Constipation is a common occurrence during pregnancy. The American Pregnancy Association estimates half of all pregnant women experience constipation at some point. Constipation during pregnancy is often due to physical, hormonal and lifestyle changes. For instance, the uterus enlarges and puts pressure on the lower intestines and rectum, narrowing the intestines and increasing bowel transit time. Additionally, progesterone levels rise, relaxing smooth muscle and slowing the peristaltic movement of the intestines.
Decreased physical activity and increased iron supplementation can also contribute to constipation. Moderate physical activity stimulates the bowels. Iron supplements may draw in water from the lower gastrointestinal tract, making stools harder and more difficult to pass.
San Jiao 6 and Stomach 36
Acupuncture can provide constipation relief while maintaining a healthy pregnancy. A combination of San Jiao 6 (Zhi Gou) and Stomach 36 (Zu San Li) is excellent for treating constipation during pregnancy. San Jiao 6 is the shu-stream and fire point of the San Jiao channel. It can regulate the qi of the three jiaos, unblock the qi of the fu organs, descend counterflow fire, open the orifices, activate the collaterals to disperse stagnation, and eliminate distention to stop pain.
Stomach 36 is the shu-stream, earth point, and the lower he-sea point of the Stomach channel. It can regulate the intestines and stomach, regulate qi to eliminate distention, move qi to stop pain, invigorate the spleen, harmonize the stomach, eliminate accumulation and remove stagnation, promote urination to eliminate edema, transform phlegm to stop coughing, descend qi to relieve asthma, harmonize qi and blood, harmonize the stomach for more peaceful sleep, and strengthen and invigorate the body.
When treating constipation, San Jiao 6’s ability to unblock the qi of the fu organs, and Stomach 36’s ability to descend stomach turbidity, are the most important point actions. The combination of San Jiao 6 and Stomach 36 provides complementary unblocking and descending functions.
Moreover, this combination has the benefits of harmonizing the shao yang, regulating the spleen and stomach, and invigorating the middle jiao. Finally, Stomach 36 tonifies middle jiao qi, strengthening the earth element. This can support the developing fetus and mitigate the risk of miscarriage.
The combination of San Jiao 6 and Stomach 36 is gentle yet effective. It is a balanced approach that addresses both excess and deficiency, unblocks and descends, tonifies qi and fortifies the middle jiao. These attributes make the combination particularly suitable for treating constipation that arises during pregnancy.
Supplemental Points
San Jiao 6 and Stomach 36 can be supplemented with more points to treat underlying conditions contributing to constipation. For qi deficiency: moxibustion on Ren 6 (Qi Hai). For yang deficiency with exuberant cold: Stomach 25 (Tian Shu) and Ren 6 (Qi Hai). Long needle retention time and ample moxibustion on these two points are recommended.
For insufficient jing and blood or fluid consumption leading to intestinal dryness: Kidney 3 (Tai Xi) and Liver 3 (Tai Chong). For excess heat: Large Intestine 2 (Er Jian) and Stomach 44 (Nei Ting).
Additional Recommendations
Lifestyle recommendations are also useful when addressing constipation. Eating a high-fiber diet helps the body create bulkier stools that are easier to pass. The daily recommended intake for dietary fiber is 25-30 grams. Adequate water intake is a must, especially when eating more dietary fiber. The daily recommended intake for fluids is 10 to 12 cups. Moderate exercise three times a week for 20-30 minutes also assists with regular bowel movements.
Finally, changing how patients take iron supplements can mitigate constipation. Patients may need to reduce, eliminate or modify their iron dosage. Taking iron in smaller doses throughout the day or with 8 ounces of water or orange juice may help.
Resources
- Constipation During Pregnancy. American Pregnancy Association, July 27, 2020.
- Parvataneni S, Maw M. Ileus due to iron pills: a case report and literature report on the importance of stool softeners. Cureus, 2020;12(6):e8392.
- Porter R (editor). The Merck Manual, 20th Edition. Merck Sharp & Dohme Corp., 2018.
