Importance and methods of treating pregnancy constipation in conventional medicine and comparison with traditional medicine

Document Type : Review Article


1 PhD student in Traditional Medicine, Faculty of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran.

2 Assisstant Professor, Department of Traditional Medicine, Faculty of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran.


Introduction: Constipation is one of the most common complaints during pregnancy that significant percentage of pregnant women experience the onset or worsening of it during pregnancy. In this article, recommendations for constipation treatment during pregnancy were extracted from traditional medicine resources and conventional medicine databases and were compared.
Methods: In this review and library study, the recommendations related to pregnancy constipation were extracted from important textbooks of traditional medicine. Then, Persian and English articles of databases including Google scholar, Pubmed, Scopus, SID, Iranmed and Magiran were searched using the keywords of pregnancy, constipation, and the combination of two words and their equivalents in Persian with no time limitation. The results which were found in first stage obtained from traditional medicine sources were compared with the results which were obtained from the articles.
Results: In Iranian traditional medicine, it is believed that constipation treatment and using of laxative if needed during pregnancy can reduce many of the pregnancy complications. Recommendations related to pregnancy constipation in Iranian traditional medicine textbooks included: nutritional recommendations such as eating fatty soups, medicinal recommendations such as Cassia fistula and Rosa damascene, non-nutritional recommendations such as mild walking and enema, and contraindications and cautions such as avoidance of spicy, bitter and astringent foods. In conventional medicine similar to traditional medicine, first-line treatment for pregnancy constipation is diet and lifestyle change, and medication use is prohibited as much as possible.
Conclusion: The general approach for treatment of pregnancy constipation in traditional medicine resources is similar to conventional medicine, but the details of recommendations in traditional medicine resources didn’t have desirable level of evidences. Also, importance of constipation treatment during pregnancy is emphasized in traditional medicine resources that is worthy to do more studies in this field.


