested material from the colon. Besides stimulating your taste, the combo has also been known to induce bowel contractions that help you pass stool.

2. Psyllium or Lspagula Husks

Isabgol (or Ispagula husks) is a bulk-forming laxative and has been used in every Indian household since ages to deal with constipation. It contains mucilage that absorbs fluid and adds volume to the stool. Isabgol should be supplemented with 8-10 glasses of water every day, and it is advisable to take to this remedy only after consulting your doctor

3. Flaxseed

It is rich in dietary fibre and helps in adding roughage to your diet. Remember to supplement the diet along with a minimum of 8-10 glasses of water for each spoonful of flaxseeds

4. Massage

In your early pregnancy you can try to massage the stomach as this helps in relaxing the muscles. With your fingers, lightly massage your tummy in a clockwise direction. However, if you are at a risk of premature labour, or have a low placenta, then it is important to avoid any massage.

5. Dried Fruits and Prune Stew

You can stew half a cup of dried fruits such as apricots or prunes with a cup of water. Stew the fruit until it is softened and eat it with liquids in the morning. Dried fruit is an excellent source of fibre

6. Rub Oil

You can ease the passing of stool by rubbing organic oil such as coconut oil on your bottom

7. Olive Oil

Mix one tablespoon of olive oil with a teaspoon of lemon juice to it and have it once every morning. Do remember that taking more than this amount can cause diarrhoea and cramping, and is not recommended. Olive oil works as a stool softener and relieves constipation

8. Take Natural Probiotic

Our body needs good bacterial activity to digest food properly. Eat a cup of yoghurt every day as it is a natural probiotic

9. Yoga

There are many yoga postures for constipation that can help move gas and undigested food through the intestines and provide relief. A few yoga asanas you can try for digestive health are the Matsyasana twist, downward facing dog and the triangle pose. Do remember to consult a yoga specialist before taking to yoga

10. Aloe Vera Juice

You can try aloe vera juice as it helps in cooling down the digestive system. Take two tablespoons of aloe vera gel for relief. It is best if you can scoop it out of an aloe vera leaf, and blend it in a cup of fruit juice.

Foods that Help Prevent Constipation

Here is the list of food items that you can include in your diet to help you prevent constipation.

Fruits: Go for guava, pears, apples, berries, oranges and tangerines

Vegetables: Eat brussels sprouts, carrots, sweet potatoes, pumpkins squash. Also include leafy vegetables such as spinach, lettuce, etc

Legumes: Consume beans, lentils and peas

Grains: Go for whole-wheat bread, brown rice, unprocessed oats and bran

Nuts and seeds: You should try to have almonds, peanuts, sunflower seeds and walnuts

Remember, like most other challenges you face in pregnancy, constipation too is a temporary phase and will subside after delivery. You can successfully deal with it if you adopt these preventive steps in your diet and lifestyle.