From the FDA Drug Label
CLINICAL TRIALS In one study, patients with less than 3 bowel movements per week were randomized to Polyethylene Glycol 3350 NF, 17 grams, or placebo for 14 days. An increase in bowel movement frequency was observed for both treatment groups during the first week of treatment. Polyethylene Glycol 3350 NF was statistically superior to placebo during the second week of treatment. In another study, patients with 3 bowel movements or less per week and/or less than 300 grams of stool per week were randomized to 2 dose levels of Polyethylene Glycol 3350 NF or placebo for 10 days each. Success was defined by an increase in both bowel movement frequency and daily stool weight. For both parameters, superiority of the 17 gram dose of Polyethylene Glycol 3350 NF over placebo was demonstrated.
The best treatment for postoperative constipation following a C-section is not explicitly stated in the provided drug label. The label discusses the efficacy of polyethylene glycol 3350 in increasing bowel movement frequency in patients with constipation, but it does not specifically address postoperative constipation following a C-section. Therefore, no conclusion can be drawn about the best treatment for this specific condition based on the provided information 1.
From the Research
For constipation after a C-section, the most effective treatment approach is to start with lifestyle modifications, including increasing water intake to at least 8-10 glasses daily and consuming fiber-rich foods, followed by the use of osmotic laxatives such as polyethylene glycol, as recommended by the most recent guidelines 2.
Treatment Approach
The treatment of constipation after a C-section should prioritize non-pharmacological interventions, including:
- Increasing water intake to at least 8-10 glasses daily
- Consuming fiber-rich foods like fruits, vegetables, and whole grains
- Gentle physical activity, such as short walks, to help stimulate bowel movements
Pharmacological Interventions
If lifestyle modifications are not effective, the following pharmacological interventions can be considered:
- Over-the-counter stool softeners like docusate sodium (Colace) at 100 mg twice daily
- Mild laxatives such as MiraLAX (polyethylene glycol) at 17g dissolved in water once daily
- Prune juice (4-8 ounces daily) can also be effective
Important Considerations
It is essential to avoid straining during bowel movements, as this can stress the incision site. Constipation after a C-section is common due to several factors, including decreased physical activity, pain medications (especially opioids), dehydration, and the body's natural response to surgery. If constipation persists beyond a week despite these measures, or if severe abdominal pain or bleeding occurs, it is crucial to contact a healthcare provider for further evaluation and potential prescription-strength medications 2, 3.