Post-operative discomfort from trapped gas is common after surgery, often causing bloating and pressure in the abdomen and sometimes the shoulder. This pain is generally a temporary and expected side effect of the procedure and the medications used. Understanding the causes of this gas buildup and applying gentle strategies can significantly improve comfort during recovery.
Why Gas Builds Up After Surgery
The primary reason for gas accumulation is a temporary slowdown in the movement of the digestive tract, known as delayed gastric motility or post-operative ileus. General anesthesia temporarily suppresses the intestinal muscles that normally propel gas and waste forward. Opioid pain medications also contribute to this effect by slowing down the smooth muscle activity of the digestive system, often leading to constipation and gas retention.
Another major source of gas, particularly following laparoscopic procedures, is the carbon dioxide used during the operation. Surgeons inflate the abdominal cavity with this gas to create space for visibility and instrument maneuvering. Residual gas can irritate the diaphragm, causing referred pain that patients often feel in their shoulder or chest, since the phrenic nerve connects these areas.
Movement and Positioning Strategies for Relief
The most effective way to stimulate the digestive system and encourage gas expulsion is through gentle movement. Short, frequent walks around the room or hallway are highly recommended, even if they are slow. This activity helps the body reabsorb residual surgical gas and promotes the natural peristaltic action of the bowels.
Changing body positions can use gravity to help shift trapped pockets of gas. Lying on your left side with your knees bent is particularly helpful for encouraging gas movement through the colon. Gentle rocking while sitting upright or performing leg-raising exercises while lying down may also help contract the abdominal muscles and facilitate release.
If cleared by your surgical team, a gentle abdominal massage may provide relief. Apply light pressure in a circular motion, following the path of the colon: from the right side of the abdomen, up toward the ribs, across the upper abdomen, and down the left side. Applying a warm compress or heating pad to the abdomen can help relax the muscles and soothe discomfort, but avoid direct placement on surgical incisions.
Adjusting Diet and Hydration
Hydration is crucial for managing post-operative gas and preventing constipation. Drinking non-carbonated liquids, such as water or herbal teas like peppermint or ginger, helps relax the digestive tract and keeps the system moving. Avoid drinking through a straw, as this causes you to swallow excess air.
When reintroducing food, begin with easily digestible, low-fiber options like clear liquids, broth, or toast, and chew thoroughly to minimize air swallowing. Gradually increase your fiber intake to prevent constipation, but temporarily avoid highly gas-producing foods, such as beans, broccoli, cabbage, and carbonated beverages. Over-the-counter aids containing simethicone may be approved by your doctor to help break down gas bubbles in the gut.
Knowing When to Contact Your Doctor
While some gas discomfort is expected after surgery, certain symptoms require prompt medical attention to rule out complications like a prolonged ileus or obstruction. Contact your healthcare provider if you experience an inability to pass gas or have a bowel movement for more than two to three days after the operation.
Other red flags include severe, persistent abdominal pain that does not improve with prescribed pain medication, or pain that progressively worsens. Vomiting, especially if it is bile-colored or you are unable to keep any fluids down, is a serious sign. A fever above 100.5°F or chills also require prompt medical evaluation.