Constipation affects at least half of all pregnant women.
However it is not only a condition of pregnancy as it also affects approximately 2% of the general population being more common in women and the elderly. So, why do we get constipated and what can we do to try and avoid it?
The digestive system is highly efficient. It takes only hours to break down the foods eaten, liquids drunk, extract the various vitamins, minerals and energy and prepare the the leftovers for disposal. This material passes through six meters of intestine, has water removed from it in the colon, and is expelled through the rectum within a day or two.
A common misconception is that to be 'regular' one needs to 'go every day'! But, depending upon factors like diet, age, and daily activity, 'normal' regularity varies from three bowel movements per day to one every three days. A normal stool, however, should neither be too firm or to soft. You ought not to have no strain unreasonably to pass it. Constipation therefore is when bowel movements become difficult or less frequent.
The longer faecial material sits in the colon, the less moist it becomes, the harder it becomes, and the more difficult to pass. Constipation is defined as having fewer bowel movements than usual, usually fewer than three times per week and is characterised by passing small amounts of hard, dry stool, often with much difficulty. These hard and dry stools are formed because the colon's muscle contractions are sluggish, causing the stool, to move through the colon too slowly.Causes of Constipation During Pregnancy
During pregnancy the following factors cause constipation:
 Hormonal changes relax the bowel, which slows the transit of food through the stomach and intestine.
The ever-growing uterus compressing the intestine.
Iron supplements.
Antacids
However, there are many other causes that occur during, but are not unique, to pregnancy. These are:
Diet. The most common cause of constipation is a low-fibre diet. Not enough liquids. Liquids add fluid to the colon, and bulk to the stools, making bowel movements softer and easier to pass.
Lack of exercise.
Ignoring the urge of a bowel movement may eventually cause a person to stop feeling the urge, leading to constipation.
Abuse of laxatives may lead to the colon beginning to rely upon laxatives to bring on bowel movements. Over time laxatives can damage nerve cells in the colon, affecting the colon's ability to contact.
Irritable bowel syndrome (IBS) causes abnormal spasms in the colon, that affect bowel movements, often leading to alternating constipation and diarrhoea.
Ageing may also affect bowel regularity because a slower metabolism results in less intestinal activity and lower muscle tone. Problems with the colon and rectum like intestinal obstruction, scar tissue, and diverticulosis, can compress, squeeze or narrow the intestine and rectum and cause constipation.
Anal Fissures are small tears at the opening of the anus. They can be so painful that bowel movements are avoided, both aggravating and causing constipation.
Diabetes.
Depression and anti-depressant medication.
Symptoms of Constipation
Individuals who are constipated have fewer than three bowel movements weekly. They find it difficult to pass the dry, hard and rough stools. Other symptoms include feeling bloated, sluggish and uncomfortable, together with a feeling that the rectum is full, even after a bowel movement.
Diagnosing Constipation
A thorough medical history and physical examination, as part of the pre-natal work up by your family doctor or obstetrician is all that is necessary.
When to Call your Doctor
If constipation develops after starting a new medication or supplement, the dosage may need to be changed, or discontinued altogether.
If you have blood in your stool, usually due to fissure or haemrrhoids, but can also be a sign of colorectal cancer.
If the constipation is associated with fewer, or lower abdominal pain, with thin or loose stools. These symptoms may be indicative of diverticulosis.
If you are losing weight.
If you have severe pain with bowel movements.
If you have been constipated longer than 10 days.
August 2008
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