Severe constipation in pregnancy

I am a 38 year old female in my 24th week of pregnancy with history of severe, chronic IBS. Before pregnancy, I was put on daily regimen of 1 dose citrucel, 2 doses miralax and 2 T. milk of magnesia. This combination is the only thing that worked.Increase fiber did not work. Now at 24 weeks, I'm taking 2 doses of citrucel, 1-2 tabs of colace, I T. milk of magnesia plus 8 glasses of water/day, FiberOne cereal, 7-8 dried prunes per day and am severely constipated. Bowels have been slowed for past week and getting progessively worse. Increased fiber helps to pass very small, pencil thin movement. But I'm feeling pressure in bowels and am unable to pass much more. Now am progressing to small balls of stool and small pieces. I cannot take my Miralax during pregnancy and am concerned about impaction. Am beginning to get abdominal pressure in lower colon area. What can I do when dietary measures don't work??? Can I add Lactulose to my regimen?

Also, Citrucel powder just taken of shelves until September. What is next best alternative - Fibersure or Benefiber???

Any suggestions appreciated.. I have also tried prune juice, but got severe gas pains and diarrhea. Not sure if bowel contractions like this are harmful to the baby.

[Kevin Pho, MD]

Lactulose is category B medication that can be added to the medication regimen.

Both Fibersure and Benefiber are acceptable supplements that can be considered.  

Fleet enemas can also be added to the regimen in addition to the Lactulose.  

I would discuss these options with your OB - who can suggest a medication regimen that is safe during pregnancy.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[hrdrssr1]

I am am 21 weeks pregnant at the age of 36.  I had severe nausea and vomiting first 3 months along with severe constipation.  The nausea has let up for the most part but for the last 3 months I have been experiencing severe abdominal pain when trying (being the key word) to use the bathroom accompianed by vomiting. I am following a strict regiment of water only with fiber, fiber, fiber and milk of magnesia along with a diet consisting of high fiber also.

I have not had a complete bowel movement in this time only about1/2 to 1 inch long watery diarrhea.  I have the urge to have a bowel movement and then nothing happens.  My concern is I am pushing so hard to defacate that it is extemely painful in the abdominal area and the pain is always there (dull) but never completely goes away and when using bathroom is so severe it feels as if I am having labor pains.  

Should I consult a gastro doctor because for lack of words my ob doctor could care less!!  Thanks for your time.

[lonnie_shawn]

A related discussion, is there any relief was started.

[NIKMAC1980]

A related discussion, Constipation was started.