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Constipation in early pregnancy

Medical expert of the article

Gynecologist, reproductive specialist
, medical expert
Last reviewed: 04.07.2025

In obstetrics and gynecology, we increasingly have to deal with such a delicate problem as constipation during early pregnancy. At the same time, most women either do not attach importance to this issue or are embarrassed to raise this issue. Many women do not believe that this is a problem that should be consulted with a gynecologist. However, it is worth talking about it and understanding the main points.

Constipation as a sign of pregnancy

When analyzing clinical cases, practicing gynecologists note that for many women the earliest sign of pregnancy is not even a delay in the menstrual cycle, but constipation. This problem usually occurs 10-20 days after conception. Thus, the woman is still waiting for the next menstruation to begin and does not suspect the onset of pregnancy. But she may experience constipation, which may indirectly indicate fertilization of the egg.

It is worth noting that the exact cause of this phenomenon has not been fully studied. There are several assumptions that equally have the right to exist. This may be a violation of hormonal regulation in the body, or more precisely, the adaptation of the hormonal system to the new needs of the body, work to maintain pregnancy. The gastrointestinal tract, including the liver and pancreas, also fall under hormonal changes.

The normal functioning of all endocrine glands is disrupted. Hormones and digestive enzymes are secreted worse, their activity decreases, normal digestion processes are disrupted, and intestinal peristalsis and motility are also disrupted. This leads to stagnation of feces in the body, and also contributes to the narrowing of the intestinal space.

The second theory says that constipation can accompany the adaptation processes occurring in the pelvic organs. The beginning of pregnancy entails the restructuring of all organs and systems, including the digestive system. At first, changes affect the reproductive organs, the uterus expands and increases in volume, the configuration and volume of the fallopian tubes change.

All this puts additional pressure on the intestines, mechanical compression of the intestine occurs, as a result of which fecal matter cannot move freely along the intestines and cannot be excreted. They stagnate in the rectum. This can have a number of negative consequences, ranging from intoxication to various complications and diseases of the digestive tract. [ 1 ]

Why is constipation dangerous in early pregnancy?

First of all, the danger of constipation is that it is accompanied by stagnation of feces. Feces cannot move freely through the intestines, since various obstacles arise in their path. These can be mechanical obstacles that arise due to compression of the intestines, disruption of hormonal regulation, and disruption of conductivity and sensitivity of receptors.

It should also be noted that the danger of constipation is that with prolonged stagnation, fermentation and putrefaction processes develop, which leads to the accumulation of putrefaction products in the body. As a result, toxins are formed that have a toxic effect on the entire body. First of all, the gastrointestinal tract is subject to putrefaction, secondly, the absorption of toxins occurs, they enter the blood, as a result of which the toxins are carried throughout the body, and cause intoxication. [ 2 ]

When toxicosis develops, which occurs against the background of the restructuring of the body, the vital activity of the fertilized egg in the early stages, there is a combined effect of toxicosis and intoxication with feces. In this case, various infectious, inflammatory, purulent-inflammatory processes develop. Such intestinal diseases as colitis, enterocolitis, gastritis, enteritis can develop. Also, such processes are accompanied by the formation of secondary foci of infection. One of the complications can be dolichosigma, in which there is an expansion of the rectal canal, as well as deformation of the intestine. This can be accompanied by painful processes, the development of inflammation, intoxication. One of the unpleasant consequences is the loss of feces. [ 3 ]

Epidemiology

According to statistics, about a third of women suffer from constipation in the early stages of pregnancy. Women often do not even know that they are pregnant and are still waiting for their next period. In about 24% of cases, with a long-term stagnation process, there is a long-term stagnation of feces, which is accompanied by dolichosigma (dilation, change in shape and structure of the intestine as a result of its deformation under the influence of various factors, including mechanical ones).

In the absence of treatment, 98% of cases are accompanied by severe intoxication, the development of purulent-inflammatory, infectious diseases. With adequate treatment, only about 15% of cases are accompanied by the development of inflammatory and infectious processes. [ 4 ]

Causes constipation in early pregnancy

The main reason for the development of constipation is the retention of feces and the inability to remove them. The reason is a violation of peristalsis and intestinal motility. This can develop due to a decrease in intestinal tone, as well as mechanical obstacles that arise in the path of movement of feces. The reason may be hormonal changes in the body, adaptation to the upcoming pregnancy and childbirth of all pelvic organs, a violation of enzymatic and hormonal activity in the body. The reason may also be the expansion or displacement of the intestine.

