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Constipation During Pregnancy

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If you are reading this article, you are probably pregnant. Congratulations! You have started this beautiful journey into parenthood.

But, as any journey, it can have some surprising pitfalls. And one of those is constipation. Don’t worry, it’s actually very common!

Around 75% of pregnant women will experience at some point during their first trimester some kind of bowel issues, including constipation1, and around 11%-38% of pregnant women will have constipation episodes during the 2nd and 3rd trimesters.2,3 In fact, the most common gastrointestinal complaints during pregnancy are nausea, and in second place, constipation.3,4

Why do pregnant women suffer from constipation?

Pregnant women are predisposed to constipation for several reasons. During the 1st trimester there is an increase in bowel transit time due to the rising of progesterone levels (which relaxes your muscles, including your intestines), to the reduction of motilin (the hormone that triggers motility movement) levels4,5, to an increase in water absorption in the intestines that provokes drier stools and to the recommended pregnancy supplements such as calcium and iron.4 Later, during the 2nd and 3rd trimesters, a larger uterus might provoke additional pressure on the intestines than creates slower onward movement of stools.4 Decreased physical activity can also help enlarge the problem.

How can you control your constipation?

The first recommendation is to increase your intake of fiber and water and try to exercise daily. A daily walk of 30 minutes can be enough. If you don’t see changes after a couple of weeks, you can try with laxatives. Sennosides, Prunelax’s Active Ingredient, are extracted from Senna, a plant that has been used as a laxative for over 2,000 years. There are dozens of independent studies about their safety and effectiveness. Sennosides work directly in the large intestine, so it’s not absorbed into the bloodstream. That’s why Senna is compatible with pregnancy and breastfeeding. TGA (Australia) has approved Senna as a Type A Drug, which means that it has been taken by pregnant women and there is no evidence of an increase in malformations and other effects in the fetus. 6,7,11 Studies show that no secondary effects have been noticed in infants nor changes in their stools consistency, when their mothers have taken Sennosides at the recommended dosages.8,9 FDA has approved Senna as a Dietary Supplement of occasional constipation10.

Prunelax is available in several alternatives, so you can find the most comfortable to your preferences: tablets, tea, jam (prune & apple marmalade with flax seeds, honey and senna extract) and liquid.

If you are pregnant, before taking any laxatives, please ask you healthcare professional.

Be careful if this is your first time taking laxatives: start with a small dose to find out what your needed dose is to have a laxative effect without feeling cramps. Everybody is different and may need different dosages.

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  1. Johnson P., Mount K. y Graziano S. (2014) Functional bowel disorders in pregnancy: effect on quality of life, evaluation and management. Nordic Federation of Societies of Obstetrics and Gynecology, Acta Obstetricia et Gynecologica Scandinavica 93. pg 874–87
  2. Interventions for treating constipation in pregnancy. Jewell DJ, Young G, Cochrane Database Syst Rev. 2001; (2):CD001142.
  3. Diagnosis and management of irritable bowel syndrome, constipation, and diarrhea in pregnancy. West L, Warren J, Cutts T, Gastroenterol Clin North Am. 1992 Dec; 21(4):793-802.
  4. Constipation and pregnancy. Cullen G, O’Donoghue D, Best Pract Res Clin Gastroenterol. 2007; 21(5):807-18.
  5. Gastrointestinal Conditions during Pregnancy. Longo SA, Moore RC, Canzoneri BJ, Robichaux A, Clin Colon Rectal Surg. 2010 Jun; 23(2):80-9.
  6. TGA. (2009) Prescribing medicines in pregnancy database. Australian Register of therapeutic Goods. Therapeutic Goods Administration.
  7. Ács, N., F. Bánhidy, E.H. Puhó, and A.E. Czeizel. 2009. Senna treatment in pregnant women and congenital abnormalities in their offspring: A population-based case-control study. Repro. Toxicol. 28 (!): 100-104.
  8. Transfer of drugs and other chemicals into human milk. American Academy of Pediatrics, Committee on Drugs. Pediatrics 108(3): 776-789.
  9. Faber, P., and A. Strenge-Hesse. 1988. Relevance of rhein excretion into breast milk. Pharmacology 36(Suppl. 1): 212-220.
  10. FDA. 1985. 21 CFR Part 334: Laxative products for over-the-counter human use; tentative final monograph. Federal Register. 15 January 1985 ; 50(10): 2124-2158
  11. Rhein and aloe-emodin kinetics from senna laxatives in man. Krumbiegel G, Schulz HU, Pharmacology. 1993 Oct; 47 Suppl 1():120-4.

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