Definition: Constipation in pregnancy is defined as having fewer than three bowel movements per week, often with stools that are hard, dry, and difficult to pass.
Symptoms include infrequent stools, straining, a sensation of incomplete emptying, and abdominal bloating or discomfort.
Causes: This is primarily hormonal, as the surge in progesterone relaxes muscles and slows gut motility. Other factors include the growing uterus pressing on the intestines, iron supplements, reduced activity, and insufficient fluid/fiber intake.
Investigation: Diagnosis is typically clinical, based on the patient’s symptoms and history.
Allopathy Treatment: Focuses on lifestyle changes first. Safe options include bulk-forming (e.g., psyllium) or osmotic laxatives (e.g., lactulose), with stimulant laxatives used cautiously and only under a doctor’s supervision.
Homeopathy Treatment: Offers individualized remedies (e.g., Bryonia, Sepia) to regulate bowel movements gently by addressing the root constitutional cause.
Ayush Treatment (Ayurveda): Manages this as Garbhini Vibandha by balancing Vata Dosha. Treatment includes Snigdha Ahara (oily foods like ghee with warm milk) and mild, safe herbal formulations under expert guidance.
Diet and Lifestyle: Crucial changes include a high-fiber diet (whole grains, fruits, vegetables, prunes), increased fluid intake (8-12 glasses/day), and daily gentle exercise (walking, yoga).
| Constipation | |
|---|---|
| Other names | Costiveness,[1] dyschezia[2] |
 |
|
| Constipation in a young child seen on X-ray. Circles represent areas of fecal matter (stool is white surrounded by black bowel gas). | |
| Specialty | Gastroenterology |
| Symptoms | Infrequent or hard to pass bowel movements, abdominal pain, bloating[2][3] |
| Complications | Hemorrhoids, anal fissure, fecal impaction[4] |
| Causes | Slow movement of stool within the colon, irritable bowel syndrome, celiac disease, non-celiac gluten sensitivity, pelvic floor disorders[4][5][6] |
| Risk factors | Hypothyroidism, diabetes, Parkinson’s disease, gluten-related disorders, colon cancer, ovarian cancer, diverticulitis, inflammatory bowel disease, certain medications[4][5][6] |
| Treatment | Drinking enough fluids, eating more fiber, exercise[4] |
| Medication | Laxatives of the bulk forming agent, osmotic agent, stool softener, or lubricant type[4] |
| Frequency | 2–30%[7] |
Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass.[2] The stool is often hard and dry.[4] Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement.[3] Complications from constipation may include hemorrhoids, anal fissure or fecal impaction.[4] The normal frequency of bowel movements in adults is between three per day and three per week.[4] Babies often have three to four bowel movements per day while young children typically have two to three per day.[8]
Constipation has many causes.[4] Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders.[4] Underlying associated diseases include hypothyroidism, diabetes, Parkinson’s disease, celiac disease, non-celiac gluten sensitivity, vitamin B12 deficiency, colon cancer, diverticulitis, and inflammatory bowel disease.[4][5][6][9][10] Medications associated with constipation include opioids, certain antacids, calcium channel blockers, and anticholinergics.[4] Of those taking opioids about 90% develop constipation.[11] Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person’s family, or it is of new onset in someone who is older.[12]
Treatment of constipation depends on the underlying cause and the duration that it has been present.[4] Measures that may help include drinking enough fluids, eating more fiber, consumption of honey[13] and exercise.[4] If this is not effective, laxatives of the bulk-forming agent, osmotic agent, stool softener, or lubricant type may be recommended.[4] Stimulant laxatives are generally reserved for when other types are not effective.[4] Other treatments may include biofeedback or in rare cases surgery.[4]
In the general population rates of constipation are 2–30 percent.[7] Among elderly people living in a care home the rate of constipation is 50–75 percent.[11] People in the United States spend more than US$250 million on medications for constipation a year.[14]
Definition
Constipation is a symptom, not a disease. Most commonly, constipation is thought of as infrequent bowel movements, usually fewer than 3 stools per week.[15][16] However, people may have other complaints as well including:[3][17]
- Straining with bowel movements
- Excessive time needed to pass a bowel movement
- Hard stools
- Pain with bowel movements secondary to straining
- Abdominal pain
- Abdominal bloating.
- the sensation of incomplete bowel evacuation.
The Rome III Criteria are a set of symptoms that help standardize the diagnosis of constipation in various age groups. These criteria help physicians to better define constipation in a standardized manner.
Causes
The causes of constipation can be divided into congenital, primary, and secondary.[2] The most common kind is primary and not life-threatening.[18] It can also be divided by the age group affected such as children and adults.
Primary or functional constipation is defined by ongoing symptoms for greater than six months not due to an underlying cause such as medication side effects or an underlying medical condition.[2][19] It is not associated with abdominal pain, thus distinguishing it from irritable bowel syndrome.[2] It is the most common kind of constipation, and is often multifactorial.[18][20] In adults, such primary causes include: dietary choices such as insufficient dietary fiber or fluid intake, or behavioral causes such as decreased physical activity. In children, causes can include diets low in fiber and fluids, underlying medical conditions, and reluctance to go to the bathroom.[21] In the elderly, common causes have been attributed to insufficient dietary fiber intake, inadequate fluid intake, decreased physical activity, side effects of medications, hypothyroidism, and obstruction by colorectal cancer.[22] Evidence to support these factors however is poor.[22]
Secondary causes include side effects of medications such as opiates, endocrine and metabolic disorders such as hypothyroidism, and obstruction such as from colorectal cancer[20] or ovarian cancer.[23] Celiac disease and non-celiac gluten sensitivity may also present with constipation.[5][24][6] Cystocele can develop as a result of chronic constipation.[25]