Constipation After Surgery

All surgeries can be stressful and constipation is often a distressing side effect that complicates the healing process, and makes you feel even more uncomfortable. What's even worse is chronic constipation that can persist for several weeks after surgery.

Constipation is generally defined as an abrupt decrease in bowel movements, or having three or less bowel movements per week. Symptoms of constipation may also include straining, bloating, compacted stools, and/or increased abdominal and rectal pain.

What Might Be Causing Your Constipation After Surgery?

The post-surgical period comes with many risks for constipation. Exactly what are the factors that cause constipation, and why does it happen?

1. Lack of Mobility

There is a link between inactivity and constipation. Depending on the type of surgery you have undergone, your surgeon may order you to restrict your movement for a few days, to aid in the healing process. Certain physical activities, such as those related to the legs and lower trunk, will have an influence on bowel activity. This lack of mobility that restricts walking or standing for a few days may be enough to trigger constipation after surgery.

2. Painkllers

Potent painkillers, particularly opiates like codeine, decrease peristaltic activity in the gastrointestinal tract. Intestinal peristalsis is the wave-like motion (motility), which takes place in the intestines responsible for moving food material forward, and if it remains in the intestines too long, stools may become dehydrated, compacted, and hard to pass. If you are already prone to constipation, you will want to ask your physician whether you will need painkillers after post-surgery, and how often you may need to take them.

3. Anesthetic Agents

General anesthesia, including benzodiazepines and barbiturates can cause constipation after surgery,because benzodiazepines, when locked onto the receptors in the gut, would slow down the bowel movement in the digestive tract. Most anesthetics also depress the central nervous system, which has a direct impact on the intestine's motility.

4. Lack of Proper Nutrition

Surgery creates two significant disruptions to your dietary routine. Pre-surgery, you will likely be asked to follow a special diet, and to refrain from eating and drinking for a period of time. No food or fluids, other than water, disrupts the intestinal rhythm, and may create constipation after surgery when normal eating is resumed. Furthermore, you may feel nauseated and not eager to eat post-surgery, and when you do feel like eating, you may develop constipation from taking medication for pain.

5. Other Causes

Other causes may include feeling stressed out from the surgery, because any changes in your daily routine can affect bowel function. Constipation is also sometimes caused by a fluid, glucose, or electrolyte imbalance. More often than not, you may develop constipation resulting from infection or trauma after surgery, which extends the amount of time your body takes to heal.

How to Relieve Constipation After Surgery

Dietary and lifestyle changes can help prevent constipation after a surgery or lessen its duration.

1. Watch Your Diet

  • Drink plenty of water a few days before your surgery and post-surgery. A high fiber diet helps avoid being constipated before the surgery. You might also want to consume prune juice or prunes after your surgery.
  • If you are not taking a fiber supplement, and think that you are not getting enough fiber from foods, talk to your physician about adding a fiber supplement to your diet. Just remember to take the fiber supplements as directed.
  • Limit foods high in processed sugars and fats. These include hamburgers, French fries, candy and cookies. Avoid foods that make you constipated, such as processed foods, bananas, dairy products, rice, and white bread.

2. Move a Bit

  • Post-surgery, and when your health care provider says it's okay, you will want to slowly resume your normal activities.
  • Begin walking as soon as possible, and try to walk a little further every day.
  • With your health care provider's approval, begin some kind of regular exercise.

3. Medications

  • Plan on taking a stool softener, and/or a fiber laxative after surgery, and purchase the products before your surgery so it is readily available when you return home.
  • If over-the-counter laxatives aren't enough, consult your healthcare provider. You may require suppositories, stimulant laxatives, or an enema to produce a bowel movement. When you have severe constipation after surgery, prescription drugs that draw more water into your intestines may help alleviate the problem.
  • Limit your use of narcotic pain relievers, and consult with your physician about when you can use acetaminophen or ibuprofen instead.

4. Additional Tips

  • Use the bathroom when you have the urge to instead of holding it in.
  • Try drinking hot liquids to kick-start a bowel movement.
  • Do not take medications without talking to your physician first.
  • Keep track of how often you have a bowel movement. If bowel movements suddenly decrease, consult your caregiver about medications that prevent constipation, and follow the directions of your healthcare provider.

When to Get Medical Help

Constipation can be painful, and potentially serious medical complications can occur if untreated. These might include:

  • Rectal prolapse (rectal walls protrude out the anus)
  • Anal fissures (small tear in tissue)
  • Fecal impaction (hard stools)
  • Hemorrhoids (swollen vein)

The time that it takes for you to feel some relief from constipation after surgery may be affected by how long you were under anesthesia. The amount of time using narcotic painkillers can also affect recovery time. However, most people usually get relief within a couple of days when taking fiber laxatives or stool softeners. Suppositories and stimulant laxatives usually work within a day. If it doesn't, notify your physician so that other measures may be taken. Other reasons to get medical help include:

  • Abdominal pain not directly related to a surgical incision
  • Rectal pain
  • Rectal bleeding
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