Constipation during pregnancy is a common problem worldwide. It is characterized by abdominal pain, irregular bowel movements and the passage of hard stools. Studies have reported that pregnant women are more prone to developing constipation during the second and third trimesters. However, it can be treated with the help of some medications and dietary modifications.

Causes of Constipation during Pregnancy

During pregnancy, a lot of hormonal changes take place. An increase in the level of progesterone during this phase is responsible for reduced intestinal smooth muscle motility. This causes the intestinal muscles to relax and slows down digestion, which in turn leads to constipation. A rise in the level of progesterone inhibits the secretion of ‘motilin’. Motilin is a hormone that stimulates smooth muscle motility.

Furthermore, these hormonal changes cause an increased absorption of water, thus leading to hardened stools.

The enlarging size of the uterus may slow down the movement of the feces.  The forward passage of the stools becomes sluggish, which causes constipation.

Other factors responsible for pregnancy constipation include:

  1. Insufficient intake of water
  2. A diet low in dietary fiber
  3. Decreased maternal activity
  4. High intake of vitamin supplements

Besides this, women who are affected by constipation pre-pregnancy, tend to have worsening symptoms during pregnancy.

Complications

  • The passing of hard and dry stools is associated with pain and straining. Excessive straining can damage the pudendal nerve leading to the weakening of the pelvic floor musculature. Such a weakening may also lead to uterine prolapse.
  • Constipation may even lead to fecal impaction, but such a complication is rare.
  • Due to excessive straining, constipation may be complicated by hemorrhoids. They are also known as piles, where a group of veins in the region of the anus is This may be marked by pain, bleeding and itching.
  • Besides physical complications, constipation may also affect the psychological health. Such complications include frustration and low mood.
  • Pregnant women with constipation have also reported poor general health, reduced vitality, poor physical functioning and poorer social life.

Dietary Guidelines for Constipation during Pregnancy

Here are a few dietary tips that can help to prevent and treat constipation during pregnancy.

Increase Your Fiber Intake

Fruits and Salad

Fruits and Salad

Dietary fiber is a carbohydrate that escapes digestion in the small intestine. This non-digestible carbohydrate has a beneficial effect on the gut. Therefore, eating a high-fiber diet is important for healthy bowel movements in pregnant women.

When you eat high fiber foods, it absorbs more water and makes the stools soft. This makes the passage of the stools easier and you don’t need to strain or put pressure to pass the stools.

It further adds bulk to the fecal matter, reduces the intestinal transit time and hastens its passage through the gut. This reduces the constipated feeling.

Dietary fiber is available in nature in two different forms:

  • Soluble dietary fiber
  • Insoluble dietary fiber

It is important to consume foods rich in both the types of dietary fiber. Here are some foods that are a great source of dietary fiber:

  1. Whole Grain Cereals: brown rice, oats, barley, sorghum, millets, broken wheat
  2. Pulses and legumes
  3. Fruits and vegetables

Drink More Fluids

Woman drinking water

Constipation is the dehydration of the colon. Low fluid intake is associated with an increased risk of constipation.

The food you eat reaches the stomach and then the intestine. If you do not drink plenty of liquids, your large intestine may absorb water from the food waste. This makes the stools hard and dry and difficult to pass. Therefore, drinking plenty of liquids will make the stools soft and easy to pass.

Besides this, it is important to increase your fluid intake when increasing the consumption of dietary fiber. Additional fluid intake improves stool consistency and bowel movement frequency.

Make sure you increase your water intake and add other healthy fluids to your diet as well, which include:

  • Buttermilk
  • Unstrained and home-made fruit juices
  • Unstrained vegetable soups

Add Probiotics to Your Diet

Yogurt with Strawberries

Yogurt with Strawberries

Probiotics are live micro-organisms that help in getting rid of toxins present in the gut. Pregnant women can safely consume probiotics from foods, which may help their digestive system to function more efficiently.

Gastrointestinal motility is associated with the gut microbiota. Probiotics help in the colonization of good bacteria and enhance the removal of the bad and unhealthy ones.

Probiotics stimulate intestinal motility, enhance colonic contractility by stimulation of smooth muscle cells. It further helps in the forward movement of the food and shortens the intestinal transit time.

Studies have reported that overproduction of methane inhibits motor activity, which may lead to constipation. Probiotics enhance colonic peristalsis and stimulate the production of short-chain fatty acids.

These short chain fatty acids improve the motor response, boost propulsive contractions and accelerate intestinal transit time.

The curd is a great source of natural probiotics. Make sure you include curd in your daily diet to improve your digestive health.

Say Yes to Whole Fruits

Fruits and Vegetables

Fruits contain water, phytochemicals, antioxidants, dietary fiber, fructose and sorbitol. These components of fruit are useful for treating constipation. Let’s have a look at which fruits may be beneficial for pregnant women with constipation:

Kiwifruit

Kiwi Fruit

Kiwi Fruit

Kiwifruit is loaded with various nutrients, which makes it beneficial for a pregnant woman’s health. Studies have reported that kiwifruit is a good source of dietary fiber. 100 grams of kiwifruit contain approximately 2-3 grams of fiber. Such a composition helps in relieving constipation and ensures softness of bowel motion.