Risk factors

The risk group includes people with disorders of the functional state of the gastrointestinal tract. First of all, these are people with low intestinal tone, with the development of various congenital and acquired defects and pathologies of the rectum, large and small intestines. The risk group includes patients suffering from frequent constipation, impaired intestinal motor function. Also, the risk group includes people with irregular bowel movements, often suffering from various diseases of the digestive organs.

A separate risk group is formed by patients who have a tendency to have irregular bowel movements, as well as the need to constantly suppress the urge to defecate by force of will (for example, a person works in a public place and is forced to constantly suppress the urge to defecate). [ 5 ]

Pathogenesis

The pathogenesis is based on the disruption of the normal functioning of the intestinal tract. The hormonal status of a person changes, which accordingly entails a disruption in the synthesis of enzymes, hormones, mediators that cause an inflammatory and infectious process, contribute to a decrease in intestinal tone, and prevent the penetration of infection into the body. Accordingly, feces move weakly outward and cannot leave the rectum. As a result, stagnant processes develop.

Symptoms constipation in early pregnancy

The development of constipation may be indicated by the inability to empty the bowels despite the urge to defecate. In this case, pain and burning in the intestines and rectum may develop, sometimes there is a feeling of pressure, and even pain in the rectum. Also, the entire process may be accompanied by chills, a feverish condition, which alternates with chills and an excessive decrease in temperature. Pain in the ovaries, uterus, fallopian tubes, and other reproductive organs may gradually develop. [ 6 ]

The first signs that may indirectly indicate possible constipation are abdominal distension, pain and pressure in the intestines or rectum. Headache, discomfort, a feeling of tension, pressure in the bladder and ovaries also occur. Quite often, a feeling of bloating develops, both in the abdomen and in the reproductive organs.

  • Bloating, constipation in early pregnancy

This happens to every second woman. The peculiarity is that the woman may not yet know about the pregnancy, since the delay has not yet occurred. It is also worth noting that many pregnancies are finally confirmed during a consultation with a gastroenterologist, who accepts about bloating, pain, prolonged constipation.

  • Hard stool in early pregnancy

Quite often, the beginning of pregnancy is associated with such an unpleasant phenomenon as constipation. But it can and should be fought. Today, the pharmaceutical industry is represented by many drugs that can gently and without consequences solve this problem. For example, during pregnancy, you can use guttalax drops, buckthorn extract, festal, and many other remedies, including traditional medicine recipes.

Complications and consequences

One of the most dangerous complications of constipation is intoxication, which develops as a result of stagnation of feces. Fermentation and rotting processes occur, this is accompanied by the release of gases, the spread of toxins throughout the body. As a result, new foci of infection can form, as well as poisoning of the entire body. This is due to the fact that decay products (toxins) can be absorbed through the blood and penetrate into all other organs and systems. Deformation of the rectum sigmoid colon, the development of purulent-inflammatory bowel diseases can also be a complication.

Various inflammatory infections of both the intestines and the genitourinary system can gradually develop. The most dangerous can be considered excessive progression of the infection, in which it enters the blood, spreads and leads to bacteremia, sepsis. Sepsis is the most severe and dangerous form of the infectious process, which comes down to blood poisoning, and requires complex treatment (antibiotic therapy). [ 7 ]

Diagnostics constipation in early pregnancy

In order to diagnose constipation and determine the causes of its occurrence, when the first signs of constipation appear, you need to see a doctor as soon as possible. Usually, he conducts diagnostics by palpation, examination of the stomach, intestines. But before this, the doctor first questions the patient, collects general information about him, anamnesis of life. [ 8 ]

Gastroenterologists rarely ask women about their last menstrual period, so it is not always easy to guess that the cause of constipation is pregnancy. In addition, the delay has not yet occurred, so even with information about when the last menstruation was, it is not always possible to determine the cause of the pathology. Most often, dolichosigma, intestinal obstruction, malabsorption, or simply a violation of normal intestinal motility, which leads to the retention of feces in the body, are suspected. The cause may also be a violation of the normal microbiocenosis, a violation of the motor activity of the ciliated epithelium, a violation of the normal state of the mucous membranes of the digestive tract, and even a violation of enzyme activity.

