What is the relationship between constipation and uterine leiomyomas (fibroids)?

From the Guidelines

Constipation can be directly related to uterine leiomyomas (fibroids), particularly when large fibroids compress the rectum, as seen in a case where an MRI revealed a 12 cm subserosal leiomyoma compressing the rectum 1. To manage constipation associated with fibroids, it is essential to consider both the symptoms and the underlying cause.

• Increasing daily fiber intake to 25-30 grams through fruits, vegetables, and whole grains can help soften stool and make it easier to pass.
• Drinking at least 8 glasses of water daily is crucial to prevent dehydration and facilitate bowel movements.
• Regular physical activity, such as walking for 30 minutes most days, can help stimulate bowel movements.
• Over-the-counter options include fiber supplements like psyllium husk (Metamucil) starting at 1 teaspoon daily in water, stool softeners like docusate sodium (Colace) 100mg once or twice daily, or osmotic laxatives like polyethylene glycol (MiraLAX) 17g daily in water. However, if constipation persists despite these measures, it may be necessary to address the fibroids themselves, considering options like medications to shrink them temporarily or surgical interventions depending on the severity of symptoms and reproductive goals, as both UAE and surgical options (myomectomy and hysterectomy) are viable alternatives in controlling bulk-related symptoms secondary to fibroids 1. The mechanical obstruction caused by fibroids compressing the rectum and colon can lead to constipation, highlighting the need for a comprehensive approach that considers both symptom management and treatment of the underlying condition.

From the Research

Relationship Between Constipation and Uterine Leiomyomas (Fibroids)

• Constipation is a symptom associated with uterine leiomyomas (fibroids) 2, 3, 4
• Fibroids can cause pressure on the bowel, leading to constipation 2, 4
• Bowel dysfunction, including constipation, is a common symptom of uterine fibroids 4
• The exact mechanism of how fibroids cause constipation is not fully understood, but it is thought to be related to the size and location of the fibroids 3, 4
• Treatment of uterine fibroids, such as hysterectomy or myomectomy, may help alleviate symptoms of constipation 2, 5, 4

Prevalence of Constipation in Women with Uterine Fibroids

• The prevalence of constipation in women with uterine fibroids is not well established, but it is considered a common symptom 3, 4
• A study found that uterine fibroids can cause a range of symptoms, including constipation, in up to 25% of reproductive women 3

Management of Constipation in Women with Uterine Fibroids

• Management of constipation in women with uterine fibroids typically involves treatment of the underlying fibroids 2, 5, 4
• Medical therapy, such as painkillers and hormone therapy, may be used to reduce symptoms of constipation 3, 4
• Surgical treatment, such as hysterectomy or myomectomy, may be necessary in some cases to alleviate symptoms of constipation 2, 5, 4