IBS and Bowel Problems After Childbirth

Many women find that their bodies are never quite the same following pregnancy and childbirth. Of all of the changes, few are as upsetting as experiencing difficulties with bowel urgency and fecal incontinence post pregnancy. Learn more about what may be causing such bowel urgency and incontinence difficulties, what can be done to address the problem, and how one can reduce the risk of this problem worsening with a future pregnancy.

Mother with newborn baby
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Possible Symptoms

Following pregnancy and childbirth, some women experience the following symptoms:

  • Bowel urgency: Strong urges to defecate, with a feeling of an immediate need to get to a toilet.
  • Passive fecal incontinence: Stool leaks out without one knowing.
  • Urge fecal incontinence: Awareness of urge to defecate, but stool leaks out before one is safely on a toilet.
  • Post-defecation leakage: Stool leaks out after a bowel movement. This is the rarest of all fecal incontinence symptoms.

How Often Does This Happen?

If you are experiencing such symptoms, it may ease your mind somewhat to know that you are not alone. Estimates as to how many women experience symptoms of bowel urgency and fecal incontinence following childbirth vary considerably, with estimates ranging from 3% to as high as 29%. Having a cesarean section is, unfortunately, not a guarantee that one will not experience urgency and incontinence problems. One study found a prevalence rate of 5% of fecal incontinence in a study of first-time mothers who delivered via cesarean section.

Why Does This Happen?

There are a variety of factors that raise one's risk of experiencing urgency and incontinence problems following childbirth:

  • The risk is much higher with first-time deliveries. The risk of ongoing problems lessens significantly with subsequent pregnancies.
  • Damage to anal sphincter muscles during delivery.
  • When an episiotomy is utilized. Research on the subject is somewhat limited due to the small number of people involved or a lack of distinction among tear types in the studies that have been conducted to date. Given that, there appears to be some evidence that women who have had fourth-degree episiotomies and tears appear to be at highest risk, most likely due to the involvement of the rectal muscles. However, ongoing bowel problems may happen with an episiotomy or tear.
  • When forceps are used during delivery.
  • Just undergoing a pregnancy itself puts one at risk. Pregnancy raises the risk of developing pelvic floor dysfunction, a predominant cause of fecal incontinence.

What You Can Do About It

The most important thing to do is for some people the hardest: Tell your healthcare provider! Your healthcare provider is in the best position to evaluate your symptoms, pinpoint the problem, and rule out other reasons why this might be happening.

The use of exercises for the pelvic floor can be helpful, particularly in the first year following childbirth. Biofeedback also has some research support as an effective treatment for fecal incontinence.

How to Prevent Long-Term Problems

Unfortunately, fecal incontinence problems stemming from pregnancy and childbirth can show up years afterward. Luckily, there are steps that you can take to reduce your chance of long-term problems:

  • Maintain a healthy weight.
  • Stay physically active.
  • Eat a healthy, nutritious diet.
  • Don't smoke.
  • Practice Kegel exercises.

Frequently Asked Questions

  • Do bowel habits change after pregnancy?

    It's common for bowel habits to change after pregnancy. Trauma to pelvic floor muscles from childbirth can lead to urinary or bowel incontinence. Many factors such as uterine contractions, medications, or stress may contribute to constipation or loose stools.

  • Is it normal to have digestive problems after pregnancy?

    Digestive issues, constipation, and incontinence are common post pregnancy. Bring it to your healthcare provider's attention. They may be able to help identify potential factors and suggest strategies, such as dietary changes or pelvic floor physical therapy, that may be helpful.

  • Can you develop IBS after giving birth?

    You can develop irritable bowel syndrome at any time and the cause it unknown. There is no evidence that it is more likely to develop or worsen after giving birth, but it does commonly begin before age 35.

  • What helps postpartum diarrhea?

    Drink plenty of fluids. You may want to temporarily avoid foods that may speed up intestinal contractions, such as greasy or fatty foods, and add binding foods, such as bananas and rice.

    If your diarrhea is accompanied by a fever or chills, seek urgent medical care since this can be a sign of infection or other complications.

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7 Sources
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