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The postpartum period is when the mother's physiological and anatomical changes return to the pre-pregnancy state. It is divided into three arbitrary phases: acute phase (first 24 hours after placenta birth), early phase (first 7 days), and late phase (last 6 weeks to 6 months). Each phase has its own set of clinical issues and challenges. 
Postpartum gas is one of the common gastrointestinal problems that arise after the delivery. Itis characterised by bloating, belching, excessive passing of gas or farting post-delivery. The symptoms usually go away in some days or weeks, if not, it is an indication of pelvic injury or other underlying health condition.
In this article, we will discuss everything you need to know about postpartum gas. Take a look.
Causes Of Postpartum Gas
Postpartum gas is caused due to multiple factors such as underlying health diseases or an unhealthy lifestyle. Some of these factors are:
Constipation during postpartum is mainly caused due to the presence of the high placental hormone relaxin in the blood, laxity of the stomach wall and loss of body fluids. According to a study, the levels of progesterone and gastrin (that stimulates gastric acid secretion) are high post-delivery and may take around a few days to get to normal. Constipation results in bloating and flatulence problems, known as postpartum gas. 
2. Anal incontinence
Pregnancy and childbirth can stretch and damage the pelvic floor muscles and nerves. This may limit a person's ability to manage how much gas they pass. The anus is controlled by the back of the pelvic floor. According to a study, anal incontinence is linked to anal sphincter laceration or tearing of the anal muscles during childbirth. Anal injuries might result in a loss of gas control. 
3. Underlying medical conditions
Some of the underlying medical conditions like diverticulitis (small and bulging pouches in the digestive tract), Crohn's disease (a type of inflammatory bowel disease that causes inflammation of the digestive tract) and ulcerative colitis (an inflammatory bowel disease that results in inflammation and ulcers in the digestive tract), can cause postpartum gas in people with the condition. 
Episiotomy or perineotomy is a surgical cut in the vaginal opening during childbirth. To avoid tearing, the doctor makes a cut between the vaginal opening and the anus. An episiotomy is normal during vaginal delivery and might take a long time to recover. However, in some cases, it may weaken the pelvic floor muscles, resulting in anal incontinence symptoms such as postpartum gas. 
5. Unhealthy lifestyle
Postpartum gas is also a result of an unhealthy lifestyle. It is mainly caused due to consumption of foods like processed foods, candies, and high-fibre foods. Reducing the intake of these foods can help reduce gastrointestinal problems like postpartum gas. Though exercising soon after the delivery is not suggested, some activities like walking can be carried out.
6. Spontaneous vaginal delivery
A study talks about the detection of gas due to uncomplicated spontaneous vaginal delivery. The gas was detected in the endometrial cavity during the ultrasound. The study was conducted on 70 clinically healthy women in the US and postpartum gas was found up to three postpartum days to three postpartum weeks. 
Symptoms Of Postpartum Gas
Some of the symptoms of postpartum gas may include:
- Passing gas frequently.
- Abdominal pain
- Feeling that bowel is not cleared properly.
- The abdomen is abnormally swollen outward. 
Complications Of Postpartum Gas
The main complications of postpartum gas are:
- Social embarrassment
- Physical discomfort
- Continuous abdominal pain.
Women with underlying medical conditions like Crohn's disease or diverticulitis may experience weight loss and blood in the stools during the postpartum.
Diagnosis Of Postpartum Gas
Untreated postpartum gas for weeks or months needs medical attention. The doctor may ask for underlying medical conditions and other conditions like food allergies, celiac disease or lactose intolerance.
Treatment And Management Of Postpartum Gas
Treatment of postpartum gas is suggested if the symptom does not go away or gets worse after a few months. The treatment method is customised as per the symptoms and the source of the gas in a patient.
Some of the treatment methods may include:
- Stool softener: It includes prescribed medications like Colace (100 mg) to ease constipation in a short time. 
- Pelvic floor exercise: To repair pelvic floor injuries and recover from anal incontinence.
- Yoga: It includes yoga poses like triangle pose to improve digestion and release gas.
- Others: Include other healthy habits like drinking plenty of water and eating a healthy diet.
Postpartum gas is not a life-threatening condition; it usually goes away on its own within a few days or weeks with a healthy diet and mild physical activities like walking. Consult a medical expert if the symptoms persist for more than a week.
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