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CC BY-NC-ND 4.0 · Journal of Coloproctology 2022; 42(03): 234-237
DOI: 10.1055/s-0042-1754382
Original Article

Does Prophylactic Use of Postcesarean Section Laxatives Favor Bowel Movements?

Isaac José Felippe Corrêa Neto 
1   Coloproctology Service, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
,
Juliana Lazzarini Pizzo 
2   Faculdade Santa Marcelina, São Paulo, SP, Brazil
,
Amanda Gambi Robles 
3   General Surgery Program, Hospital Santa Marcelina, São Paulo, SP, Brazil
,
Leonardo Mauri 
4   Department of Gynecology and Obstetrics, Hospital Santa Marcelina, São Paulo, SP, Brazil
,
Laercio Robles 
1   Coloproctology Service, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
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Abstract

Introduction Chronic constipation (CC) is a highly prevalent disease in Western society. Chronic constipation can have a different etiology in patients who underwent a cesarean section and result from postoperative stress and metabolic response to trauma, analgesic agents, immobilization, and dietary restrictions. Chronic constipation may also occur due to puerperium-related psychological changes and to the stretching and weakening of the perineal and abdominal muscles after childbirth.

Objectives The present study analyzes intestinal transit restoration after a cesarean section and the influence of osmotic laxative agents.

Methods The present prospective, nonrandomized sample study used the ROME III questionnaire and the Bristol stool scale in adult women who underwent a cesarean section. We divided the subjects into 2 groups, each with 30 patients, to compare the effect of the prophylactic administration of an osmotic laxative.

Results We evaluated 60 randomly-chosen pregnant women from the Obstetrics ward of Hospital Santa Marcelina, São Paulo, SP, Brazil, from October 2019 to March 2020. Their mean age was 26.8 years old, and the mean gestation time was 37.95 weeks. Ten patients (16.7%) presented with constipation before the cesarean section, and 38 (63.3%) had a bowel movement after the procedure. However, in 84.2% of these patients, the usual stool consistency worsened. After the cesarean section, 46.7% of the women who did not receive laxative agents had a bowel movement, compared with 80% of those who did (p = 0.0074).

Conclusion Some factors, including those related to the procedure, may hamper intestinal transit restoration after a cesarean section. Osmotic laxative agents can facilitate transit restoration with no negative effects in this group of patients.

Keywords

constipation - pregnancy - cesarean delivery - puerperium - laxatives


Publication History

Received: 18 February 2022

Accepted: 07 June 2022

Article published online:
20 July 2022

© 2022. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Corrêa Neto IJF, Maneira ALC, Teixeira NB. et al. There is an agreement between constipation referred and that documented by objective criteria?. J Coloproctol (Rio J) 2016; 36 (03) 153-156
    Article in Thieme ConnectGoogle Scholar
  • 2 Klug WA, Aguida HAC, Ortiz JA, Fang CB, Capelhuchnik P. Alterações das pressões anais na gravidez. Rev Bras Coloproctol 2007; 27 (02) 196-201
    CrossrefGoogle Scholar
  • 3 Lacy BE, Brunton SA. Partnering with gastroenterologists to evaluate patients with chronic constipation. MedGenMed 2005; 7 (02) 19-34
    PubMedGoogle Scholar
  • 4 Sobrado CW, Corrêa Neto IJF, Pinto RA, Sobrado LF, Nahas SC, Cecconello I. Diagnosis and treatment of constipation: a clinical update based on the Rome IV criteria. J Coloproctol (Rio J) 2018; 38 (02) 137-144
    Article in Thieme ConnectGoogle Scholar
  • 5 McNicol E, Horowicz-Mehler N, Fisk RA. et al; Americal Pain Society. Management of opioid side effects in cancer-related and chronic noncancer pain: a systematic review. J Pain 2003; 4 (05) 231-256
    CrossrefPubMedGoogle Scholar
  • 6 Gómez López ME, Morales Carmona F, Aldana Calva E, Gaviño Gaviño F. Estado emocional de la mujer en relación con el parto o cesárea. Ginecol Obstet Mex 2008; 76 (07) 365-372
    PubMedGoogle Scholar
  • 7 Derbyshire E, Davies J, Costarelli V, Dettmar P. Diet, physical inactivity and the prevalence of constipation throughout and after pregnancy. Matern Child Nutr 2006; 2 (03) 127-134
    CrossrefPubMedGoogle Scholar
  • 8 Ross GR, Gabra BH, Dewey WL, Akbarali HI. Morphine tolerance in the mouse ileum and colon. J Pharmacol Exp Ther 2008; 327 (02) 561-572
    CrossrefPubMedGoogle Scholar
  • 9 Chiarelli P, Brown W, McElduff P. Constipation in Australian women: prevalence and associated factors. Int Urogynecol J Pelvic Floor Dysfunct 2000; 11 (02) 71-78
    CrossrefPubMedGoogle Scholar
  • 10 Lewis SJ, Heaton KW. Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997; 32 (09) 920-924
    CrossrefPubMedGoogle Scholar
  • 11 Anderson AS, Whichelow MJ. Constipation during pregnancy: dietary fibre intake and the effect of fibre supplementation. Hum Nutr Appl Nutr 1985; 39 (03) 202-207
    PubMedGoogle Scholar
  • 12 Greenhalf JO, Leonard HSD. Laxatives in the treatment of constipation in pregnant and breast-feeding mothers. Practitioner 1973; 210 (256) 259-263
    PubMedGoogle Scholar
  • 13 Trottier M, Erebara A, Bozzo P. Treating constipation during pregnancy. Can Fam Physician 2012; 58 (08) 836-838
    PubMedGoogle Scholar
  • 14 Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. BMJ Clin Evid 2010; 2010: 1411-1418
    PubMedGoogle Scholar
  • 15 Shin GH, Toto EL, Schey R. Pregnancy and postpartum bowel changes: constipation and fecal incontinence. Am J Gastroenterol 2015; 110 (04) 521-529 , quiz 530
    CrossrefPubMedGoogle Scholar
  • 16 Ferdinande K, Dorreman Y, Roelens K, Ceelen W, De Looze D. Anorectal symptoms during pregnancy and postpartum: a prospective cohort study. Colorectal Dis 2018; 20 (12) 1109-1116
    CrossrefPubMedGoogle Scholar
  • 17 Jewell DJ, Young G. Interventions for treating constipation in pregnancy. Cochrane Database Syst Rev 2001; x (02) CD001142
    PubMedGoogle Scholar
  • 18 Santana LS, Gallo RBS, Marcolin AC. Utilização dos recursos fisioterapêuticos no puerpério: revisão da literatura. Femina 2011; 39 (05) 245-250
    Google Scholar