Some women become constipated only when pregnant, and others prone to constipation find that pregnancy increases the difficulty. The condition results from physiologic changes occurring normally as the effect of pregnancy: decreased contractions of the intestinal tract, pressure from the enlarged uterus on the bowel, and diminished expulsive ability of the overstretched abdominal muscles. The hazards of constipation are greatly overrated in the public mind, probably in part from the emphasis on intestinal hygiene in pharmaceutical advertising in all popular media of communication. There is no evidence of any harm resulting to the patient who does not have a daily bowel movement, except the harm which her propaganda-fired mind imagines. However, an evacuation every twenty-four or forty-eight hours is preferable. The following regimen will aid constipation. 1. Take a moderate amount of daily physical exercise. 2. Eat a coarse cereal such as oatmeal for breakfast, and have whole-wheat bread in place of white bread. Also eat freely of salads and leafy vegetables. 3. Take some fruit at night before going to bed. Certain fruits are especially efficacious, notably prunes, apples, figs, dates, and raisins. 4. Licorice candy has a mild cathartic action; take advantage of this property. 5. Try to develop the habit of a regular, unhurried visit to the bathroom at the same hour each day, preferably after breakfast. Smoking a cigarette while on such an excursion may help. Incidentally, when you become a mother, institute a program of routine bowel training for your youngster, especially if she is a girl. This is the best preventative against constipation in pregnancy. A stool reflex should be established on the basis of conditioning. A conditioning factor may be breakfast, a specific food, or some form of exercise. 6. Refrain from excessive straining while at stool.
When additional measures are necessary, one or two tablespoons of mineral oil nightly before retiring may be tried. This should not be taken during the day because of its interference with the absorption of vitamins and other nutrients. If necessary, a mild laxative such as milk of magnesia or cascara may be taken together with the mineral oil. A popular combination of mineral oil and milk of magnesia is Haley’s M-O. Medicines such as Colace and Doxinate, which cause the stool to absorb water, can be taken daily. Rectal suppositories may be used with impunity if efficacious. Occasional small warm soapsuds enemas are ordinarily permitted unless there has been some complication such as vaginal bleeding or previous premature delivery. It is safest to consult your doctor before resorting to an enema.