What did pregnancy do to my gut? From nausea to constipation and farting

Constipation and haemorrhoids are common in pregnancy. Shutterstock^[11]

Read more: Health Check: what causes constipation?^[12]

Increased levels of oestrogen also lead to your blood vessels and connective tissue (tissue that connect one type to another, such as ligaments) becoming softer.

This, plus pressure from the growing baby, and increased blood volume and flow, can contribute to the development of haemorrhoids^[13] – columns of cushioned tissue and blood vessels found close to the opening of the anus.

Read more: Explainer: why do people get haemorrhoids and how do you get rid of them?^[14]

Your body also needs more water and sodium in pregnancy to help produce amniotic fluid (liquid that surrounds the growing baby in the uterus) and build the blood supply of the growing baby^[15]. This necessary water and sodium is absorbed from your intestines and can contribute to constipation, and an increased risk of haemorrhoids.

Haemorrhoids are very common during pregnancy. One study^[16] found 86% of pregnant women reported them.

Read more: Explainer: why do people get haemorrhoids and how do you get rid of them?^[17]

No wonder I feel full

Oestrogen is thought to be responsible^[18] for decreasing the movement of the stomach in pregnancy, keeping the food in the stomach longer and making it more likely you’ll feel full.

During the third trimester, your growing uterus and baby also start to really push up on the abdominal organs. No wonder you’re likely to feel pressure on your stomach and discomfort the closer you are to the end of your pregnancy.

You can also feel pressure at the other end of the gut. Pressure from the expanding uterus on the end part of the colon (the sigmoid colon) can also make you feel constipated even if you’re not.

Read more: Mega study confirms pregnant women can reduce risk of stillbirth by sleeping on their side^[19]

I have incontinence. Is that because of how I gave birth?

There has been a lot of debate about whether urinary or faecal incontinence is more likely after a vaginal or a caesarean birth.

However, the strongest evidence we have suggests the mode of birth makes no difference^[20]. If you’ve had incontinence during pregnancy^[21] this is the strongest predictor^[22] of having it afterwards.

Urinary incontinence that doesn’t improve within three months of giving birth is more likely to persist^[23]. So if you’ve experienced this during pregnancy, you might like to see a pelvic floor physio^[24].

Fortunately, faecal incontinence after pregnancy is very uncommon, affecting only around 3%^[25] of women. However if this persists, please seek medical attention.

Why am I still constipated?

A study from Finland^[26] on more than 400 women found constipation affected 47% of women in the first few days after a vaginal birth and 57% of women in the first few days after a caesarean.

The researchers suggested this may be caused by too much physical inactivity and insufficient intake of fluids after birth, or the effects of anaesthetic and disturbance to the intestines during surgery.

One month after childbirth, constipation became less common. Some 9% of women were constipated after a vaginal birth and 15% after a caesarean.

Feeling gassy? No, you’re not imaging it

The Finnish study also found excess farting is extremely common a few days after birth. It affected 81% of women but this number dropped to 30% one month after birth.

Bloating is another common symptom found a few days after birth affecting 59% of women, and this decreases to 14% of women one month afterwards.

So why is this happening? We can look to your gut microbiome for clues. This is the unique universe of micro-organisms (bugs), and their genes, that live in your gut.

Remind me again, what is the microbiome?

During and after pregnancy, there are profound changes^[27] to the gut microbiome. These may cause an increase in gas production or lead to constipation.

So the good news from the Finnish study is that normal bowel function is restored quickly after childbirth for most women, but might be a touch longer for women after a caesarean.

If you’re concerned about gut symptoms during or after pregnancy, seek advice from a health-care professional, who can discuss treatment and referral options.

Read more https://theconversation.com/what-did-pregnancy-do-to-my-gut-from-nausea-to-constipation-and-farting-193012