Constipation during pregnancy in the 1st trimester. How to deal with this - tips in the pregnancy calendar on Babyblog.ru

Pregnancy is often accompanied by various problems, including constipation. The frequency of bowel movements for a pregnant woman should be approximately once a day. If stool is observed less frequently, this may indicate insufficient intestinal motility, which can be caused by various reasons. This problem should be resolved delicately, since the use of most medications is undesirable in the first trimester of pregnancy.

Causes of constipation in the first trimester of pregnancy

Constipation that occurs early in pregnancy may be due to hormonal changes. Since the onset of pregnancy stimulates the synthesis of a hormone such as progesterone, which has a relaxing effect on smooth muscles, the intestinal muscles lose their tone. The effect of progesterone is justified by bringing the uterus into a calm state, so as not to interfere with normal gestation. However, a side effect of this hormonal surge is a slowdown in intestinal motility. For this reason, the ability to empty it suffers.

Among other things, taking calcium and iron may help cause constipation. Also, constipation can be a consequence of a sedentary lifestyle, which is carried out in the first trimester of pregnancy. Most often, it happens that at this stage a woman is prescribed bed rest to avoid the risk of miscarriage. Of course, nutrition also plays an important role in the functioning of the gastrointestinal tract. A small amount of fiber in the diet can lead to the development of intestinal motility disorders.

How to deal with constipation in the first trimester?

A fairly common problem in early pregnancy is constipation during pregnancy in the 1st trimester. How to deal with this? Of course, taking medications for such a short period of time is undesirable, so the expectant mother should change her lifestyle and introduce walks in the fresh air into her daily routine. This solution will effectively prevent constipation. When choosing a place for a walk, you should focus on park areas where there is no car traffic and there are not too many crowds.

An effective way to tone your intestines is moderate-intensity exercise. In the absence of relevant contraindications, it is necessary to engage in a set of exercises provided for pregnant women, and also not to limit oneself in activity during the day. But physical education alone is not enough. The issue of treating constipation must be approached comprehensively. Proper nutrition plays an important role in this matter.

In order to get rid of constipation in the first trimester, you need to change not only your diet, but also the diet itself. You should eat small and often, at least 5 times a day, in small portions. A pregnant woman's diet should contain a wide range of different foods, from fruits and vegetables to cereals, dairy products, as well as various dried fruits and walnuts. It is better not to eat fried and floury foods, and you should also give up sweets. Strong tea, blueberries and lingonberries, semolina and white bread can all cause constipation. If the problem with the functioning of the intestines cannot be solved by these methods, you should consult a doctor who will prescribe a laxative that is not harmful to the health of the expectant mother and her child.

Constipation during pregnancy

What is constipation?

Medicine defines constipation as difficult or systematically incomplete bowel movements or as the absence of bowel movements for a day and a half or more.
Constipation often occurs already in the early stages of pregnancy, when the intestines are not yet under pressure from the enlarged uterus, and subsequently haunt the woman throughout the 40 weeks of pregnancy allotted by nature. Moreover, the birth of a child does not always mean normalization of intestinal function. The causes of constipation in different women at different stages of pregnancy and in the postpartum period are different, but all of them are, to one degree or another, associated with disruption of the processes of formation and movement of feces through the intestines, caused by disorders of motor activity (motility) of the intestinal muscles, weakening of the urge to defecate. In turn, these disorders are provoked by a number of changes in the female body. Among them, the most significant are the following:

A change in hormonal levels that reduces the tone of the muscles of the uterus, and at the same time all other muscle cells similar to them (in the walls of the intestines and in the walls of large vessels).
Irrational diet of a pregnant woman.
Changes in the position of the intestines in the abdominal cavity, its gradual displacement by the enlarging uterus at a later date.
Fear of straining in late pregnancy (rather a psychological problem). More often it occurs in women with increased uterine tone and the threat of miscarriage.
A sedentary lifestyle, especially with increased uterine tone.
Psychological stress.
Congenital features of the intestine, for example, elongated sections.

Types of constipation

There are spastic and atonic constipation, which differ in the mechanism of their occurrence and in the characteristics of their manifestation. Naturally, the diets recommended for different forms of constipation are also different.

The atonic variant is associated with a decrease in the tone of the muscular wall of the intestine; peristalsis (intestinal movements that ensure the movement of food) becomes slow, sluggish and unproductive. This muscle weakness, in turn, can occur due to errors in diet, hormonal changes, and also after operations. Such constipation is accompanied by a feeling of intestinal fullness, aching and nagging pain in the abdomen, flatulence and bloating, lack of appetite, nausea, lethargy , apathy, depressed mood, When defecating there is a lot of feces; their initial portion is shaped, dense, its diameter is larger than usual, the final portion is liquid and mushy. Defecation is painful, even tears in the mucous membrane of the rectum and anus may occur, and then streaks of blood remain on the surface of the stool.

