bowel in pregnancy

Overview

Pregnancy can affect how your bowels work. Many women experience constipation, bloating, or piles (swollen veins around the back passage). These changes are common and often manageable with simple lifestyle adjustments.

Yes, bowel changes are very common in pregnancy. Constipation and piles affect many pregnant women, especially later in the pregnancy.

It can affect anyone who is pregnant, and is more likely if you have had constipation or irritable bowel syndrome (IBS) before. It often gets worse in the second and third trimesters.

Symptoms

Common symptoms

• Hard, dry, or infrequent stools
• Straining to pass poo
• Feeling bloated or uncomfortably full
• Tummy pain or cramps
• Itching, soreness, or bleeding around the back passage
• A feeling of not having fully emptied your bowels

Symptoms in children

• Not applicable — this topic is about pregnancy, not children.

Symptoms in older adults

• Not specifically applicable — this topic is about pregnancy. Older pregnant women may have similar bowel symptoms, and the advice is the same.

Causes

Main causes

• Hormone changes (especially progesterone) relax the bowel muscle, slowing down digestion.
• The growing womb (uterus) presses on the bowel, making it harder for waste to pass through.
• Iron tablets that are often given during pregnancy can cause constipation.
• Being less active than usual or not drinking enough water can make symptoms worse.

Risk factors

• Having had constipation or IBS before pregnancy
• Taking iron supplements
• Drinking too little fluid
• Eating a low-fibre diet
• Being less physically active than usual

When to see a doctor

See a doctor urgently if:

• Call your local emergency number right away if you have severe tummy pain, heavy bleeding, or a fever.
• See a doctor the same day if you cannot pass wind or poo and are vomiting, or if you have a lot of blood in your poo.

Book a routine appointment if:

• If constipation or piles are making you miserable and self-care has not helped
• If your bowel habits change suddenly and the change lasts more than a few days
• If you are worried about any symptom, even if it seems small

Diagnosis

Your doctor or midwife will ask about your symptoms, diet, and medical history. They may gently feel your tummy and, if needed, look at your back passage to check for piles (haemorrhoids).

Tests that may be done

• A urine test to rule out a urine infection
• A blood test to check for anaemia or thyroid problems
• A simple examination of your back passage (anus) to check for piles or tears

What to expect at your appointment

Most people do not need tests. Your healthcare team will talk through gentle, safe ways to ease your symptoms, using lifestyle changes and treatments that are safe in pregnancy.

Treatment

Treatment focuses on easing symptoms gently and safely. Lifestyle changes come first. Any medicine used during pregnancy should be recommended by a doctor, midwife, or pharmacist who knows you are pregnant.

Self-care at home

• Eat more fibre — fruit, vegetables, wholemeal bread, beans, and oats
• Drink plenty of water throughout the day so your urine is pale yellow
• Move regularly — a short walk after meals can help
• Don't delay going to the toilet when you feel the urge
• Use a small footstool to raise your feet when sitting on the toilet, which helps with passing stool
• Soak in a warm bath to ease soreness from piles

Medical treatments

If lifestyle changes are not enough, your doctor or midwife may recommend a laxative that is safe to use during pregnancy. They may also suggest creams or suppositories for piles that can be used for a short time. Always ask your healthcare provider before using any medicine during pregnancy, including herbal or over-the-counter products.

When is surgery considered?

Surgery for piles is rarely needed in pregnancy. If symptoms do not improve after you have given birth, your doctor may discuss other options with you.

Living with this condition

Many bowel symptoms settle after your baby is born. Until then, small changes to how you eat, drink, and move can make a big difference. Be patient with your body — it is working hard.

Lifestyle tips

• Add fibre to your diet gradually to avoid bloating
• Try gentle activities like walking, swimming, or prenatal yoga
• Practise pelvic floor exercises to support the muscles around your bowel
• Avoid sitting on the toilet for too long, as this can make piles worse

Diet and exercise

Eat a balanced diet with plenty of high-fibre foods and drink enough fluid. Regular light exercise helps keep the bowels moving. Avoid too much caffeine, and be careful with foods that you know make you feel bloated.

Mental health and emotional wellbeing

Bowel problems can feel embarrassing or upsetting, and they can add to the stress of pregnancy. It's normal to feel frustrated. If you feel anxious or overwhelmed, tell someone you trust. If you ever have thoughts of harming yourself or your baby, contact your local crisis team or call your local emergency number right away.

Prevention

You can lower your chances of constipation by keeping a good intake of fibre, fluid, and regular activity. Going to the toilet when you feel the urge, rather than holding it in, also helps. To prevent piles, try to avoid straining on the toilet.

Complications

If left untreated

• Severe constipation can lead to faecal impaction — where hard stool gets stuck in the bowel and is very painful.
• Piles (haemorrhoids) can become more painful, bleed, or develop blood clots.
• Straining can cause or worsen tears around the back passage (anal fissures).
• Long-lasting constipation after birth may make it harder to recover and can increase the risk of urinary problems.

Long-term outlook

For the vast majority of women, bowel changes during pregnancy are temporary and improve after the baby is born. With the right support, you can manage your symptoms and avoid serious problems. Your body is doing an amazing thing, and you deserve kind, practical care.

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