Furthermore, this fruit contains ‘actinidine’, an enzyme that stimulates the motility of the upper gastrointestinal tract. Thus, it promotes laxation, increases stool frequency, volume and ease of defecation.

Prunes

Prunes are dried plums and eating this fruit can avoid constipation during pregnancy. The high content of dietary fiber, sorbitol and fructose in prunes makes it beneficial for treating constipation in pregnant women.

100 grams of prunes contain 6.1 grams of dietary fiber, making it a great source of fiber. This helps in increasing the stool weight.

Neochlorogenic acid and chlorogenic acid are two phenolic compounds present in prunes that aid in the laxative effect. Eating prunes can increase the gastric emptying and reduce the intestinal transit time. It even makes the gut bacteria healthier and helps in the clearance of toxins and bad bacteria.

An interesting study found that prune juice or puree was effective in treating constipation in pregnant women caused by intake of iron supplements. Hence, eating 2 prunes a day may be helpful in relieving constipation.

Exercise

Exercise during Pregnancy

Exercise during Pregnancy

Exercise is important for regular bowel movements. It stimulates the bowels and help in the easy passage of the stools.

Pregnant women should go for a walk 2 to 3 times a week or practice pre-natal yoga. Yoga increases the flow of the blood towards the digestive tract and causes the intestine to contract. This improves digestion of food and relives constipation.

Discuss with your doctor about what exercises are safe for you and your little one.

Limiting Specific Foods

Now we know which foods are good for the gut, but we even need to know what kind of foods should be limited to prevent constipation:

Persimmon

Persimmon

Persimmon

Persimmon is a highly nutritious fruit, but the high tannin content of this fruit may slow down the transit of the intestinal contents. It inhibits peristalsis and may even lead to painful defecation.

Hence, pregnant women with constipation must avoid excess intake of this fruit. Women who have normal bowel movements can enjoy this fruit in limited quantities.

Banana

Banana

Banana

Banana is a healthy fruit, which is economical and available all around the globe. Unripe bananas contain tannins and high amount of amylase-resistant starch. Thus, unripe bananas may cause constipation or aggravate pre-existing constipation.

Though ripe bananas contain less of tannins and amylase-resistance starch, it is better to avoid its intake during constipation.

Refined Food Products

Pasta

Pasta

Eating a diet rich in refined food products like refined flour, pasta, noodles and breads may contribute to constipation.

These foods contain little or no dietary fiber, because the outer-covering of the grains (bran and the germ parts) are removed while processing.

Hence, eating such foods may not add bulk to the stools, making them hard and difficult to pass. Replace refined grains with whole grains to get rid of constipation during pregnancy.

Fried Foods

Fried Foods

Fried Foods

Pregnant women can sometimes enjoy fried foods, but an over-intake of such foods may increase the risk of constipation.

Fried foods and foods that are naturally high in fat, for example – ice creams, red meat and chips may slow down the digestion of food.

Fried foods further reduce the water content of the stools and makes them hard. This makes the passage of the stools difficult.

Chocolates

Chocolate

Chocolate

An interesting study observed that chocolate was a major cause of constipation among various individuals.

A high intake of chocolate may slow down the contraction of intestinal muscles as well as the passage of food through the bowel.

This effect of chocolate is attributed to its high fat content. Hence, pregnant women must make sure that they do not overdo on chocolates.

Untreated constipation during pregnancy can have a negative impact on physical, psychological as well as social health.

The above-mentioned ways to treat pregnancy constipation are simple and natural. If this does not solve the problem, it is advised that pregnant women should seek medical help.

References

  1. Jing Yang, Li Zhou, Effect of dietary fiber on constipation: A meta-analysis, World Journal of Gastroenterology, Volume 18, 2012 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544045/)
  2. Sun Hwan Bae, Diets for Constipation, Pediatric Gastroenterology, Hepatology and Nutrition, Volume 17, 2014 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4291444/)
  3. Chang Hwan Choi, Alteration of Gut Microbiota and Efficacy of Probiotics in Functional Constipation, Journal of Neurogastroenterology and Motility, Volume 21, 2015 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4288092/)
  4. Drummond L, Kiwifruit modulation of gastrointestinal motility, Advances in Food and Nutrition Research, 2013 (https://www.ncbi.nlm.nih.gov/pubmed/23394990)
  5. El-Dakak Abeer M. N. H, Sayed Ahmed E. F, Utilization of prune juice or puree as a laxative for constipation pregnant rats induced iron intake during pregnancy and the impact on newborns, International Journal of Nutrition and Food Sciences, Volume 2, 2013 (http://article.sciencepublishinggroup.com/pdf/10.11648.j.ijnfs.20130206.23.pdf)
  6. Magan Trottier, Aida Erebara, Treating constipation during pregnancy, Canadian Family Physician, Volume 58, 2012 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418980/)
  7. Muller-Lissener S.A, Layer P, The perceived effect of various foods and beverages on stool consistency, European Journal of Gasteroenterology and Hepatology, Volume 17, 2005 (https://www.ncbi.nlm.nih.gov/pubmed/15647650)