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Constipation treatment safety at pregnancy

Abstract

 

The aim of review. To present literature data on development and treatment of constipation at pregnancy.

Original positions. Pregnant women, who suffer of constipation, ingest less amount of products, containing plant fibers and less water. It is supposed, that high progesteron level during pregnancy results in increased production of renin, activation of rennin-angiotensinaldosterone system causes increased absorption of water in the large intestine. In late pregnancy the large intestine is pushed aside and compressed by enlarged uterus that can impair passage of fecal masses and provoke constipation. Polyethylene glycol-containing laxatives, are safe and recommended as treatment of choice in constipation at pregnant and breast-feeding women. Macrogol-4000 is not metabolized and not absorbed, having therefore no undesirable effect on fetus.

Conclusion. Treatment of constipation during pregnancy should begin with nonpharmaceutical methods. However, if sure nutrition, keeping of proper lifestyle and moderate physical activity do not result in desirable effect, drugs should be prescribed. Macrogol 4000 is effective and safe at pregnancy even at long-term intake.

About the Author

O. Z. Okhlobystina
ГОУ ВПО «Первый Московский государственный медицинский университет им. И.М. Сеченова»
Russian Federation


References

1. Минушкин О.Н., Елизаветина, Зверков И.В. Запор и Форлакс // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 1999. – Т. 19, № 5. – С. 63.

2. Рациональная фармакотерапия заболеваний органов пищеварения / Под ред. В.Т. Ивашкина. – М.: Литтерра, 2003. – С. 580–586.

3. Румянцев В.Г., Косачева Т.А., Коровкина Е.А. Дифференцированное лечение запоров // Фарматека. – 2004. – Т. 90, № 13. – С. 1–4.

4. Яковенко Э.П., Агафонова Н.А. Механизмы развития запоров и методы их лечения // Клин. перспективы гастроэнтерол. гепатол. – 2003. – № 3. – С. 25–32.

5. Acs N., Bánhidy F., Puhó E.H., Czeizel A.E. No assotiation betwen severe constipation with related drug treatment in pregnant women and congenital abnormalities in thein offepming: Adopulation-based case-study. Congenit Anom (Kyoto). – 2010. – Vol. 50, N 1. – P. 15–20.

6. Anderson A.S. Constipation during pregnancy: incidence and methods used in treatment in a group of Cambridgeshire women // Health Visit. – 1984. – Vol. 57. – P. 363– 364.

7. Arnaud M.J. Mild dehydration: a risk factor of constipation // Eur. J. Clin. Nutr. – 2003. – Vol. 57. – P. 88–95.

8. Artal R., O′Toole M. Guidelines of the American college of obstetricians and gynaecologists for exercise during pregnancy and the postpartum period // Br. J. Sports Med. – 2003. – Vol. 37. – P. 6–12.

9. Berkowitz R.L., Cousten D.R., Mochizcki T.K. (eds.). Handbook for prescribing medications during pregnancy. – Boston: Little, Brown & Co., 1981.

10. Bonen A., Campagna P., Gilchrist L. et al. Substrate and endocrine responses during exercise at selected stages of pregnancy // J. Appl. Physiol. – 1992. – Vol. 73, N 1. – P. 134–142.

11. Bruce L.A., Behsudi F.M. Progesterone effects on three regional gastrointestinal tissues // Life Sci. – 1979. – Vol. 25. – P. 729–734.

12. Compendium of drug therapy. – New York: Biomedical Information Corp., 1984.

13. Corman M.L. Anal incontinence following obstetrical injury // Dis. Colon Rectum. – 1985. – Vol. 28. – P. 86–89.

14. Cranston D., McWhinnie D., Collin J. Dietary fibre

15. and gastrointestinal disease // Br. J. Surg. – 1988. – Vol. 75. – P. 508–512.

16. Cullen G., O′Donoghue D. Constipation in pregnancy // Best Pract. Res. Clin. Gastroenterol. – 2007. – Vol. 21, N 5. – P. 807–818.

17. Denis P., Lerebours E. Study of the long-term tolerance of Forlax in 16 patients treated for the average of 17 months for the chronic constipation // Actualites Therapeutiques. – 1996. – Vol. 25, N 5. – Reprint.

18. Derbyshire E., Davies J., Costarelli V. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy // Matern. Child Nurs. J. – 2006. – Vol. 2. – P. 127–134.

19. Gill R.C., Bowes K.L., Kingma Y.J. Effect of progesterone on canine colonic smooth muscle // Gastroenterology. – 1985. – Vol. 88. – P. 1941–1947.

20. Langer B., Grima M., Coquard C. et al. Plasma active renin, angiotensin 1 and angiotensin 2 during pregnancy and in preeclampsia // Obstet. Gynaecol. – 1998. – Vol. 91. – P. 196–202.

21. Lawson M., Kern F., Everson G.T. Gastrointestinal transit time in human pregnancy: prolongation in the second and third trimesters followed by postpartum normalisation // Gastroenterology. – 1985. – Vol. 89. – P. 996–999.

22. Parry E., Shields R., Turnbull A.C. The effect of pregnancy on colonic absorption of sodium, potassium and water // J. Obstet. Gynaecol. Br. Commonw. – 1970. – Vol. 77. – P. 616–619.

23. Rome foundation. Guidelines–Rome 3 diagnostic criteria for functional gastrointestinal disorders // J. Gastrointest. Liver Dis. – 2006. – Vol. 15, 3. – P. 307–312.

24. Shafik A., El-Sibai O. Study of the levator ani muscle in the multipara: role of levator dysfunstion in defaecation disorders // J. Obstet. Gynaecol. – 2002. – Vol. 22. – P. 187–192.

25. Snooks S.J., Barnes P.R.H., Swash M. Damage to the innervations of the pelvic floor musculature in chronic constipation // Gastroenterology. – 1985. – Vol. 89. – P. 977–981.

26. Sultan A.H., Kamm M.A., Hudson C.N. et al. Anal sphincter disruption during vaginal delivery // N. Engl. J. Med. – 1993. – Vol. 329. – P. 1905–1911.

27. Wald A. Constipation, diarrhoea and symptomatic hemorrhoids during pregnancy // Gastroenterol. Clin. North Am. – 2003. – Vol. 32. – P. 309–322.

28. Wald A., Van Thiel D., Hoechsetter L. et al. Effect of pregnancy on gastrointestinal transit // Dig. Dis. Sci. – 1982. – Vol. 27. – P. 1015–1018.


Review

For citations:


Okhlobystina O.Z. Constipation treatment safety at pregnancy. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2010;20(6):70-75. (In Russ.)

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