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Modern approaches to the treatment of constipation in pregnant women

https://doi.org/10.51793/OS.2024.27.7.001

Abstract

Background. Constipation, or constipation, is a polyetiological pathological condition characterized by prolongation of the intervals between acts of defecation and changes in the shape and consistency of fecal matter. The incidence of this pathology is very high all over the world, mainly depending on the nature of nutrition, hypodynamia, standard of living and availability of medical care in different regions of the world. Special attention is paid to the problem of constipation in pregnant women, as it is not only a matter of quality of life, constipation can affect the course of pregnancy and even contribute to its termination. Constipation is one of the most frequent pathologies of the gastrointestinal tract and can occur in 11-62% of pregnant women. The article presents factors predisposing to the development of constipation in each trimester, explains its mechanisms, describes possible complications of chronic constipation in expectant mothers and the negative impact on the course of pregnancy and in the postpartum period.

Results. Approaches to the diagnosis of constipation according to modern classifications, including the "Rome criteria for constipation" 2016, are shown. Special attention is paid to the prevention of constipation in pregnant women. The importance and expediency of a comprehensive approach to the prevention and treatment of constipation in expectant mothers, namely, changing the nature and diet, the level of physical activity in the absence of contraindications and adequate choice of drugs approved for use during pregnancy. A comparative analysis of the use of the most common drugs (lactulose and psyllium) by two groups of pregnant patients is given, the mechanisms of action and effectiveness of psyllium in the treatment of constipation, as well as some other positive properties of psyllium and its tolerance by pregnant women are noted. Clinical examples of effective therapy of constipation in expectant mothers with the use of a medicinal preparation containing plantain ovata (Plantago ovata Forssk.) seed coatings are described.

About the Author

A. K. Minaeva
Medsi Group of Companies
Россия

Anna. K. Minaeva - Gastroenterologist, Deputy Chief Physician for Clinical and Expert Work, Joint-Stock Company Medsi Group of Companies.

12 p. 1 Solyanka str., Moscow, 109240



References

1. Clinical Guidelines "Constipation." https://cr.minzdrav.gov.ru/recomend/274_2. (In Russ.)

2. Minushkin O. N. Chronic constipation (definition, epidemiology, diagnosis): current drug therapy. Meditsinskiy sovet. 2015; (13): 100-105. (In Russ.)

3. Platoshkin E. N., Shut S. A. Functional constipation (Communication 1: epidemiology and diagnosis) (literature review). Gomel State Medical University, 2013. (In Russ.)

4. Quinn M. Pretermpredictors: Constipation, childbirth, andcervicalsurgery? 2005. DOI: https://doi.org/10.1016/j.ajog.2005.05.028.

5. Rybakova T. N., Nazarova L. V., Kovalenko M. S., Tuzlukov I. I. Comparative evaluation of functional constipation prevention methods in pregnant women. Ginekologiya. 2022. Vol. 24. N. 5. P. 369-373. DOI: 10.26442/20795696.2022.5.201928. (In Russ.)

6. Normal Pregnancy Clinical Guidelines. https://cr.minzdrav.gov.ru/recomend/288_2. (In Russ.)

7. Dobrokhotova Yu. E., Borovkova E. I., Simonyan T. D., Selimshaeva D. S. Large bowel obstruction during pregnancy: the efficacy of dietary fibers. RMZh. Mat' i ditja. 2021; 4 (1): 36-41. (In Russ.) DOI: 10.32364/2618-8430-2021-4-1-36-41.

8. Turkina S. V. Disorder of intestinal function in pregnant women: constipation in the intestine. Еksperimental'naja i klinicheskaja gastrojenterologija. 2016; 132 (8): 88-92. (In Russ.)

9. Stremoukhov A. A., Vlasova N. L. Some aspects of the treatment of constipation in therapeutic outpatient practice. Lechaschi Vrach. 2023; 11 (26): 62-67. (In Russ.) https://doi.org/10.51793/OS.2023.26.11.009.

10. Strokova O. A., Gerasimenko I. V. The main approaches to the diagnosis and treatment of constipation. Еksperimental'naja i klinicheskaja gastrojenterologija. 2019; (5): 49-55. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-165-5-49-55.

11. Lazebnik L. B., Turkina S. V., Golovanova E. V., Ardatskaya M. D., Ostroumova O. D., Komissarenko I. A., Korochanskaya N. V., Kozlova I. V., Uspensky Yu. P., Fominykh Yu. A., Levchenko S. V., Loranskaya I. D., Tkachenko E. I., Sitkin S. I., Bakulin I. G., Bakulina N. V., Shemerovsky K. A. Constipation in adults Еksperimental'naja i klinicheskaja gastrojenterologija. 2020; (3): 10-33. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-175-3-10-33.

