Why It Occurs and How to Treat It
Your body endures a lot during surgery.
It may not be surprising, then, to hear that people often have bouts ofconstipationafter surgery.
Constipation happens when stools are dry or hard and you have trouble passing them.
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There is no rule for how often you should have a bowel movement.
Constipation shows up when your bowel movements are less frequent than what is normal for you.
What Causes Constipation After Surgery?
There are a few reasons why surgery patients are prone to constipation.
The most common culprit is the prescription drugs given for pain relief.
Pain Medication
Opioidsare a powerful pop in of pain medication.
These drugs are often givenafter surgery for paincontrol.
Unfortunately,constipation is a well-known side effectof all opioids.
Opioids slow the movement of food through the intestinal tract.
This gives the body more time to remove water which can lead to a drier than typical stool.
Opioids may also increase the amount of water absorbed from the gastrointestinal tract.
Finally, opioids may decrease the urge to have a bowel movement.
This also allows more time for the body to remove water.
Food and Drink After Surgery
You may have been instructed not toeat or drink before surgery.
After surgery, you may have been told to drink only small amounts.
You may also have been told not to eat at all for a day or two.
Too little fluid and no food can work against your bodys normal routine of elimination.
Too little fluid in the body means less fluid in your stools.
This can cause hard, dry bowel movements.
Food stimulates the digestive system and keeps things moving.
If you aren’t eating, food in, food out doesnt work as well.
Your food choices may have also changed after surgery.
Even the food you ate in the hospital may be a major change from your normal diet.
These kinds of changes can cause constipation.
Inactivity
Physical activity can help trigger a bowel movement.
After surgery, you spend most of your time in bed recovering.
This can slow down your bowels.
Anesthesia
Anesthesiaparalyzes your muscles.
This stops movement in the intestinal tract.
Until your intestines “wake up,” there is no movement of stool.
These tips will help you stay regular and avoid discomfort as much as possible.
Medications
Your surgeon may prescribe astool softenerto take along with your pain medication.
Be sure to follow your surgeon’s instructions even if you have never had constipation before.
For example, abowel stimulantmay be too hard on your body after surgery.
Common types of anti-constipation therapies include:
Drink More Fluids
Drinking more fluids can help prevent constipation.
Instead, choose beverages like water and juice.
These will keep you well hydrated and lower your risk of constipation.
Fluids can also help you recover after developing constipation.
Remember to take your pain medication with water.
Keep drinking water throughout the day.
The recommended daily intake of water is typically about 64 ounces.
This may not be enough when taking opioids.
Eat More Fiber
What you eat can increase or decrease your risk of constipation.
Increase your fiber intake by eating fruits and vegetables.
It is best to eat fruits and vegetables in as close to their natural state as possible.
A whole orange, for example, provides more fiber than pulp-free orange juice.
you’re free to also add fiber to your diet withfiber supplements.
Remember, though, that adding supplemental fiber can increase constipation if you’re not drinking enough water.
Avoid foods known to cause constipation.
Cheese, for example, can cause constipation.
So can a diet with lots of meat and few fruits and vegetables.
Regular Meals and Snacks
Your body naturally eliminates stool when more food is introduced.
This is why many people have a bowel movement after breakfast.
Food goes in, so stool must go out.
This is also why small, frequent meals can help you have regular bowel movements.
Physical Activity
Physical activity can decrease the risk of constipation.
This can be something as simple as walking.
It is important, though, to follow your surgeon’s instructions if you have limits on exercise.
Complications of Constipation
You will feel more comfortable if you’re free to avoid post-surgical constipation.
There are also other reasons why you will want to prevent it.
Constipation can progress toimpaction.
This takes place if the stool is so hard and dry that you cannot have a bowel movement.
Sometimes, segments of the intestine must be removed.
This often means the patient will need acolostomy.
Constipation and impaction can lead to straining.
Straining may stress both internal and external incisions.
In extreme cases, it cancause the incisions to open.
Open heart surgerypatients can be at particular risk.
For these patients, straining to have a bowel movement may cause heart rhythm changes.
It is common after surgery.
Pain medication, what you eat and drink, inactivity, and anesthesia can all contribute to post-surgery constipation.
It is best to avoid developing constipation since it can lead to impaction.
This is when your stool is so hard that you cannot pass it.
Straining can also lead to problems like unusual heart rhythms and hemorrhoids.
you could help prevent constipation after surgery by taking medications as recommended by your doctor or surgeon.
Drinking more fluids and eating more fiber can also help.
Eat regular meals and snacks and stay active if your doctor approves.
If you do develop constipation, increase your fluid intake and eat more fiber.
Your doctor can recommend medications that may also help.
HSS.Tips for managing constipation after surgery.
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2013;26(03):186-190.
National Institute of Diabetes and Digestive and Kidney Diseases.Treatment for constipation.
Obokhare I.Fecal impaction: a cause for concern?Clin Colon Rectal Surg.
2015;21(5):598-604. doi:10.1111/ijn.12312
