Wednesday, January 9, 2013

The Constipated Pregnancy

Re: Constipation.
Wow! I do not remember being this constipated in my last pregnancy!
It finaly seems to be easing now that I am stepping firmly into my second trimester.
I do eat a lot of whole fruits, and a midling amount of steamed or baked veggies.  Also everything we eat is whole grain or whole wheat.  Of course one can always get more fiber - I could chew lettuce topped with grapenuts, but let's talk about what's realistic here.
Here are the things that I tried for treatment:
1. Fiber Powder: Metamucil mixed with 12 ounces of Water
-effect - overall increased feeling of bloatedness, and increased stool bulk, no relief of constipation
-tolerability - very tolerable - the orange taste is actually kind of nice, and it gets me to drink more water
- pregnancy safety - 4 stars - not absorbed
2. Walking - no less than 30 minutes per day
-effect - increased sensation of urge to defecate, no relief of constipation
-tolerability - moderate - it's hard to get on that treadmil when you're tired and you've had a long day and your back hurts, but in the end it actually increased my energy
- pregnancy safety - 5 stars - moderate to mild exercise always recommended in pregnancy
3. Switching to liquid Calcium Magnesium Supplement
- effect - decreased muscle cramps and back pain, no relief of constipation symptoms
-tolerability - moderate - the stuff I have tastes like vanilla but it's still a thing I have to take
-pregnancy safety - 5 stars - calcium and magnesium are recommended in pregnancy - see vitamins and supplements post
4. Aloe liquid
- effect - none discernable
- tolerability - low, this stuff tastes fairly awful although I have had worse
- pregnancy safety -2.5 stars - unknown
5. Senna 17.6 mg at bedtime
- effect - over relief of constipation or no effect - ie diarrhea
- tolerability - very good - just throw it on the pile with the other pills
- Pregnancy safety - 3.5 stars - Short-term use of senna is generally considered safe during pregnancy*
5. Colace - Docusate Sodium 100 mg Oral Three times daily
- effect - fair relief - easier bowel movements although not as soft as could be desired
- tolerability - fair/moderate- easy enough to swallow these but hard to remember to take something three times a day
- pregnancy safety - 3 stars- Short-term use of docusate is generally considered safe during pregnancy*

* Mahadevan U and Kane S, "American Gastroenterological Association Institute Medical Position Statement on the Use of Gastrointestinal Medications in Pregnancy," Gastroenterology, 2006, 131(1):278-82

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