Constipation following surgery is a common and uncomfortable experience. This temporary slowing of bowel function is a normal physiological response to the surgical process. Several effective strategies can help encourage bowel movements and promote a smoother recovery.
Understanding Post-Surgery Bowel Sluggishness
The digestive system slows down after surgery due to several factors. General anesthesia, for instance, temporarily impairs gastrointestinal motility by affecting the muscles and nerves that control bowel movement, a condition known as postoperative ileus. This effect can last for a few days as the intestines “wake up.”
Pain medications, particularly opioids, are a major contributor to sluggish bowels. Opioids bind to receptors in the digestive system, slowing the movement of food and waste through the intestines and increasing water absorption, which leads to harder, drier stools. Many patients taking opioids for pain relief after surgery report constipation as a side effect.
Reduced physical activity and immobility during recovery also play a role in slowing digestion. The body’s stress response to surgery and changes in diet, including restricted food or fluid intake, can further contribute to constipation. These combined effects create an environment where the bowels become less active than usual.
Effective Strategies for Encouraging Bowel Movement
Engaging in gentle physical activity as soon as medically approved can help stimulate bowel activity. Early ambulation, even short walks around the room or hospital hallway, promotes blood flow and encourages the intestines to regain their normal rhythm. Early mobilization can accelerate the recovery of gastrointestinal function, leading to quicker passage of gas and stool.
Adequate fluid intake is another important step in preventing and alleviating post-surgery constipation. Drinking plenty of water, clear broths, and diluted juices helps to soften stool, making it easier to pass. Dehydration can worsen constipation by causing the body to reabsorb more water from the stool.
Gradually incorporating fiber-rich foods into your diet, as tolerated and approved by your medical team, supports regular bowel movements. Foods such as prunes, prune juice, soft fruits, vegetables, and whole grains add bulk to stool and help it move through the digestive tract. Avoid foods that can increase constipation, such as dairy products, white bread, white rice, and processed foods.
Over-the-counter aids can be beneficial, but consult with your surgeon or nurse before taking any medication. Stool softeners, like docusate sodium, work by drawing water into the stool to make it softer and easier to pass. Gentle laxatives, such as milk of magnesia or polyethylene glycol, can help stimulate bowel movements. For opioid-induced constipation, specific medications may be prescribed that block the effect of opioids on bowel movement.
When to Contact Your Doctor
While post-surgery constipation is common, certain symptoms require medical attention. Contact your doctor if you have no bowel movement for more than three to five days post-surgery, especially if advised a specific timeframe by your surgeon. Prolonged absence of bowel movements can lead to complications such as fecal impaction or bowel obstruction.
Other concerning symptoms include severe abdominal pain or cramping that worsens, significant abdominal bloating, and persistent nausea or vomiting. A fever alongside these symptoms also indicates a need for medical evaluation. Any rectal bleeding or black, tarry stools should be reported to your healthcare provider. Always prioritize your surgeon’s specific post-operative instructions, as this information is general guidance and not a substitute for professional medical advice.