What causes constipation and pelvic issues after childbirth?

Question

Hi doctor,

I am 28 years old and two months postpartum after a vaginal delivery with an episiotomy. I have had ongoing constipation since delivery, with a feeling of heaviness in my pelvis and occasional bleeding when I strain. My hemoglobin is 9.6 g/dL. Could this be due to pelvic floor dysfunction or a mild rectocele? Is pelvic floor therapy or stool softeners like Lactulose safe while breastfeeding?

Please guide.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Constipation after childbirth is quite common, and in most cases, it improves within six weeks postpartum. It can happen due to several reasons like low fluid intake or dehydration, a low-fiber diet, changes in dietary habits, and fear of pain during straining. Since you have also mentioned occasional bleeding, there could be a possibility of hemorrhoids. It is best to consult a surgeon for a proper evaluation. Yes, you can take Lactulose while breastfeeding, and it is considered safe. However, it is only for symptomatic relief.

To manage it effectively, the first step is to make dietary and lifestyle changes. Increase fiber in your diet, especially green leafy vegetables and fruits like oranges, kiwi, mangoes, and papaya. Prefer whole grains over refined ones, stay well-hydrated throughout the day, and take a daily 30-minute walk to improve bowel movement. If you suspect rectocele, a clinical examination is needed to confirm the diagnosis.

I hope this helps.

Kindly follow up if you have more doubts.

Thank you.