Then the doctor collects the anamnesis of the disease. Tell the doctor everything you consider necessary, any assumptions about what could provoke the cause of the development of constipation, no matter how ridiculous they may seem to you. The more information, the easier it will be for the doctor to make a diagnosis. After all, at first glance it seems that prescribing a pregnancy test for a complaint of constipation is also sheer nonsense.

Usually, only after a full examination and questioning of the patient are the necessary examinations prescribed. Palpation can also provide important diagnostic information, since it allows determining the degree of intestinal density, its bloating, and, consequently, stagnation of fecal matter.

If necessary, additional laboratory and instrumental research methods may be prescribed.

Tests

Traditionally, clinical tests are prescribed: blood, urine, feces. They allow you to assess the general direction of the processes occurring in the body. Based on the test results, you can judge the possible pathology. Thus, they can indicate an inflammatory, infectious, or allergic process. You can also roughly assume how severe and neglected the inflammatory process is.

But few gastroenterologists will dare to prescribe a pregnancy test if you consult them about constipation. At least, there must be good reasons for this. For example, a gastroenterologist may prescribe standard clinical tests first, and only if the results indicate a suspicion of pregnancy, then he can prescribe such a test.

To determine pregnancy at early stages, an analysis is prescribed for hCG - human chorionic hormone, which is produced from the moment of fertilization until the moment of placenta formation, that is, approximately the first four weeks. After this, the placenta gradually begins to form, and hCG stops being synthesized by the body. At this stage, it is already necessary to prescribe tests for progesterone (placental pregnancy hormone). It continues to synthesize from the 1st month until the very birth. At different stages, its amount may be different. So, if signs are found in the blood that may indirectly indicate pregnancy (during a clinical blood test), further research can be conducted in this direction.

It is interesting that the signs of pregnancy in a blood test are similar to the signs of a parasitic invasion. This is due to the fact that the embryo developing in the body is initially foreign to the mother's body. Pregnancy can be assumed if the blood test shows a high content of eosinophils and an increased level of histamine. But this can also indicate parasites, and an allergic process can also be assumed. To clarify the data, a pregnancy test is prescribed. If this option is excluded, allergy tests are prescribed, an analysis of the content of total and specific immunoglobulin E, and the level of histamine. A detailed immunogram may be required, which will display the current state of the immune system.

If pregnancy is confirmed, it would be a good idea to conduct a bacteriological examination, a dysbacteriosis test or a microbiological screening, which will eliminate the possibility of dysbacteriosis and infectious diseases. The fact is that constipation is accompanied by stagnation of feces in the body, resulting in suppuration, which is inseparable from the infectious process.

If an infectious disease is suspected, virological studies are prescribed, as well as bacteriological culture, which will allow differentiating a viral disease from a bacterial or fungal one. Smears and scrapings are taken. Blood or feces are also examined using microscopy, bacteriological culture, serological or virological studies. In case of a disease of unclear etiology, it is advisable to conduct a study on latent infections, parasitic diseases.

Instrumental diagnostics

The diagnostic method the doctor chooses depends on what is presumed to be the cause of the disease. It is usually prescribed after a preliminary examination and questioning of the patient, after conducting a standard set of studies, when the doctor already has a presumptive diagnosis, or a presumptive cause of the pathology.

Thus, if a gastrointestinal disease is suspected, gastroscopy, X-ray, ultrasound, and colonoscopy may be required. Magnetic resonance imaging may also be required, which allows you to assess the condition of internal organs and soft tissues, and identify possible pathologies at the earliest stages of their formation. If there is reason to suspect pregnancy, it is advisable to prescribe an ultrasound, since it is the main method for confirming or excluding pregnancy. In addition, this is the safest method. A method such as X-rays should be excluded if pregnancy is suspected, since there is a high risk of irradiation of the fetus, which can negatively affect its further development, especially in the early stages. [ 9 ]

Differential diagnosis

First of all, it is necessary to determine what is the probable cause of constipation: inflammatory, infectious, allergic process, parasitic invasion, or pregnancy (possibly another reason). For this, laboratory and instrumental diagnostics are carried out.

