Interventions for treating constipation in pregnancy

Mild laxatives help relieve constipation in pregnancy.

Constipation is a common problem in late pregnancy. The time taken for food to get through the gut to the bowel is increased in the second and third trimester and may be caused by an increase in the hormone, progesterone. Adding more fibre to the diet increases the frequency of defecation (bowel movement) and leads to softer stools. The review of trials found that laxatives which stimulate the bowel are more effective than those that add bulk but may cause more adverse effects such as diarrhoea and abdominal pain. Fibre supplements are effective and appear to have no adverse effects.

Authors' conclusions: 

Dietary supplements of fibre in the form of bran or wheat fibre are likely to help women experiencing constipation in pregnancy. If the problem fails to resolve, stimulant laxatives are likely to prove more effective.

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Background: 

Constipation is a common problem in late pregnancy. Circulating progesterone may be the cause of slower gastrointestinal movement in mid and late pregnancy.

Objectives: 

The objective of this review was to assess the effects of different methods for treating constipation in pregnancy.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register and MEDLINE. Date of last search: January 2001.

Selection criteria: 

Randomised trials of any treatment for constipation in pregnancy.

Data collection and analysis: 

Trial quality assessments and data extraction were done independently by two reviewers.

Main results: 

Two suitable trials were identified. Fibre supplements increased the frequency of defecation (odds ratio 0.18, 95% confidence interval 0.05 to 0.67), and lead to softer stools. Stimulant laxatives are more effective than bulk-forming laxatives (odds ratio 0.30, 95% confidence interval 0.14 to 0.61), but may cause more side effects.