Another form of constipation - spastic - on the contrary, is associated with increased intestinal tone, peristalsis also slows down, but due to the “tight” state of the intestine. Psychological causes are more typical for this type of constipation. In the spastic form, the pain is paroxysmal, even sometimes cramping. They occur more often in the left side of the abdomen along the colon and extend to the left groin area. A woman may be plagued by flatulence (bloating), lack of appetite, inadequate and unexplained fatigue, nervousness, irritability, and nausea. The urge to defecate may occur several times a day, but bowel movements are incomplete, difficult, and in small portions. The feces are very dense and are excreted in separate small rounded fragments, in the form of so-called “sheep feces.”

Constipation associated with lengthening of the large intestine should be especially highlighted. Firstly, their occurrence is not associated with pregnancy, although it can intensify them. Secondly, although outwardly such constipation appears in the same way as spastic ones, they are not associated with increased intestinal tone, but with a longer passage of feces along a longer path. At the same time, more water is absorbed back into the body from the intestinal contents, and the stool becomes hard. Such constipation should be treated not as spastic, but rather as atonic.

Principles of nutrition

To solve the problem of regular bowel movements, it is first necessary to properly organize the nutrition of a pregnant woman.

You should eat in small portions, but 5 times a day. Long (more than 4 hours) breaks between meals are also unacceptable.
It is recommended to steam, boil or bake dishes. It is better not to chop food.
Fresh fruits and vegetables must be included in the diet.
Kissels, jelly, aspic and jellied meat, as well as fried foods, slow down intestinal motility - these dishes should be avoided.
It is extremely important to choose a diet taking into account the type of intestinal motility disorder and possible allergic reactions, which are different for each person.
It is necessary to receive at least 1.5-2 liters per day. liquids, otherwise food cellulose (pectin, etc.) will cease to perform its adsorbing function, which is to “capture” toxic substances. This does not contribute to the normalization of intestinal function, but only increases gas formation and can even provoke colicky pain in the intestines in people prone to spastic reactions. Mineral waters of high and medium mineralization, as well as waters containing magnesium ions and sulfates (for example, Essentuki No. 4 and 17) have a laxative effect. Mineral waters should be at room temperature. They drink them 2-3 times a day, half a glass.

For atonic constipation, the diet is based on the “slag load” type with an increased amount of dietary fiber (in the literature they are also called ballast substances, fiber, cellulose). Dietary fiber is not digested in the digestive tract, some of it is utilized by the intestinal microflora, and some passes through “transit”. The main function of fiber is the adsorption of water, which increases the volume of feces and normalizes peristalsis. In terms of the content of ballast substances in products, food bran (53-55% fiber) is in first place, followed by vegetables (20-24%) and rye bread (5-10%). Refined products: premium white flour, sugar, etc. - do not contain fiber. Ballast substances taken with food have a laxative effect of varying severity on the quality of stool, depending on the ability to bind and adsorb water (the less water is bound, the denser the stool).

It is advisable to eat up to 20-30 g of wheat bran per day, which is doused with boiling water and consumed in pure form or added to liquid dishes. You can also take bran mixed with kefir or yogurt according to the following scheme: starting with 4 teaspoons per day and increasing the dosage by 1 teaspoon per day until regular, gentle bowel movements are restored. After achieving the effect within 2 weeks, the dosage of bran is gradually reduced to the minimum required maintenance dose, this dose is individual for everyone. You should take bran for at least 6 weeks, and you must drink a sufficient amount of liquid - as already mentioned, at least 1.5-2 liters. Daily intake of 30 g of bran shortens the passage time of feces-forming masses by 2-3 times.

Vegetables, fruits and berries, mostly raw, contribute to the activation of the intestines, at least 200 g per day; prunes or dried apricots (8-12 pieces); honey (1 tablespoon 3 times a day - with tea or as an addition to dishes); buckwheat, barley, pearl barley porridge, in particular crumbly ones. Special varieties of bread are useful: grain bread, etc., made with the addition of crushed grain or bran. Drinking cold drinks in the morning on an empty stomach - carbonated or plain water, a glass of cold milk or vegetable juice - helps to empty the intestines. This reflexively causes increased peristalsis.

For spastic constipation, especially if it is accompanied by colicky abdominal pain, a diet rich in dietary fiber may cause increased pain. In such cases, at first, a diet with a low content of coarse dietary fiber is used, respectively, without the addition of bran. Vegetables are allowed mainly in boiled, finely chopped or pureed form. Much attention is paid to vegetable fats: it is recommended to take 1-2 tablespoons of vegetable oil per day on an empty stomach or added to a glass of kefir (drink at night). Meat and fish dishes are also chopped, boiled or steamed. To reduce and subsequently eliminate intestinal spasms, foods containing delicate fiber (for example, dried fruits) are gradually added to food. Since plums contain organic acids that promote bowel movement, despite their relatively low fiber content (only 0.5 g per 100 g of fruit), prunes in any form are recommended for patients with constipation, including infusion, dried fruit puree .

