Constipation is an uncomfortable side effect following surgery. It arises from factors like general anesthesia, opioid pain medications, reduced physical activity, and dietary changes. While it adds to healing discomfort, it is typically temporary. Understanding its common occurrence helps patients prepare for and manage it.
Dietary and Hydration Strategies
Dietary adjustments and adequate hydration help manage post-surgery constipation. Increasing fiber intake through specific food choices adds bulk to stool, promoting smoother passage. Sources include fresh fruits like prunes and pears, vegetables, and whole grains such as oats and whole-wheat bread. Eating small, frequent meals also stimulates bowel movements.
Alongside fiber, consuming sufficient fluids softens stool and prevents dehydration, which worsens constipation. Aim for 8 to 10 cups (64-80 ounces) of water daily, unless directed otherwise by your healthcare provider. Warm liquids, such as herbal tea or clear broths, also stimulate bowel activity. Limit or avoid dehydrating beverages like caffeinated drinks and processed foods, which offer little fiber.
Gentle Movement and Positioning
Gentle physical activity, as permitted by your surgeon, encourages bowel movements after surgery. Light walking, even short strolls, stimulates the intestines and promotes natural movement of digested food. This increased activity helps restore normal bowel function and reduces the likelihood of constipation.
For individuals who cannot walk, changing positions in bed offers some benefit. Lying on your left side may help gas move through the bowels more easily. Sitting upright in a chair and performing gentle abdominal tightening exercises, if approved, also contribute to bowel motility. Always listen to your body and adhere to all post-operative instructions regarding activity levels to prevent injury.
Medication and Supplement Options
When dietary and movement strategies are not enough, various medications and supplements can help relieve post-surgery constipation.
- Stool softeners, such as docusate sodium, work by drawing water into the stool, making it softer and easier to pass. They are often recommended proactively to prevent hardening.
- Bulk-forming agents, like psyllium, absorb water in the intestines to create a larger, softer stool, stimulating bowel contractions. These require adequate fluid intake and may not suit those with opioid-induced constipation.
- Osmotic laxatives, such as polyethylene glycol (MiraLAX) or magnesium hydroxide (milk of magnesia), draw water into the colon to hydrate and move stool.
- Stimulant laxatives, including bisacodyl or senna, directly act on intestinal muscles to promote contractions and expedite bowel movements. They are generally used for more severe or persistent constipation when other options have not provided relief.
Always consult your healthcare provider before starting any new medication or supplement after surgery, especially if you are taking other prescribed drugs, to ensure safety and appropriate use.
When to Contact Your Doctor
While constipation after surgery is common, certain symptoms indicate a need for medical attention. Contact your doctor if you experience severe abdominal pain unrelated to your incision or if the pain worsens. Persistent nausea or vomiting also warrants medical evaluation.
Inability to pass gas or have a bowel movement for more than four days, despite home remedies, is a concerning sign. Other warning symptoms include a swollen or tender belly, fever, or blood in your stool. These symptoms could indicate a more serious complication, such as a bowel obstruction or ileus, requiring prompt assessment and intervention.