Pregnancy and Postpartum Bowel Changes: Constipation and Fecal Incontinence

Abstract

Pregnancy and the postpartum period are often associated with many gastrointestinal complaints, including nausea, vomiting, and heartburn; however, the most troublesome complaints in some women are defecatory disorders such as constipation and fecal incontinence, especially postpartum. These disorders are often multifactorial in etiology, and many studies have looked to see what risk factors lead to these complications. This review discusses the current knowledge of pelvic floor and anorectal physiology, especially during pregnancy, and reviews the current literature on causes and treatments of postpartum bowel symptoms of constipation and fecal incontinence.

Anal incontinence after vaginal delivery or cesarean section

“…1,7 However, the belief that CS may prevent the development of AI may be one of the reasons for increased requests for CS. 9,10 Fecal incontinence (FI) and AI are defined as the involuntary loss of solid or liquid stool, and loss of stool or gas, respectively. 9,10 Fecal incontinence (FI) and AI are defined as the involuntary loss of solid or liquid stool, and loss of stool or gas, respectively.…”

Prevalence of Fecal Incontinence in Women During Pregnancy

“…these data would be specially interesting, considering that symptoms of fi during pregnancy could be one of the predictors of postdelivery symptoms, and early intervention and information may aid in reducing and preventing this clinical disorder. 8,9 the aim of this study was to determine the incidence and severity of fi during the first and third trimesters of pregnancy, to evaluate its impact on quality of life, and to identify whether there is a specific clinical pattern that could identify patients at risk.…”

Management of opioid-induced constipation in pregnancy: a concise review with emphasis on the PAMORAs

“…A leading cause is thought to be increased production of progesterone, which via activation of progesterone receptors produces relaxation of smooth muscle cells and prevents premature uterine contractions to maintain pregnancy . Progesterone also decreases colonic motility and weakens tonic contractions of sphincters in association with androgen, oestrogen and progesterone receptors located on stratified squamous epithelium of the anal canal . Other influencing factors of pregnancy on bowel function include increased bowel transit time due to reduced levels of motilin, increased water absorption from the intestines, obstructed defecation caused by the combination of ligamentous laxity, and the constipatory effect of vitamin and mineral supplements such as iron and calcium .…”