Dr. Tanya Lee, H.BSc, ND

Constipation is a common condition with one-third of pregnant women experiencing this at some point of their pregnancy. It is most common in the first and second trimester and can occur for a multitude of reasons. A recent study found that pregnant women over 35 years of age, and those with sedentary jobs had higher rates of constipation during their pregnancy.1 Other factors such as increased protein and fat consumption, less exercise and the increase in the hormone “progesterone” during pregnancy can also contribute to constipation.1 Constipation can be quite uncomfortable, and chronic cases can lead to other problems, most commonly the development of hemorrhoids. Here are some natural remedies that you can try if you are suffering from constipation during your pregnancy.1

Drink your water!

Water consumption is probably the most overlooked root cause to constipation – when people come to the office seeking advice for their constipation, they often don’t realize they are not drinking enough water. Improving water consumption (to at least 3L daily) can greatly improve constipation.2 Along with hydrating the rest of the body, water is drawn in to the colon to help your body easily pass a bowel movement; if you feel like you’re drinking a fair amount of water daily (at least 2L daily) try increasing your daily consumption by another 2-4 cups and see if this helps.

Fibre

Improving the fibre consumption in the diet is also a great way to help with stubborn bowel movements and has been found to greatly help with constipation during pregnancy.3 There are two types of fibre. Soluble fibre is mainly found in foods such as oats, beans, psyllium, rice, barely, and apples and can help with your movements by drawing more water in to the intestines, and swelling in the intestine to form softer, larger stools. Insoluble fibres are found mainly in fruit skins, seeds and wheat bran/germ products. This type of fibre helps with constipation by adding more “bulk” to the stools, triggering the intestines to move the stool through efficiently. Insoluble fibre tends to be more suitable for constipation cases as it’s doesn’t “swell” like soluble fibre; however both types can be helpful in constipation. While adding fibre can help with constipation cases quite often, sometimes it can aggravate the condition as well. Introducing fibre slowly in to the diet in order to see if it’s helpful or aggravating.

Exercise

Pregnancy can create a multitude of symptoms that lead to less activity during this time. While lower activity rates are consider normal, no exercise can be problematic to the digestive system and has been consider a factor in the prevalence of constipation during pregnancy.1 Regular exercise has been found to decrease stress and improve digestive function in pregnancy.4 30 mins of gentle exercise 3-5 times a week is generally recommended for healthy exercise in pregnancy.

Probiotics

Probiotics are used for a number of different digestive concerns in and out of pregnancy. There are a number of benefits of using probiotics during pregnancy (see my previous articles on the the benefits of probiotics during pregnancy) and treating constipation is another benefit for probiotic use. The normalization of gastrointestinal flora through probiotic supplementation is important for regulating they way your body digests and processes food. Probiotics help constipation by improving the time your stools to pass through the colon, as well as improving frequency and consistency of bowel movements.5 Probiotics can be particularly helpful if you have recently been on antibiotics and have been experiencing constipation since using these medications.

Laxatives

Laxatives are not typically recommended as first line therapy for constipation and should be reserved for crucial and stubborn cases and should be recommended by a healthcare professional before use. Be aware of stimulating laxatives from plants such as rhubarb, aloe, cascara, senna. Although these are natural, they work by causing contractions in the large intestine to elicit a bowel movement, so can potentially stimulate contractions in the uterus and therefore should be avoided. Short-term use of senna has been used in pregnancy and is considered safe, however it is still advised to talk to your healthcare provider before using this as a constipation remedy.6 Osmotic laxatives, such as magnesium citrate, are different as they help relax the bowel and draw more water in to the colon, but should also be recommended by a qualified health professional before use for dosage and to see if they are appropriate for you.

These are some of the most common ways to treat constipation during pregnancy and most cases can be easily managed by applying the lifestyle changes and remedies outlined above. When dealing with medical concerns of the digestive tract, it is always wise to consult a healthcare professional for a full assessment and work up of these symptoms.


HCM HSDr. Tanya Lee, N.D. received her Honours Bachelor of Science degree in Biochemistry and Biomedical Sciences from McMaster University and was trained as a Naturopathic Doctor at the Canadian College of Naturopathic Medicine.  Dr Lee practices full-time between two clinics located in Toronto and Milton Ontario and has been voted Milton’s favourite Naturopath in 2013 and 2014.   Her primary care practice focuses on family medicine, treating a wide variety of conditions such as hormonal (endocrine) disorders, fertility, digestive problems, cardiovascular disease, diabetes, insomnia and fatigue.  She has a special interest in the treatment of autoimmune diseases, paediatric and perinatal health.  Tanya offers her clinical knowledge to a number of publications, including the NaturalPath.


References:

  1. Shi W al Epidemiology and Risk Factors of Functional Constipation in Pregnant Women. PLoS One. 2015 Jul 24;10(7)
  2. Rungsiprakarn P al., Interventions for treating constipation in pregnancy. Cochrane Database Syst Rev. 2015 Sep 4;(9)
  3. Derbyshire E., The importance of adequate fluid and fibre intake during pregnancy. Ours Stand 2007; 21(24):40-3.
  4. Wald A., Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy. Gastroenterol Clin North Am. 2003 Mar;32(1):309-22
  5. Dimidi E al The effect of probiotics on functional constipation in adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr. 2014 Oct;100(4):1075-84.
  6. Leng-Peschlow E. Senna and its rational use. Pharmacology 1992;44 (Suppl.1):1-52.
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