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Constipation pendant la grossesse : que faire ?

Constipation during pregnancy: what can you do?

It is estimated that approximately 10 to 40% of women experience constipation during pregnancy, and a third of them haemorrhoids. The causes of constipation during pregnancy are multiple.

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It is estimated that around 10 to 40% of women experience constipation during pregnancy, and a third of those experience haemorrhoids.
Constipation is defined as stools that are dry and difficult to pass. Generally, having fewer than three bowel movements per week is also associated with constipation [1].

STATS

10 to 40% of women experience constipation during pregnancy.

What are the causes of constipation during pregnancy?

The causes of constipation during pregnancy are multiple [2].

Gastrointestinal responses to hormones such as oestrogen and progesterone slow the movement of food through the intestine, which increases water absorption and promotes constipation.

Other causes include reduced physical activity (pregnant women are sometimes less active), lower levels of motilin (a gastric hormone that controls intestinal motility), increased absorption of sodium and water by the colon, and iron supplementation in pregnant women. Indeed, poorly absorbed forms of iron can cause constipation. Opt for iron bisglycinate forms, such as in our iron supplement for pregnant women Iron Mama, which contains a patented form with no side effects. 

Mechanical uterine obstruction is also observed, and is considered a major physiological factor. Later in pregnancy, the expanding uterus compresses the large intestine and can slow the movement of food through the gut.

In addition, many pregnant women modify their diet due to pregnancy nausea. Some women even find it difficult to drink as much water as usual, or become dehydrated due to vomiting in early pregnancy — all of which are factors that may help explain the causes of constipation during pregnancy.

Finally, the use of aluminium-based antacids, sometimes prescribed to manage acid reflux in pregnancy, may contribute to the onset of constipation [3].

Why this product?

Our gluten-free Jolly Bread contains psyllium, which acts as a prebiotic: it nourishes and promotes the growth of beneficial gut bacteria, and also helps improve functional constipation by increasing the water content of stools and reducing transit time.

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What are the consequences of constipation?

Around one third of pregnant women experience haemorrhoids. Constipation often causes haemorrhoids, which are veins located around the anus and rectum that become swollen. Haemorrhoids can cause pain and light bleeding during bowel movements.

Other factors may contribute to their onset, including prolonged straining during bowel movements, a 30% increase in blood volume, progesterone-induced relaxation of venous smooth muscle, and increased intra-abdominal pressure due to uterine growth [1].

The causes of constipation and haemorrhoids are most often beyond our control, but that does not mean nothing can be done to relieve and manage them!

A few tips

Stock up on fibre and healthy fats
Mind your posture
Try to get a little exercise

What dietary approaches can help with constipation?

The recommended fibre intake for pregnant women is a minimum of 25 g/day, with a satisfactory intake set at 30 g of total dietary fibre per day [4].

Studies show that fibre consumption increases stool frequency as well as consistency [5]. 

Fibre comes in two forms: soluble (which dissolves in water) and insoluble. Most fibre is soluble and is found at the heart of plant foods. This type of fibre is broken down in the colon and becomes viscous when in contact with liquids. Insoluble fibre, on the other hand, is less broken down — it absorbs water, swells and increases stool volume while speeding up transit. It is commonly found in the outer layers of plant foods, in pears, apples, potatoes, broccoli and whole wheat.   

Soluble fibre is not particularly effective at relieving constipation. However, it does have other benefits. Some types stimulate the growth of intestinal bacteria that are beneficial to health. Gentle on the gut, soluble fibre may be recommended for people with a sensitive digestive system or irritable bowel.

For example: wholegrain cereals, brown rice, berries, almonds, desiccated coconut, avocados, 100% cocoa powder... Don't forget pulses (lentils, chickpeas, white, red or black beans, etc.), even though they are particularly high in soluble fibre.

Vegetables are particularly effective. Sometimes simply increasing your vegetable intake by 1–2 cups per meal can help reduce constipation. 

Whilst wholegrains are a good source of fibre, they are not necessarily the best. In fact, they contain a relatively low amount of fibre compared to the quantity of carbohydrates they provide. 

