Is lactulose safe during pregnancy
Constipation is a rare evacuation of a stool that is too hard, whereby bowel movements can only be normal every three days if the stool is normal. Up to 40% of all pregnant women complain of symptoms of constipation during the course of pregnancy. The hormonal changes during pregnancy lead to muscle relaxation of the smooth muscles of the intestine and thus to a prolonged gastrointestinal transit time. The increased absorption of water and electrolytes during pregnancy also favor constipation. Other possible causes are changes in eating habits and reduced physical activity during pregnancy.
Special features of therapy in pregnancy
During pregnancy, the non-drug measures for the treatment of constipation are in the foreground. Patients should eat a diet rich in fiber, drink enough and exercise. Since infrequent bowel movements are often referred to as constipation by pregnant women, it is essential to clarify whether there is real constipation before using any medication. Laxatives should only be used in severe constipation and after the unsuccessful use of dietary and physical measures. It should be used as quickly as possible, since water loss and electrolyte changes could damage the fetus.
Means of choice
If switching to a high-fiber diet does not work sufficiently, fillers and bulking agents can be used. They are not absorbed and promote intestinal peristalsis. This group of laxatives includes flax seeds, wheat bran and Indian psyllium husks (Plantago ovata). The use of these substances is harmless during pregnancy, however, care should be taken to ensure adequate fluid intake. If bulking agents are inadequate, lactulose is the laxative of choice during pregnancy. The osmotic laxative macrogol is an alternative. Short-term use of bisacodyl or glycerol would only be considered if these substances fail. Sodium picosulfate, Glauber's salt, and rectal mannitol or sorbitol are also acceptable. Restraint is advised with docusate and Epsom salts. Anthraquinone derivatives (senna leaves, rhubarb root, buckthorn bark, aloe), paraffinum and castor oil should not be used.
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