Then it is necessary to differentiate between diseases and conditions that can cause constipation. Here, instrumental methods are mainly used; consultations with other specialists may be required. [ 10 ]

Who to contact?

Treatment constipation in early pregnancy

If constipation occurs, it is necessary to treat it, since the accumulation of feces provokes the development of intoxication, stagnation, which is unacceptable. It is recommended to build an optimal diet, select products that best meet the individual needs of the body.

If proper nutrition does not solve the problem, it is worth trying folk remedies, homeopathy, which will allow you to gently get rid of the problem. And only if there is no effect from these methods, you can resort to using more severe methods (pharmaceuticals). Also, if there is no effect, you can try an enema, including one based on plant extracts. Oil (olive, sunflower, castor), taken internally, helps well. You need to ensure plenty of fluids. [ 11 ]

Remedies for constipation in early pregnancy

The mildest, safest and most well-known drug against constipation is Duphalac. It is a reliable means of treating and preventing constipation. The drug is based on herbal ingredients, so it can be used even during pregnancy. Before starting treatment, you need to carefully read the instructions. It causes virtually no side effects, so it can be taken as needed as indicated in the instructions. [ 12 ]

Another drug is mukofalk. It is produced in the form of a sachet of powder. One sachet is designed for one dose. Side effects are rare. Usually the entire sachet is dissolved in a glass of water (warm), and drunk after lunch. The maximum dosage is 4 sachets per day. [ 13 ]

Duspatalin Retard is also a laxative, which is used 200 mg in 2 doses, about 20 minutes before meals. It should also be washed down with plenty of water. It is available in capsule form, which is swallowed without opening. [ 14 ]

Vitamins

In the event that constipation is accompanied by purulent, infectious processes (stagnation), it is better to exclude vitamins, since they act as stimulants and a nutrient medium for bacterial flora, respectively, the infection will only progress. Also, vitamins increase fermentation, cause bloating, pain, spasms, suppuration. The only vitamin that can be taken is vitamin C, since it, on the contrary, has antiseptic, antioxidant properties, removes toxins, neutralizes metabolic by-products and free radicals.

If the infectious process has been stopped and it is only necessary to ensure good intestinal motility, vitamins can be given. It is recommended to take vitamins in the following daily concentrations:

  • Vitamin PP – 60 mg
  • Vitamin A – 240 mg
  • Vitamin E – 45 mg
  • Vitamin C – 1000 mg.

Physiotherapy treatment

Physiotherapy for eliminating stool stagnation in the intestines is rarely used, and it is ineffective. In case of severe stagnation, which is accompanied by the development of purulent-inflammatory processes, the rectum is cleaned, if necessary - intestinal or gastric lavage. But this is done mechanically. For further treatment and restoration of intestinal motor function, electrophoresis, hydromassage baths may be required. [ 15 ]

A massage chair or massage bed has a positive effect. It has a vibration and thermal effect, which allows you to eliminate congestion, break up deposits, stimulate muscles (increase contractile activity). Sometimes they treat with ultrasound, microcurrents, waves of different lengths. Electrophoresis is used, with the help of which drugs are introduced directly into the damaged tissue. The depth of their penetration is regulated by microcurrent.

Folk remedies

The most famous method of treating constipation, which has long been used in folk medicine, is fresh potato juice, it must be squeezed out and drunk throughout the day. It is recommended to drink about a glass of juice per day. But in fact, there are no restrictions. Everything depends on how you feel, the individual characteristics of the body. Usually, at least 10 days of treatment are needed to completely normalize the stool. [ 16 ]

Dandelion juice has also always been used to treat constipation. There are different ways to prepare dandelion. It can be used as a decoction, syrup, or infusion. Dandelion root infusion, which is prepared using cold water, has proven itself to be especially effective. [ 17 ]

Aloe juice can also be recommended to relieve constipation. Choose the fattest leaf, squeeze out the juice, let it sit for about 10-15 minutes, then drink. You can drink up to 100 ml of juice per day. [ 18 ]

