Constipation is a common complaint in pregnancy and affects many pregnant women and the post partum period. During pregnancy, it’s likely due to the increased level of progesterone in your body, which has the effect of slowing your bowels down. If you’re constipated during pregnancy, ensure you have this sorted early otherwise it could lead to pelvic floor dysfunction as well as distress! Also, straining on the toilet is NOT OK! All that straining is like having a mini birth every day, so think of your poor pelvic floor! Constipation can be both the cause of and be caused by pelvic floor dysfunction. It’s often not a visible thing, meaning you’re not wetting the bed, however it can become all consuming taking over your life.
There can be many reasons for constipation:
· Not being active enough
· Not drinking enough water
· Not consuming enough fibre in your diet
· Vaginal prolapse
· Resisting the urge to poo (can begin in childhood)
· Hemorrhoids or anal fissures (hesitation to poo)
· Pregnancy and the initial post partum period
· Slow transit faeces within your colon
· Pelvic floor dysfunction/dyssynergia
· Irritable bowel syndrome
· Certain medical conditions
Signs and symptoms
· Straining to poo
· Going to the toilet less than three times per week
· Passing hard, dry and lumpy stools
· Having a lot of bloating or stomach cramps
· Having to put your fingers either into your vagina or rectum to empty yourself
· Often feeling that you haven’t emptied your bowels properly
Constipation may have started earlier on in your life as a child or a common fear is not wanting to poo in public places. What if here are noises or, smells? Is there any toilet paper? Or fear of sitting on the toilet seat so you hover instead. Or the classic example, there are people I know in the toilets so I’m too embarrassed to poo here. Most of the time we can put off the urge to poo until we are in a safe place, preferable at home with the door locked. But we shouldn’t feel embarrassed about opening our bowels, it is something we all do on a regular basis, yet even today we still remain very private about the whole process.
A classic example of a mum who came to see me for feeling heavy in the back passage. It turned out that she always needed to poo in the morning right at the same time as getting the baby ready for the day. As a result, by consistently not able to go when she needed to, often the urge had passed and an awful cycle of being constipated begins. Eventually this led to a prolapse. It got to a stage where she had to push on the back wall of her vagina in order to empty her bowels. This sounds shocking, but something similar is going on a lot behind closed doors. So, don’t feel alone with this problem – start doing something about it.
To help sort out your constipation you will probably need to do a variety of things. With the right assessment and treatment with a pelvic health physiotherapist, you can get a lot of relief! Constipation can also be a symptom of colon cancer so if you have any concerns you should go straight to your GP.