For example, 1 cup of brown rice contains 45g of carbohydrates, but only 3.5g of fibre. Lentils, on the other hand, contain 16g of fibre for the same amount of carbohydrates — more than 4 times as much fibre!

The aim is to find the right balance between a sufficient fibre intake and a carbohydrate intake that is not too high. To help with this, we recommend:  

1 cup of blueberries: 8g of fibre (14g of carbohydrates)
½ cup of cooked lentils: 8g of fibre (20g of carbohydrates)
1 cup of raspberries: 7g of fibre (12g of carbohydrates)
½ avocado: 7g of fibre (8g of carbohydrates)
1 teaspoon of chia seeds: 5g of fibre (5.5g of carbohydrates)
1 cup of cooked cauliflower: 4g of fibre (9g of carbohydrates)
2 teaspoons of unsweetened cocoa: 4g of fibre (6g of carbohydrates)

Fat helps to lubricate the intestines, which reduces the risk of dry, hard stools and thus limits constipation. In addition, fatty acids such as omega-3s (DHA, EPA) act on the production of bile acids. They stimulate their production [9], which in turn increases peristalsis (intestinal movements) and promotes the elimination of salts [10]. Our pregnancy omega-3 Omega Mama helps to top up your DHA levels.  

To get enough of it, we recommend varying the oils you use, adding a little organic butter to your vegetables, eating avocados, and including nut butters in your diet. 

The magnesium can help relieve constipation. The aim is to find a form of magnesium that combines content, absorption, and also has an effect on bowel transit. Magnesium glycerophosphate is a very interesting form in terms of content and absorption, but it has no effect on intestinal transit. In cases of constipation, it is better to opt for magnesium citrate, which has a mild laxative effect (citrate draws water into the intestines and softens stools).  

Be cautious with other forms of magnesium, which are poorly absorbed by the body and rather hard on digestion (magnesium oxides and sulphates) — best avoided, unless under medical supervision of course!

Discover our products

To stock up on good omega-3 fats, our food supplement for pregnant women Omega Mama is ideal. 

And above all, it is important to drink enough water. Low water intake has been associated with a significant increase in constipation [6].

Adequate water intake alongside a good fibre intake is essential, as the effect of fibre on bowel transit is linked to water absorption — so if water intake is low, increasing fibre consumption may actually increase the risk of constipation. 

What are the best superfoods for relieving constipation?

Consuming chia seeds is beneficial (you can also consume flaxseeds, although some doctors have noted that they can worsen constipation in certain individuals [7]), while making sure to maintain adequate water intake.

Psyllium contains both soluble and insoluble fibre. Daily intake of psyllium, which acts as a bulking agent thanks to its high fibre content, taken with 1 to 2 glasses of water, helps to relieve constipation by increasing the water content of stools, reducing colonic transit time and increasing stool weight [8]. 
It may sometimes take a few days before any effects are noticed.

Pregnancy food challenge

Our step-by-step advice for your diet during pregnancy

Constipation during pregnancy: what can you do?

Jolly Bread

Our seeded bread mix gluten-free Jolly bread contains psyllium and may be beneficial for constipation! Bonus: it is rich in magnesium! 

How can I manage constipation naturally?

You can seek support from a healthcare professional trained inpregnancy acupuncture, which helps to relieve constipation. 

You can also take action yourself with the following 2 points. 

Adjusting your posture and doing a little exercise

Good posture can ease your digestive issues. For example, a slouched position will compress your intestines and increase the risk of constipation.

Just as taking a little exercise, such as a walk, or doing some prenatal yoga suitable during pregnancy, will help to stimulate the intestines. Gentle exercise will softly massage your intestines. To find out more, see our article on sport and pregnancy.

Toilet positioning

In some traditional cultures, people do not sit to have a bowel movement — they squat! Studies show that this technique allows the colon and pelvic floor to be well aligned, which requires less effort and makes bowel movements easier [11]. It may also help to prevent and relieve haemorrhoids [12].

In practice, this is not quite so straightforward. A more accessible tip would be to raise your feet with a small stool or step and/or lean slightly backwards.