A sample menu can be presented as follows:

First breakfast: vegetable salad with vegetable oil, steam omelette, tea. Or cottage cheese with sugar and sour cream, oatmeal porridge, tea.
Second breakfast: fresh apple.
Lunch: vegetarian cabbage soup with sour cream or beetroot soup. Boiled meat with stewed beets or boiled chicken in milk sauce with cauliflower. Dried fruits compote.
Afternoon snack: rose hip decoction, cookies.
Dinner: boiled fish with white sauce and vegetable broth, mashed potatoes, cheesecake with cottage cheese, tea.
At night: kefir or other fermented milk drinks.

In conclusion, let us remind you that resorting to laxatives and cleansing enemas for constipation is allowed only on the recommendation of the attending physician.

Recommended products and dishes

Bread and flour products. We recommend wheat bread made from second grade flour, or rye if tolerated. All bakery products are only dried, yesterday's baked goods. Unsweetened cookies, dry biscuits, unsweetened baked goods with fruits and berries.

Soups. They are prepared mainly from vegetables in meat broth; borscht, beetroot soup, cabbage soup made from fresh cabbage, and cold fruit and vegetable soups are recommended. Meat and poultry. You can eat lean varieties of various types of meat, chicken, turkey (boiled or baked, in pieces or chopped), and milk sausages. Fish. Low-fat and moderately fatty types of fish (cod, hake, ice fish, pike perch, navaga, etc.) are allowed - boiled and baked.
Dairy products. Whole milk is acceptable - if tolerated well or as an addition to various dishes. Various fermented milk drinks are recommended: kefir, yogurt, acidophilus (good for the night!), fresh cottage cheese and dishes made from it: puddings, lazy dumplings and cheesecakes. Cream and sour cream are allowed as additions to dishes.
Eggs. No more than 1 egg per day is allowed. Eggs can be soft-boiled or hard-boiled (if tolerated), added to dishes; You can eat steamed omelettes.
Cereals. Recommended are crumbly porridges, casseroles and krupenniki (porridges baked with cottage cheese) made from buckwheat, millet, wheat and barley groats, cooked in water with the addition of milk, and muesli. Rolled oats porridge in water with vegetable oil is useful.
Vegetables. Healthy foods include beets, carrots, tomatoes, lettuce, cucumbers, zucchini, pumpkin, cauliflower, and broccoli—raw and boiled for side dishes and casseroles. White cabbage and green peas are consumed boiled if tolerated well. Potatoes are allowed, but in limited quantities. Squash caviar is useful as a snack.
Snacks. Salads from raw vegetables and vinaigrettes with vegetable oil, fruit salads are recommended; mild cheese, low-fat ham, boiled tongue, soaked herring once a week.
Fruits. You can eat non-sour, ripe, sweet fruits and berries - raw and baked. Natural juices are beneficial - better with pulp. Dried fruits (prunes, dried apricots, apricots, figs) are consumed soaked and in various dishes, in compote.
Sweets. Honey, jam in small quantities, marmalade, marshmallows, and milk caramel are allowed.
Sauces and spices. Sauces are prepared with weak meat and fish broth; bechamel milk sauce is used, less often sour cream and fruit sauce. Dill, parsley, celery are added to dishes.
Beverages. Weak tea, substitute coffee and weak natural coffee are acceptable; decoction of rose hips and wheat bran, fruit and vegetable juices (from plums, apricots, carrots, etc.).
Fats. You can use butter, soft (bulk) margarine; vegetable oils - in dishes (including olive oil).

The following have slight independent laxative properties: olives, dried fruit compotes, raw, boiled or soaked prunes, honey, watermelon, melon, apples, apricots, grapes, red currants or their juice, cherries.

Foods to Avoid or Limit

Patients with constipation and complaints of bloating should limit or even exclude from the diet foods that are rich in dietary fiber and cause increased gas formation, namely: legumes, cabbage, sorrel, spinach, apple and grape juices. Vegetables rich in essential oils are limited or even prohibited: onions, garlic, radishes, radishes, turnips. Foods containing tannin delay bowel emptying: blueberries, quince, dogwood, pears, pomegranate, hawthorn, bananas, black currants, strong black tea, cocoa, chocolate. Intestinal motility is inhibited by pureed food, substances with a viscous consistency (mucous soups, porridges, especially semolina, rice and potato dishes), as well as refractory fats (pork, lamb, beef, shortening).

Not recommended: bread made from premium flour, butter dough, pasta, noodles, strong broths, fatty meats and fish, mushrooms, spicy dishes and seasonings (horseradish, mustard, pepper), smoked and canned foods, walnuts, hard cheeses, milk with poor tolerance.