Managing Constipation after Bariatric Surgery

Life after bariatric surgery can have many challenges from learning to eat and drink differently, a new routine with vitamins and mineral supplements, ensure adequate hydration and exercise, but many patients also struggle with constipation in the first few months after surgery.  And it is not uncommon to struggle with constipation for up to six months post-surgery.

How do I know if I am constipated? – You should have a bowel movement at least every 3 days after surgery that are soft and easy to pass.

Common Symptoms

1. Cramps or Stomach pain
2. Not passing gas
3. Nausea
4. Bloating
5. Feeling like you need to go, but can’t go

If you are not having a bowel movement at least every 3 days or if going becomes painful or uncomfortable, it is time to consider contacting your doctor.  In the meantime, try some of the measures below as well.

Why does constipation occur? – It is a combination of reasons usually after bariatric surgery.  Anesthesia and pain medications often lead to constipation.  Other causes, include a smaller stomach size which limits water intake at first.  Fiber intake in the first 1-2 months after surgery is also limited.  Increased protein intake and dietary supplements such as iron also increase constipation after bariatric surgery.

A few tips to help manage constipation after surgery:

 Ensure that you are well hydrated daily with noncaffeinated beverages – this will help soften your stools.   Many patients struggle with hydration as you need to sip on liquids throughout the day after surgery.  If you are struggling to drink the recommended 64 ounces of liquids daily, set a timer on your watch or phone for every 9 minutes to remind you to take a drink.

Move your body – you will likely have a lifting restriction after surgery, but most patients have no restriction on their activity.  Try to move your body regularly, even in small bursts to help with bowel movements.  Please be sure to check with your doctor before beginning a new exercise program after bariatric surgery.

Avoid certain foods like – rice, bananas, and potatoes as this can increase constipation

Increase certain other foods like – diluted prune juice or healthy fats (avocados or olive/flax oil drizzled over your food) as this will help encourage things to move along more smoothly.  You can also try warm water with lemon as well as ginger or mint tea to help relax the muscles of the digestive tract.

Medications – please speak to your health care provider first before starting a laxative like MiraLAX or Milk of Magnesia or a stool softener.  You may also need to use a suppository or enema.  All of these are commonly used after surgery.

Related Posts:

Maintaining Hydration after Bariatric Surgery

Building a Healthy Gut Microbiome

Managing Gas after Weight Loss Surgery