  1. Sanchez MI, Bercik P. Epidemiology and burden of chronic constipation. Can J Gastroenterol 2011; 25(Suppl B):11B-5.
  2. Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. BMJ Clin Evid 2010; 2010:1411.
  3. Cullen G, O'Donoghue D. Constipation and pregnancy. Best Pract Res Clin Gastroenterol 2007; 21(5):807-18.
  4. Keller J, Frederking D, Layer P. The spectrum and treatment of gastrointestinal disorders during pregnancy. Nat Clin Pract Gastroenterol Hepatol 2008; 5(8):430-43.
  5. Body C, Christie JA. Gastrointestinal diseases in pregnancy: nausea, vomiting, hyperemesis gravidarum, gastroesophageal reflux disease, constipation, and diarrhea. Gastroenterol Clin North Am 2016; 45(2):267-83.
  6. Bharucha AE. Constipation. Best Pract Res Clin Gastroenterol 2007; 21(4):706-31.
  7. Changavi F, Delfan B, Akbari S, Janani F. Evaluation of The effect of Cotoneaster on constipation during pregnancy. Aflak J 2008; 1(1):5-9. (Persian).
  8. Trottier M, Erebara A, Bozzo P. Treating constipation during pregnancy. Can Fam Physician 2012; 58(8):836-8.
  9. Mozaffarpur A, Mojahedi M. Explanation the definition of constipation and compare its different causes in Iranian traditional medicine and modern medicine. J Islam Iran Tradit Med 2012; 3(2):162-73.
  10. Elsagh M, Hadizadeh F, Mazaheri M, Yavari M, Babaeian M, Sharifi Olounabadi AR, et al. Constipation in traditional Iranian medicine. J Islam Iran Tradit Med 2012; 2(4):361-71.
  11. Avicenna A. The Canon of Medicine. Beirut, Lebanon: Alaalami Beirut Library Press; 2005.
  12. Arzani MA. Mofarreh Al-Gholob. 1st ed. Tehran: Almaee; 2012.
  13. Ahmadieh A. Raz-e-darman. Tehran, Iran: Eghbal Press; 2007.
  14. Azam Khan M. Exir Azam [Great Elixir]. Lucknow, India: Monshi Nou; 2008.
  15. Nejatbakhsh F. The rules of nutrition in disease based on Iranian traditional medicine. Tehran, Iran: Choogan; 2013. P. 767.
  16. Aqili khorasani S. Kholasa-al-Hikmat. Qom, Iran: Esmaeilian; 2006.
  17. Ahvazi AA. Kamel-al-Sanaat-al-tebbieh. Qom, Iran: Jalaleddin; 2008.
  18. Mokaberinejad R, Tansaz M, Bioos S, Jafari Dehkordi E, Akhtari E, Yousefi S, et al. Healthy pregnancy in perspective of iranian traditional medicine and its brief comparison with modern medicine. Iran J Obstet Gynecol Infertil 2014; 17(121):1-9. (Persian).
  19. Dabaghian FH, Siahpoosh M, Shirazi MT. Iranian traditional medicine views about prenatal care. Hist Med J 2016; 4(12):139-59.
  20. Arzani MA. Tebb-e-Akbari. Tehran, Iran: Institute of Medical History, Islamic and Complementary Medicine, Iran University of Medical Sciences; 2005.
  21. Dehestani Ardakani M, Jamali F, Momeni F, Rezayat A, Yavari M. Nutrition in pregnancy: from viewpoint of traditional medicine to new medicine. J Islam Iran Tradit Med 2013; 4(4):344-59.
  22. Jafari Dehkordi E, Sohrabvand F, Nazem E, Minaei B, Hashem Dabaghian F, Sadeghpour O, et al. Nausea and vomiting in pregnancy: revisiting their a etiologies and treatments in Iranian. Med Hist 2013; 5(14):33-48. (Persian).
  23. Mozaffarpur SA, Naseri M, Kamalinejad M, Esmaeili DM, Yousefi M, Mojahedi M, et al. Introduction of natural medicinal materia effective in treatment of constipation in Persian traditional medicine.. Med Hist 2011; 3(9):79-95. (Persian).
  24. Jorjani SI. Zakhireh Kharazmshahi (Treasure of Kharazmshahi). Tehran, Iran: Iranian Culture Foundation; 1976.
  25. Khorasani Shirazi MH. Makhzan-al-Advieh. Tehran, Iran: Bavardaran; 2001.
  26. Arzani MA. Mizan-al-Tib. Qom, Iran: Sama Cultural Institue; 2001.
  27. Aqili Khorasani MH. Qarabadin-e-Kabir. Tehran: Institute  for  Islamic  and Complementary Medicine of Iran University of Medical Science; 2008.
  28. Rhazes M. Al-havi. Tehran, Iran: International Academy of Medical Sciences; 2005.
  29. Rungsiprakarn P, Laopaiboon M, Sangkomkamhang US, Lumbiganon P, Pratt JJ. Interventions for treating constipation in pregnancy. New York: The Cochrane Library; 2015.
  30. de Carvalho ÉB, Vitolo MR, Gama CM, Lopez FA, Taddei JAC, de Morais MB. Fiber intake, constipation, and overweight among adolescents living in Sao Paulo City. Nutrition 2006; 22(7):744-9.
  31. Fernández-Bañares F. Nutritional care of the patient with constipation. Best Pract Res Clin Gastroenterol 2006; 20(3):575-87.
  32. Okubo H, Sasaki S, Murakami K, Kim MK, Takahashi Y, Hosoi Y, et al. Dietary patterns associated with functional constipation among Japanese women aged 18 to 20 years: a cross-sectional study. J Nutr Sci Vitaminol 2007; 53(3):232-8.