Herbal treatment

Alder buckthorn has long been used to treat constipation. Previously, it was a folk medicine, but later buckthorn roots were approved for use in official medicine. Today, various preparations made from buckthorn are widely used. Buckthorn extracts and infusions are produced. Buckthorn is also produced as a pharmaceutical raw material. The industrial version is used according to the instructions. As for the decoction, you can make it at home yourself and very simply: pour a tablespoon of buckthorn root with a glass of boiling water, cover, leave for an hour, drink half a glass twice a day. [ 19 ]

One of the most effective means of treating constipation is a decoction of dill (fennel). It also eliminates toxins, relieves inflammation, normalizes the condition of the mucous membranes, as a result of which motility and peristalsis improve. The decoction is prepared at the rate of 0.5 teaspoons of dill per glass of boiling water. Infuse for 30 minutes, drink in small sips. [ 20 ], [ 21 ] Can even be given to newborns with colic. [ 22 ]

Black elderberry flowers have also proven themselves to be an effective anti-inflammatory agent, a means of normalizing stool. It is used as a decoction or infusion. Drink a tablespoon every 1.5-2 hours. [ 23 ] The plant is poisonous, so you need to ensure that there is no overdose. [ 24 ]

Anise fruits are used in the form of a decoction. To prepare, take 2 teaspoons of the decoction per glass of water, pour boiling water over it, let it brew for 20-30 minutes, drink a third of a glass 2-3 times a day. [ 25 ]

Homeopathy

Homeopathic remedies should be used with caution, observing safety precautions. The main measure is to always consult a doctor. Self-medication is always dangerous, especially during pregnancy. After all, if complications arise, you risk not only your life and health, but also the life of the child. At first glance, it may seem that homeopathy is safe. Thus, homeopathic remedies have significantly fewer complications and side effects. But among homeopathic remedies, there are many that are not compatible with other drugs and components, or cause an abortive effect, cause miscarriages, premature births, edema, allergic reactions, toxicosis. [ 26 ]

  • Remedy No. 1.

A mixture of licorice root and violet herb in equal parts is used to treat abdominal pain that occurs as a result of prolonged constipation.

  • Remedy No. 2.

For spasms and flatulence associated with constipation, use a decoction of birch leaves (a tablespoon per glass of boiling water).

  • Remedy No. 3.

Buckthorn bark (2 tablespoons per liter of water) can be used as an enema.

  • Remedy No. 4.

An infusion of anise fruit and buckthorn bark (3 tablespoons of each per glass of vodka or alcohol) is drunk one third of a glass per day every day for a month for chronic constipation.

Surgical treatment

During pregnancy, surgical operations are not performed. If possible, all operations are postponed until after childbirth. The exception is cases of acute pathology. For example, with prolonged constipation, suppuration may develop, fermentation occurs. If it is impossible to empty the bowels for more than 5-7 days, rinsing, cleansing of the intestines, and possibly even surgical removal of part of the intestine may be required. This is necessary to prevent sepsis (blood poisoning), peritonitis (inflammation and suppuration of the abdominal cavity).

Prevention

Prevention is based primarily on timely diagnostics. It is important to identify the pathology at an early stage of its formation and take the necessary measures. This will prevent the progression of the disease. It is necessary to monitor nutrition, drink enough water, follow the daily routine and diet. [ 27 ]

When constipation occurs, it is necessary to take medications in a timely manner. A high level of mobility and physical activity is also important. Hatha yoga and therapeutic exercise also have an arsenal of tools that can prevent constipation. Massage (visceral, abdominal massage) is also a reliable means of prevention. Stimulation of biological points and alternative medicine also have a positive effect. [ 28 ]

Forecast

If the cause is identified in a timely manner and the necessary treatment is carried out, the prognosis will be favorable. Constipation during pregnancy in the early stages can be completely and completely eliminated, and nothing will darken the remaining months of pregnancy, the birth of the baby and the joy of motherhood. If you delay diagnosis and treatment, the prognosis can be unpredictable. You can start a serious pathology of internal organs, get peritonitis, sepsis, and even a fatal outcome or death of the fetus.


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