From the Guidelines
Bisacodyl should be avoided in pregnant women due to conflicting safety data and the availability of safer alternatives, as recommended by the most recent guidelines 1. When considering treatment options for constipation during pregnancy, it is essential to prioritize safer alternatives to minimize potential risks to the mother and the fetus.
- The American Gastroenterological Association (AGA) suggests that constipation in pregnant persons may result from hormonal, medication-related, and physiological changes, and recommends treatment options such as dietary fiber, lactulose, and polyethylene glycol–based laxatives 1.
- Stimulant laxatives, including bisacodyl, should be avoided because safety data on these medications are conflicting, and their use can lead to electrolyte imbalances or dependency 1.
- Bulk-forming agents, such as psyllium husk or methylcellulose, are safe to administer in pregnancy due to the lack of systemic absorption, and soluble fiber like psyllium husk can improve stool viscosity and transit time 1.
- Osmotic laxatives, such as polyethylene glycol or lactulose, can also be administered safely during pregnancy, but excessive use can cause maternal bloating 1.
- Pregnant women should be encouraged to avoid straining during bowel movements by providing ample time, using relaxation techniques, and adjusting diet and hydration 1. It is crucial to consult with a healthcare provider before using any medication during pregnancy to ensure the safest possible outcome for both the mother and the fetus.
From the Research
Safety of Bisacodyl for Pregnant Women
- Bisacodyl is a stimulant laxative that can be used to treat constipation in pregnant women 2.
- According to a study published in the Zeitschrift fur Geburtshilfe und Neonatologie, bisacodyl is recommended as a second-line treatment for chronic constipation during pregnancy, especially in the second and third trimesters 2.
- The study suggests that bisacodyl can be used safely during pregnancy, but the decision to use it should be based on the individual patient's needs and medical history 2.
- Another study published in The Cochrane database of systematic reviews found that stimulant laxatives, including bisacodyl, were more effective in improving constipation in pregnant women compared to bulk-forming laxatives, but were also associated with more abdominal discomfort and diarrhea 3.
- However, it's essential to note that the quality of evidence for the safety and effectiveness of bisacodyl during pregnancy is moderate, and more research is needed to fully understand its effects 3.
Comparison with Other Laxatives
- A study published in the American family physician found that most over-the-counter laxatives, including bisacodyl, have a good safety record during pregnancy, but it's crucial to weigh the benefits and risks of each medication 4.
- Another study published in Expert opinion on pharmacotherapy noted that while some medications can cause birth defects, the risk should not be exaggerated, and the benefits of treatment should outweigh the risks to the fetus 5.
- A more recent study published in Clinics in perinatology discussed the safety of biologic agents during pregnancy, but did not specifically address bisacodyl 6.