It may be wise to try not to strain "too hard". When you feel the urge to go to the toilet, go straight away and wait for your body to begin natural bowel movements before pushing. 
Bonus: it's a great way to prepare for labour — it helps you learn to release the pelvic muscles and encourages blood circulation, which reduces the risk of tearing!

In conclusion

Constipation and haemorrhoids during pregnancy can be difficult to avoid, but there are ways to help manage them: 
Drink enough water
Consume fibre with a balance of soluble and insoluble 
Choose foods with a good fibre-to-carbohydrate ratio
Eat healthy fats 
Do some gentle exercise such as yoga or walking

[1] Longo SA, Moore RC, Canzoneri BJ, Robichaux A. Gastrointestinal Conditions during Pregnancy. Clin Colon Rectal Surg. 2010 Jun;23(2):80-9. doi: 10.1055/s-0030-1254294. PMID: 21629625; PMCID: PMC2967327.w10.1055/s-0030-1254294

[2] Longo, Sherri A., Robert C. Moore, Bernard J. Canzoneri, et Alfred Robichaux. 2010. « Gastrointestinal Conditions during Pregnancy ». Clinics in Colon and Rectal Surgery 23 (2): 80‑89. https://doi.org/10.1055/s-0030-1254294.

[3] Talley, Nicholas J., Michael Jones, Guy Nuyts, et Dominique Dubois. 2003. « Risk Factors for Chronic Constipation Based on A General Practice Sample ». Official Journal of the American College of Gastroenterology | ACG 98 (5): 1107‑11. https://doi.org/10.1111/j.1572-0241.2003.07465.x.

[4] « AVIS révisé de l'Anses relatif à l'actualisation des repères alimentaires du PNNS – Femmes enceintes et allaitantes | Anses – Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail ».

[5] Rungsiprakarn, Phassawan, Malinee Laopaiboon, Ussanee S. Sangkomkamhang, Pisake Lumbiganon, et Jeremy J. Pratt. 2015. « Interventions for Treating Constipation in Pregnancy ». Cochrane Database of Systematic Reviews, no 9.https://doi.org/10.1002/14651858.CD011448.pub2.

[6] Markland, Alayne D., Olafur Palsson, Patricia S. Goode, Kathryn L. Burgio, Jan Busby-Whitehead, et William E. Whitehead. 2013. « Association of Low Dietary Intake of Fiber and Liquids with Constipation: Evidence from the National Health and Nutrition Examination Survey (NHANES) ». The American journal of gastroenterology 108 (5): 796‑803. https://doi.org/10.1038/ajg.2013.73.

[7] Lily Nichols

[8] Trottier, Magan, Aida Erebara, et Pina Bozzo. 2012. « Treating constipation during pregnancy ». Canadian Family Physician 58 (8): 836‑38.

[9] Jonkers, Iris J. A. M., Augustinus H. M. Smelt, Hans M. G. Princen, Folkert Kuipers, Johannes A. Romijn, Renze Boverhof, Ad A. M. Masclee, et Frans Stellaard. 2006. « Fish Oil Increases Bile Acid Synthesis in Male Patients with Hypertriglyceridemia ». The Journal of Nutrition 136 (4): 987‑91. https://doi.org/10.1093/jn/136.4.987.

[10] Wong, Banny S., Michael Camilleri, Sanna McKinzie, Duane Burton, Hans Graffner, et Alan R. Zinsmeister. 2011. « Effects of A3309, an Ileal Bile Acid Transporter Inhibitor, on Colonic Transit and Symptoms in Females With Functional Constipation ». Official Journal of the American College of Gastroenterology | ACG 106 (12): 2154‑64. https://doi.org/10.1038/ajg.2011.285.

[11] Sikirov, Dov. 2003. « Comparison of Straining during Defecation in Three Positions: Results and Implications for Human Health ». Digestive Diseases and Sciences 48 (7): 1201‑5. https://doi.org/10.1023/a:1024180319005

[12] Dimmer, Christine, et al. « Squatting for the Prevention of Haemorrhoids?» Townsend Letter for Doctors & Patients, Issue No. 159, October 1996: 66-70.

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Ready in 2 mins before cooking!

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