Pregnancy is a process that can cause various changes in the expectant mother’s body. These changes may lead to different symptoms and complaints in different individuals. While one expectant mother may be significantly affected by pregnancy, another may experience very few issues, even in the case of a twin pregnancy. Therefore, such changes are considered normal; however, if they cause significant discomfort to the mother, they should be treated. In all cases, it is appropriate for the expectant mother to report her complaints to the physician following her. The physician will provide information regarding the importance of the complaint and treatment if necessary.
Digestive system problems are among the most common issues encountered during pregnancy. The nausea, vomiting, and loss of appetite frequently seen in the first months are replaced by problems such as bloating, constipation, and hemorrhoids in the second half of pregnancy. The primary cause of bloating during pregnancy is the relaxation of the muscle tissue in the stomach and intestines. As a result of this relaxation in the digestive tract muscles, intestinal movements slow down, food remains in the digestive system for a longer period, and stool hardens. Consequently, pregnant women experience complaints of bloating and gas. The reason for the relaxation of muscle tissue during pregnancy is the increased level of the hormone progesterone. In addition to hormonal changes, the pressure exerted on the intestines by the growing uterus in later months also contributes to bloating and constipation. The slower progression of food through the intestines not only causes bloating but also leads to hardened stool, difficulty during bowel movements, and constipation. Constipation during pregnancy is more common in women who experienced gastrointestinal problems before pregnancy. While every woman’s bowel habits are different, there should be at least three bowel movements per week; otherwise, it is referred to as constipation. Persistent and long-term constipation can eventually lead to hemorrhoids or anal fissures. Hemorrhoids are swellings caused by the dilation of veins in the terminal part of the intestine, which can be occasionally painful and cause rectal bleeding.
Pregnant women experiencing bloating, constipation, and hemorrhoid problems should be reassured that this can be normal. However, treatment should be sought for pregnant women with severe gas pain and constipation distress. In such cases, the first recommendation is a change in nutrition and behavior. It is very important to increase fluid consumption and the intake of high-fiber foods. A pregnant woman should consume 1.5–2 liters of fluid daily. Adding fiber-rich foods, vegetable or fruit portions, and probiotic foods containing bacteria such as yogurt or kefir to daily meals can prevent or reduce these complaints. Drinking 1–2 glasses of warm water before breakfast in the morning along with the consumption of dried figs or apricots can be beneficial.
Furthermore, consuming liquid foods such as yogurt, fruit-based milk desserts, or compote in the evening will regulate bowel movements. Drinking 1–2 cups of linden tea daily can also be helpful for gas and constipation. Implementing these dietary changes, taking 20-minute walks 2–3 days a week, and, if possible, attempting to establish a regular bowel habit at the same time each day will help prevent constipation. Voluntarily postponing the urge to defecate is also one of the conditions leading to constipation. If constipation becomes chronic, hemorrhoids and anal fissures may occur due to straining and the retention of stool in the intestines. If hemorrhoids have developed, they can be controlled through stool softeners (syrups), rectal creams, and sitz baths, thereby preventing painful defecation or rectal bleeding. In pregnant women who experience constipation despite adequate fluid intake and dietary adjustments, syrups, medications, or enemas that stimulate bowel movements can be used; at this point, the attending physician will prescribe medications that are safe for use during pregnancy.
If there are fewer than three bowel movements per week, or in cases of painful defecation or rectal bleeding during bowel movements, a physician must be consulted to ensure the problem is resolved. Especially in women with pre-pregnancy constipation issues or expectant mothers with intestinal diseases, using certain medications recommended by the physician will prevent the occurrence of complaints. Additionally, vitamin and iron supplements used during pregnancy can cause constipation. Taking these medications in the evening or using iron supplements in divided doses may be beneficial. The way to prevent intestinal problems, which are seen in nearly one out of every two pregnant women, lies in establishing regular toilet habits, a high-fiber diet, and plenty of fluid intake.