  33. Cass L, Frederik W. Malt soup extract as a bowel content modifier in geriatric constipation; a clinical study. J Lancet 1953; 73(10):414-6.
  34. Savino F, Maccario S, Guidi C, Castagno E, Farinasso D, Cresi F, et al. Methemoglobinemia caused by the ingestion of courgette soup given in order to resolve constipation in two formula-fed infants. Ann Nutr Metab 2006; 50(4):368-71.
  35. Malekzadeh F, Ansari R, Malekzadeh R. Approach to chronic constipation. Govaresh 2014; 19(1):7-13.
  36. Markland AD, Palsson O, Goode PS, Burgio KL, Busby-Whitehead J, Whitehead WE. Association of low dietary intake of fiber and liquids with constipation: evidence from the National Health and Nutrition Examination Survey. Am J Gastroenterol 2013; 108(5):796-803.
  37. Park M, Bang YG, Cho KY. Risk factors for functional constipation in young children attending daycare centers. J Korean Med Sci 2016; 31(8):1262-5.
  38. Wang X, Yin J. Complementary and alternative therapies for chronic constipation. Evid Based Complement Alternat Med 2015; 2015:396396.
  39. Fleming T. PDR for herbal medicines. New York: Thompson health care Inc; 2009.
  40. Hashem Dabaghian F, Taghavi Shirazi M, Amini Behbahani F, Shojaee A. Interventions of Iranian traditional medicine for constipation during pregnancy. Med Plant J 2015; 1(53):58-68.
  41. Pinkerton P. Psychogenic megacolon in children: the implications of bowel negativism. Arch Dis Child 1958; 33(170):371-80.
  42. Shemerovskii KA. Circadian rhythm of rectal reactivity in individuals with regular and irregular bowel evacuation function. Bull Exp Biol Med 2002; 134(6):565-7.
  43. Comas Vives A, Polanco Allué I. Case-control study of risk factors associated with childhood constipation. The FREI study. An Pediatr 2005; 62(4):340-5.
  44. Inaba R, Kurokawa J, Mirbod SM. Comparison of subjective symptoms and cold prevention measures in winter between traffic control workers and construction workers in Japan. Ind Health 2009; 47(3):283-91.
  45. Nagashima Y, Igaki M, Suzuki A, Tsuchiya S, Yamazaki Y, Hishinuma M, et al. Application of a heat- and steam-generating sheet increases peripheral blood flow and induces parasympathetic predominance. Evid Based Complement Alternat Med 2011; 2011:695095.
  46. Hosono K. Effects of abdominal warming on constipation among young female students. Clin Thermomet 2007; 25:1-4.
  47. Chen D, Xiong Y, Lin Y, Tang Z, Wang J, Wang L, et al. Capsaicin alleviates abnormal intestinal motility through regulation of enteric motor neurons and MLCK activity: relevance to intestinal motility disorders. Mol Nutr Food Res 2015; 59(8):1482-90.
  48. Palombo EA. Phytochemicals from traditional medicinal plants used in the treatment of diarrhoea: modes of action and effects on intestinal function. Phytother Res 2006; 20(9):717-24.
  49. Chung M, Choi E. A comparison between effects of aroma massage and meridian massage on constipation and stress in women college students. J Korean Acad Nurs 2011; 41(1):26-35.
  50. Nam MJ, Bang YI, Kim TI. Effects of abdominal meridian massage with aroma oils on relief of constipation among hospitalized children with brain related disabilities. J Korean Acad Nurs 2013; 43(2):247-55.
  51. Kim MA, Sakong JK, Kim EJ, Kim EH, Kim EH. Effect of aromatherapy massage for the relief of constipation in the elderly. Taehan Kanho Hakhoe Chi 2005; 35(1):56-64.
  52. Dugoua JJ, Seely D, Perri D, Koren G, Mills E. Safety and efficacy of chastetree (Vitex agnus-castus) during pregnancy and lactation. Can J Clin Pharmacol 2008; 15(1):e74-9.
  53. York NE, Borofsky MS, Lingeman JE. Risks associated with drug treatments for kidney stones. Expert Opin Drug Saf 2015; 14(12):1865-77.
  54. Argoff CE, Brennan MJ, Camilleri M, Davies A, Fudin J, Galluzzi KE, et al. Consensus recommendations on initiating prescription therapies for opioid‐induced constipation. Pain Med 2015; 16(12):2324-37.
  55. Tosun Güleroǧlu F, Gördeles Beşer N. Evaluation of sexual functions of the pregnant women. J Sex Med 2014; 11(1):146-53.
  56. Bielefeldt K, Tuteja A, Nusrat S. Disorders of gastrointestinal hypomotility. F1000Res 2016; 5:1897.
  57. Koloski NA, Talley NJ, Boyce PM. Does psychological distress modulate functional gastrointestinal symptoms and health care seeking? a prospective, community cohort study. Am J Gastroenterol 2003; 98(4):789-97.
  58. Guilfoyle P, O'Brien H, O'Keeffe ST. Delusions of pregnancy in older women: a case series. Age Ageing 2015; 44(6):1058-61.