Constipation During pregnancy

 

Constipation is irritating at the least but constipation during pregnancy is most distressing. Already saddled by the mental and physical demands of the growing fetus constipation only adds to the mother’s list of woes. In adults, having less than 3 bowel motion per week is classified as constipation. Food as you know moves down the intestine with recurring waves of contraction called peristalsis.

 

Though peristalsis is an automatic process requiring no stimulus its intensity is dependent on how the intestine is stretched by food. To understand what causes constipation we have to understand something of the ultra structure of the intestine and the physiology of nerve conduction and muscle contraction.

 

Ultra Structure of Intestine

 

From inside outwards the intestine consists of the mucus membrane, lamina propria, the muscularis mucosae, the submucus coat, the muscularis externa and the serous coat. The layers that are of interest to us in understanding constipation are the submucus coat and the muscularis externa. The submucus coat contains two bundles of nerve fibers arranged in two plexuses, the Messner’s plexus and the Aurebach’s plexus.

 

These nerve fibers conduct electrochemical currents in the form of moving sodium and potassium ions. These impulses occur when the nerve fibers are stimulated by stretch receptor which as their name suggests are themselves stimulated by stretching of the intestine in whose walls they are situated. The muscularis externa contains two layers of smooth muscle cells. These smooth muscles contract when a nerve impulse initiated by stretching of the intestinal walls reaches its cell surface forcing calcium ions into the cytoplasm and making its contractile protein actin and myosin to interdigitate. The contraction of these muscle cells forces the stool stored in the intestine through the rectum to the exterior. In constipation the intestine is not stretched and these muscles do not contract. This is the basic patho-physiology of constipation.

 

There is another reason why constipation occurs is that when stool moves through the colon water is gradually absorbed from the fecal mass. If too much water is absorbed the stool becomes hard and is difficult to excrete.

 

Reasons For Constipation During Pregnancy

 

Your body becomes constipated in pregnancy for the following reasons:-

 

Excess of Intestinal Water Absorption: In pregnancy the body retains a lot of water so more water from your intestines is absorbed leading to dry stools and constipation

 

Loss of Appetite: In pregnancy there is loss of appetite and the mother eats less. As the bulk of the stool decreases it results in constipation.

 

 

Hormonal Changes: There is a lot of hormonal change during pregnancy. For some unexplained reason this leads to constipation.

 

Increased Intestinal Pressure Due to Growing Uterus: There is increased pressure on the intestines by the growing uterus. This constant pressure depolarizes the intestinal muscles making them electrically inactive and unable to contract. This results in constipation.

 

Gastric Problems: There is a lot of gas formation, during pregnancy, in the intestines. This impedes the movement of stool down to the rectum.

 

Iron Supplements play a major role in constipation of pregnancy. Iron is a metal and carries an electric and magnetic charge. This in some unexplained way affects the electrochemical conduction in the intestinal nerves. As a result intestinal muscle cells cannot contract which leads to constipation.

 

Problems Linked to Constipation

 

Ignoring constipation can lead to various problems. One of them is fissure. In this condition the mucus membrane around the anus tears and gets infected. The other serious condition is piles where veins around the rectum swell up and sometimes rupture during defecation. The cure for both conditions is surgical.

 

Steps to Cope Up With Constipation During Pregnancy

 

These are the following steps you can take to relieve constipation during pregnancy.

 

1. Eat a lot of foods containing fiber like fruits and vegetables. The fibers react with water in the intestine forming a gelatinous mass increasing the bulk of the stool thus making it easier to pass.

 

2. Drink a lot of water. This will help hydrate your stool and make it soft.

 

 

3. Take a little exercise like a leisurely walk (after consulting your gynecologist). This will go a long way towards relieving your constipation.

 

4. Avoid ignoring the defecatory urge. When you feel a ‘call’ coming on, visit the toilet.

 

5. Avoid eating pre cooked food like canned fish or meat.

 

6. Avoid dairy products like milk or cheese and wheat products like bread or pastry.

 

7. Take laxatives, suppositories and enemas only after detailed consultation with your gynecologist.

 

Constipation during pregnancy is troublesome and irritating and causes great mental and physical anguish. Following the above measures will grant you relief to a great extent. Consult your gynecologist when in doubt and remember help is never far away.



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