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