12. Iron Deficiency Anemia Clinical Guidelines. https://cr.minzdrav.gov.ru/recomend/669_1. (In Russ.)

13. Stuklov N. I., Kunina M. Yu., Semenova E. N. Effectiveness and tolerability of iron preparations. What is more important? Is there an optimal solution? (In Russ.) Poliklinika. 2014; 2.

14. Sheptulin A. A., Uspenskaya Yu. B. Features of the clinical picture, diagnosis and treatment of the gastroesophageal reflux disease in pregnancy. Klinicheskaya meditsina. 2020; 98 (6): 414-418. (In Russ.) DOI http://dx.doi.org/10.30629/0023-2149-2020-98-6-414-418.

15. Pandey A. K., Gautam D., Tolani H., et al. Clinical outcome post treatment of anemia in pregnancy with intravenous versus oral iron therapy: a systematic review and meta-analysis. SciRep. 2024; 14, 179. https://doi.org/10.1038/s41598-023-50234-w.

16. Shemerovskii K. A., Kantemirova R. K., Seliverstov P. V. A modern view of the problem of constipation. Lechaschi Vrach. 2024; 2 (27): 36-42. (In Russ.) https://doi.org/10.51793/OS.2024.27.2.007.

17. Solovyeva A. V., Ermolenko K. S. Constipation in pregnancy. Approaches to the treatment. Meditsinskiy sovet. 2020; (3): 44-47. (In Russ.) https://doi.org/10.21518/2079-701X-2020-3-44-47.

18. Ignatko I. V. Modern approaches to the therapy of constipation in pregnant women. Voprosy ginekologii, akusherstva i perinatologii. 2012; 1 (11): 41-47. (In Russ.)

19. Akusherstvo: natsional'noerukovodstvo. Pod red. G. M. Savel'evoi, G. T. Sukhikh, V. N. Serova, V. E. Radzinskogo. 2-e izd., pererab. I dop. M.: GEOTAR-Media, 2018. Seriia "Natsional'nye Rukovodstva". Available at: https://www.rosmedlib.ru/book/ISBN9785970449165.html. Accessed: 10.10.2022. (In Russ.)

20. Plotnikova E. Yu., Gracheva T. Yu., Sinkovа M. N., Isakov L. K. The role of dietary fiber in the correction of digestion and constipation of various etiologies. Meditsinskiy sovet. 2019;(14):99-106. (In Russ.) https://doi.org/10.21518/2079-701X-2019-14-99-106.

21. Pilipenko V. I., Perova I. B., Kochetkova A. A., Isakov V. A. Prospects of dietary fibers food fortification for the treatment and prevention of gastrointestinal diseases: A review. Terapevticheskii arkhiv. 2023. Vol. 95. N. 8. P. 701-705. DOI: 10.26442/00403660.2023.08.202328.

22. Morozov S. V., Kucheryavy Yu. A., Kukushkina M. D. Role of dietary fiber deficiency in the development of manifestations and course of gastroesophageal reflux disease. Rossijskij zhurnal gastrojenterologii, gepatologii, koloproktologii. 2013; 1 (2): 6-13. (In Russ.)

23. Ginzburg M. M. Experience of using the drug Mucofalk in complex therapy in patients with obesity and metabolic syndrome. Samara: Research Institute of Dietetics and Dietotherapy, 2010. 9 p. (In Russ.)

24. Zakharenko M. A., Vekovtsev A. A., Serba E. M, Poznyakovsky V. M., Vyatkin A. V. Biologically Active Complex Based on Fermented Fiber to Normalize and Ensure the Vital Microflora Activity. Industrija pitanija. 2023; 8(4): 68-78. (In Russ.) DOI: 10.29141/2500-1922-2023-8-4-7. EDN: SPNSPL.

25. P'yanykh O. P. The role of psyllium in the treatment of metabolic syndrome. Endokrinologiya: novosti, mneniya, obuchenie. 2020; 9 (1): 87-91. (In Russ.) DOI: 10.33029/2304-9529-2020-9-1-87-91.

26. Image rights are owned by PearsonEducation, Inc. pearson.com.

27. Mehmood M. H., Aziz N., Ghayur M. N., Gilani A. H. Pharmacological basis for the medicinal use of psyllium husk (Ispaghula) in constipation and diarrhea. Dig. Dis. Sci. 2011; 56 (5): 1460-1471.


Review

For citations:


Minaeva A.K. Modern approaches to the treatment of constipation in pregnant women. Lechaschi Vrach. 2024;(7):11-16. (In Russ.) https://doi.org/10.51793/OS.2024.27.7.001

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ISSN 1560-5175 (Print)
ISSN 2687-1181 (Online)