Gastrointestinal Disease and Pregnancy C. Constipation

Constipation symptoms are most common in the first and second trimesters and less common in the third. Other symptoms, such as abdominal pain and bloating, may accompany constipation.

Book an appointment with your gynaecologist if you experience any of these symptoms.

Sedentary lifestyle, bed rest, low fiber intake, and insufficient fluid intake are all risk factors for constipation. Medications, such as iron, can also cause constipation

Physical examination should focus on clinical signs of hypothyroidism, diabetes, and perineum and anal canal evaluation
Digital rectal examination for sphincter tone and anal canal evaluation
Laboratory testing to rule out endocrine and electrolyte abnormalities
Anoscopy or flexible sigmoidoscopy: if symptoms are associated with bleeding or anorectal lesions

The initial treatment for constipation in pregnancy is the same as it is for the general population: dietary and lifestyle changes.

Moderate physical activity can help maintain normal bowel function.
Increased fluid intake (>8 glasses per day) and fiber consumption (>20-35 g per day) are two dietary adjustments.
Bulk-forming agents are usually considered because they are not systemically absorbed, are safe during pregnancy, and can be used for long periods of time.

Lactulose and methylcellulose have the potential to be used during pregnancy. Class (B)