Constipation After Surgery: Tips to Prevent and Treat It
Is it normal to be constipated after surgery?
If you already suffer from constipation, it is important to mention this to your doctor and surgeon so that you may be proactive. This may include attempting to determine the cause of your constipation so you can start treating it before your surgery. And prevent recurrence or worsening of the constipation postoperatively. —Dr. Shria Kumar
Constipation after surgery is very common. It may even be the most common complication after surgery. Prevention is key. Once constipation occurs it can be more difficult to fix.
While constipation is often not serious, it can be uncomfortable—and even more so after surgery.
Bloating and gas can be painful. And straining to pass a bowel could affect the body’s healing. That is especially true if the surgery involved the abdominal area.
What helps with constipation after surgery?
There are several ways to treat post-surgical constipation. The best way is to try at least a few of these together. Also, you can get a jump-start by following this advice before the surgery to keep bowel movements softer and prevent constipation.
Just be sure to follow any directions your doctor gives you for restricting eating and drinking prior to the procedure.
- Get moving: As soon as your doctor or nurse gives you the ok, try walking. Physical activity stimulates your gut. Go for short walks a few times a day.
- If you aren’t yet allowed to get out of bed, ask if you can move your arms and legs. Try not to be laying down or seated for long stretches of time.
- When recovering at home, walk around the block. Check with your doctor about other light physical activity.
- Drink lots of fluids—six to eight glasses a day. This helps prevent dehydration by keeping stools softer.
- Have a cup of coffee: Studies show that coffee, both caffeinated and decaf, stimulates bowels. Drink a cup of coffee the day after surgery. But don’t drink too much. Caffeine can also be dehydrating, which worsens constipation.
- Eat a high-fiber diet, which adds bulk to your stool and draws in water to make it easier to pass. In general, foods high in fiber include whole grains, fruits and vegetables, and beans. Some very high-fiber options are oatmeal, lentils, popcorn, chickpeas and lentils, dark chocolate, avocado, and pears.
- Eat prunes and drink prune juice—a tried and true home remedy.
- Limit opioid-type pain medicine post-surgery as soon as possible. Opioids such as Percocet make you more likely to become constipated. When you no longer need an intense pain-killer, switch to an over-the-counter pain reliever like acetaminophen (Tylenol) or ibuprofen (Advil or Motrin). But make sure you check with your doctor first.
Most common symptoms
- Fewer than three bowel movements a week
- Straining to pass stool
- Lumpy or hard stools
- Feeling like the bowel is not empty or there is a blockage
- Bloating, gas, or pain
Constipation can progress to or be confused with postoperative ileus. Ileus is when a part of the intestines is not working properly leading to blockage of stool and/or gas. It is also important to differentiate constipation from a mechanical bowel obstruction, which is caused by something else (i.e. mass, adhesions, or scar tissue). —Dr. Kumar
Why does anesthesia cause constipation?
Constipation after surgery is caused by a combination of factors. General anesthesia slows down your digestive system, and the slower it is, the harder your stool. You may be given other medications during surgery that also slow your gut. And some pain medications like opioids, given after surgery, also slow digestion. In addition, not eating or drinking before and after surgery, lying in bed, and being inactive all can contribute to constipation.
Treatments for constipation after surgery
It may be a few days post-surgery before you have a bowel movement. If the other treatments aren’t kick-starting your digestive system, ask your doctor about laxatives.
- Stool softeners draw water from the intestines. They soften stool, making them easier to pass. They are usually taken at bedtime and work within six to eight hours. Stool softeners include docusate sodium (Colace).
- Fiber laxatives, such as psyllium (Metamucil), may be recommended, but speak to your doctor first. They are not typically recommended when constipation is caused by pain medications.
- Stimulant laxatives, such as bisacodyl (Dulcolax), cause the intestines to contract. They are also taken in at bedtime.
How long can you go without moving your bowels?
Constipation and gas pain can be very painful. And straining to have a bowel movement can lead to wound dehiscence (opening of surgical site). —Dr. Kumar
Let your doctor know if you’re constipated for more than a few days or having serious discomfort in your abdomen. While most of the time, the constipation will go away within a few days of following the recommended treatments, untreated constipation can lead to these mild to serious complications.
- Hemorrhoids. These are swollen veins around the rectum and can be caused from straining to pass stool.
- Tear to the anus (called an anal fissure) occurs when a large stool causes skin in the anus to tear.
- Blockage (called fecal impaction) is when a hard stool becomes stuck in the bowels
- Reopening of a surgical incision, which can happen when you have to strain to pass stool.
Dr. Kumar is a gastroenterologist, who completed her fellowship at the Hospital of the University of Pennsylvania in Philadelphia. She received her undergraduate degrees in Religious Studies and Chemistry from New York University (2010) and graduated from the Albert Einstein College of Medicine (2014), where she was inducted into the Alpha Omega Alpha Honor Medical Society. She is completing her therapeutic endoscopy fellowship at MD Anderson Cancer Center in Houston. She joined Buoy Health in 2020. She believes in the importance of patients being educated about their health, and joined Buoy in order to be part of a platform that helps disseminate clear and verified advice directly to patients.