From the Guidelines
Lactulose and polyethylene glycol-based laxatives are safe to use during pregnancy.
Safe Laxatives During Pregnancy
The following laxatives are considered safe for use during pregnancy:
- Dietary fiber: Increasing dietary fiber intake to the recommended daily amount of approximately 30 g/d can help promote regular bowel movements and prevent constipation 1.
- Bulk-forming agents: Such as psyllium husk or methylcellulose, are safe to administer in pregnancy because of the lack of systemic absorption 1.
- Osmotic laxatives: Such as polyethylene glycol or lactulose, can also be administered safely during pregnancy 1. It is essential to note that stimulant laxatives should be avoided because safety data on these medications are conflicting 1. Additionally, excessive fiber and osmotic laxatives like lactulose can cause maternal bloating 1.
Key Considerations
- Encouraging pregnant women to avoid straining during bowel movements by providing ample time, using relaxation techniques, and adjusting diet and hydration is helpful 1.
- Increasing fluid intake, particularly water, can help soften stools and ease bowel movements 1.
From the Research
Safe Laxatives During Pregnancy
The following laxatives are considered safe for use during pregnancy:
- Natural fibres (bulk-forming agents) 2
- Docusate sodium (stool-softener) 2
- Mineral oils (lubricant laxatives) 2
- Macrogol (polyethylene glycol, PEG) 2
- Sugars and sugar alcohols (osmotic laxatives) 2
- Anthraquinones and diphenolic laxatives (stimulant laxatives) 2
- Fibre supplements 3, 4
- Senna 4
- Lactulose 2
First-Line Therapy
First-line therapy for constipation during pregnancy includes:
- Increasing fibre intake through diet or supplements 3, 4, 5
- Increasing fluids and exercise 5
- Macrogol and lactulose are recommended as first-line therapy for treating chronic constipation during pregnancy 2
Second-Line Therapy
Second-line therapy for constipation during pregnancy includes:
- Diphenolic laxatives such as bisacodyl and sodium picosulfate 2
- Osmotic laxatives may be beneficial for some patients 4
- Stimulant laxatives may be used in the short term or occasionally to avoid dehydration or electrolyte imbalances in pregnant women 5
Precautions
- The use of pharmacologic agents for treatment of constipation during pregnancy must be weighed against possible adverse effects 4
- Most laxatives carry a pregnancy category B or C classification 4
- Osmotic and stimulant laxatives should be used only in the short term or occasionally to avoid dehydration or electrolyte imbalances in pregnant women 5