La stitichezza in gravidanza

stitichezza o stispiUna delle cose che ricordo con più terrore, soprattutto nel caso della prima gravidanza, è la stitichezza e i conseguenti crampi addominali che arrivavano a svegliarmi alla notte. Il giorno stesso in cui ho comprato un lassativo che la ginecologa mi aveva obbligato ad usare, ho cominciato a regolarizzarmi spontaneamente.

Flacone nuovo, l’ho dovuto poi usare per microba. Ma questa è un’altra storia…

La stipsi, o stitichezza, è un disturbo caratterizzato da emissione di feci di consistenza dura e con una frequenza inferiore a 2-3 volte la settimana.

Nel I trimestre di gravidanza la causa della stipsi è da ricercare in alterazioni ormonali; si ha  ipotonia intestinale e attenuazione del “riflesso gastro-colico”.  Nel II-III trimestre prevalgono i fattori meccanico-compressivi da parte dell’utero gravido sul colon-retto.

La prevenzione e i rimedi non farmacologici per la stitichezza in gravidanza, costituiscono la terapia “gold standard” per le gravide e le mamme in allattamento.

  1. applicazione di borsa di acqua calda
  2. aumentare l’attività fisica quotidiana: soprattutto dopo i pasti fare una passeggiata per favorire la digestione e la peristalsi intestinale.
  3. aumentare l’apporto di fibre sia attraverso il cibo (pane e pasta integrali, pane di segale, verdura cotta e cruda, legumi, frutta) sia aggiungendo 2-3 cucchiai di crusca in polvere al latte, minestra, yogurt (25 gr di fibre/die in totale).
  4. Condire con olio di oliva crudo
  5. evacuare ad orari prestabiliti, possibilmente dopo il pasto principale per sfruttare l’effetto del riflesso “gastro-colico”
  6. evitare l’abuso di lassativi
  7. limitare l’assunzione di caffè, tè e alcolici.

Per quanto riguarda i lassativi in gravidanza sono da assumere con cautela, in caso di necessità e solo per il tempo indispensabile. Molti lassativi, fra cui l’olio di ricino che è assolutamente da evitare, infatti contengono sostanze ad attività utero-tonica, capaci cioè di indurre minaccia di aborto, distacco di placenta e morte fetale.

È consentita la malva impiegata per le sue proprietà idratanti, antinfiammatorie e per la dolce azione lassativa, dovuta alla capacità delle mucillagini di trattenere l’acqua. Il trattamento della stitichezza con la malva risulta non irritante e non violento, per cui è indicato oltre che in gravidanza, per bambini e per gli anziani.

Il lattulosio in gravidanza e allattamento si può assumere alle dosi indicate e solo in caso di necessità non essendoci studi di certezza sulla sua assoluta innocuità. Il farmaco deve essere diluito in almeno 2 bicchieri di acqua, assumere lontano dai pasti (>60’) e mai prima di addormentarsi.

La senna ha come effetto negativo la comparsa di crampi addominali ed è perciò controindicato in gravidanza.

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