Does Prophylactic Use of Postcesarean Section Laxatives Favor Bowel Movements?

• Published in: Journal of Coloproctology Vol. 42; no. 3; pp. 234 - 237
• Main Authors: Corrêa Neto, Isaac José Felippe, Pizzo, Juliana Lazzarini, Robles, Amanda Gambi, Mauri, Leonardo, Robles, Laercio
• Format: Journal Article
• Language: English
• Published: Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil Thieme Revinter Publicações Ltda 01.09.2022
• Subjects: cesarean delivery; constipation; laxatives; Original Article; pregnancy; puerperium; constipation; cesarean delivery; puerperium; pregnancy; laxatives
• ISSN: 2237-9363; 2317-6423
• DOI: 10.1055/s-0042-1754382

Abstract Introduction  Chronic constipation (CC) is a highly prevalent disease in Western society. Chronic constipation can have a different etiology in patients who underwent a cesarean section and result from postoperative stress and metabolic response to trauma, analgesic agents, immobilization, and dietary restrictions. Chronic constipation may also occur due to puerperium-related psychological changes and to the stretching and weakening of the perineal and abdominal muscles after childbirth. Objectives  The present study analyzes intestinal transit restoration after a cesarean section and the influence of osmotic laxative agents. Methods  The present prospective, nonrandomized sample study used the ROME III questionnaire and the Bristol stool scale in adult women who underwent a cesarean section. We divided the subjects into 2 groups, each with 30 patients, to compare the effect of the prophylactic administration of an osmotic laxative. Results  We evaluated 60 randomly-chosen pregnant women from the Obstetrics ward of Hospital Santa Marcelina, São Paulo, SP, Brazil, from October 2019 to March 2020. Their mean age was 26.8 years old, and the mean gestation time was 37.95 weeks. Ten patients (16.7%) presented with constipation before the cesarean section, and 38 (63.3%) had a bowel movement after the procedure. However, in 84.2% of these patients, the usual stool consistency worsened. After the cesarean section, 46.7% of the women who did not receive laxative agents had a bowel movement, compared with 80% of those who did ( p  = 0.0074). Conclusion  Some factors, including those related to the procedure, may hamper intestinal transit restoration after a cesarean section. Osmotic laxative agents can facilitate transit restoration with no negative effects in this group of patients.