Constipation After Surgery? Everything You Need to Know

A surgery, in itself, can be quite a painful process. The pain, discomfort, and anxiety before, during and after a surgery forces you to restrict yourself till your recovery is complete and it can be quite frustrating to feel weak and helpless during this time. Well, if you’ve ever had a surgery, then you probably already know that pain isn’t the only factor that can be quite frustrating post your surgery. As if all of the above-mentioned wasn’t unpleasant enough, using the washroom can also become quite traumatic, as one of the common major after-effects of surgery is constipation. Unpleasant as it may seem to discuss bowel movements, there’s no denying their importance! Your body goes through a lot of stress during surgical procedures. This stress may result in an inability or difficulty in passing stool. However, though this problem is quite bothersome, it can also be just as easily remedied as its occurrence!  

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Why Do You Face Constipation after Surgery?

It’s important to understand the cause of any problem before looking for its solution. Therefore, let’s take a look at why you may experience constipation after surgery at all:

Prescription Drugs

During and after surgery, you’re given painkillers to ease your pain and discomfort. This pain medication, also known as “opioids”, is a major cause of constipation as it decreases the movement of food through the intestine, leading to a delay in water removal from the body. Ergo, dry stools. Opioids are also known to negatively affect the urge to cleanse your bowels by decreasing gas secretions, which again increases the time your body takes to remove water. Most often, patients are also given antibiotics to prevent any infections, following surgery. Antibiotics can have a negative impact on your healthy gut-friendly bacteria (which are highly important for bowel movements), thereby inducing constipation.

Inactivity

This one is quite logical when you think about it. One of the major factors that help maintain healthy bowel movements is physical exercise. Being bed-ridden or physically less active after surgery inhibits the movement of waste through your intestinal tract and bowels.

Pre and Post-Surgery Diet

Sometimes, in order to prepare for an upcoming surgery, your doctor may advise you to change your diet. This can carry on to post-surgery as well, where you’re generally required to favor fluids and keep away from solid food for a couple of days. Such dietary changes can also adversely affect your bowel movements. Due to the lack of sufficient food, there is not enough stimulation for your digestive system to keep things moving. With no “food in”, there’s “no food out”! Due to insufficient fluids, any stool that you may be lucky enough to pass become hard and dry. Chances are you’ll also be depending on the hospital cafeteria for food rather than home-cooked food, which could also result in constipation due to the change.

Anesthesia

Relaxing as anesthesia is perceived to be, it actually works by paralyzing your muscles so that you don’t feel any pain when your doctors perform surgeries that can sometimes seem like medieval methods of torture (Though only when viewed by paranoid third parties as these surgeries are really quite life-saving!). Anyway, turns out that anesthesia, especially when it is general, stops food from being moved along the intestinal tract due to the paralysis of the muscles. Till the effects of anesthesia wears off, there is no stool movement.

Stress

Sometimes, the stress and anxiety of a surgical procedure can affect your bowel movements. Stress causes your digestion to slow down or even shut down in extreme cases, disrupting the absorption of food and water. Stress and anxiety can also adversely impact your appetite, thus resulting in dietary changes and ensuing constipation.

How Do I Know I Have Constipation?

Though the answer to this may seem highly obvious, symptoms of constipation can include:
  • Hard stools
  • Bloating or increased gas
  • Pain in the abdomen or rectal region
  • Still feeling full despite having passed stools
  • Less than three bowel movements a week
  • The need to strain during bowel movements
  • A sudden decrease in bowel movements
Bowel movements should ideally happen smoothly every single day. Thus, even if you’re passing stools, but only thrice a week, it can be a sign of constipation.  

Is There a Chance I Can Avoid This Pain?

Absolutely! Constipation isn’t an inevitability after surgery. The only answer to constipation isn’t treatment; prevention is also an answer. You can take several steps to ensure that you don’t have to go through major constipation issues post-surgery, such as:
  • Drink Plenty of Fluids: Though you may not feel like it, increase your fluid intake before and after surgery to let your body adjust to dietary changes. Avoid caffeine in any form, sticking to water and juices instead. Drinking warm water is a great way to help your intestine move things along.
  • Eat Plenty of Fiber: Fiber is one of the most important food groups for healthy bowels. Eat fruits and vegetables, especially in their natural forms, to reduce the risk of constipation. Avoid foods that cause constipation, such as meat and dairy. But ensure you don’t go overboard, as that can be counterproductive.
  • Eat Regularly: Surgery may take away your appetite but it’s important to have regular meals to keep your bowels moving. Even if you don’t feel like it, eat small, frequent meals to encourage digestive activity, for the sake of your bowels!
  • Physical Activity: As soon as you are able and your surgeon has given you the green light, start slowly exercising, such as taking a turn around your room or slowly walking the hospital corridors. This can help encourage bowel movements, but make sure you are under supervision so you don’t push yourself too much.
  • Medications: Your surgeon may also prescribe medicines that help stool movements such as stool softeners, to take along with the pain medication. Make sure you don’t self-prescribe, and follow your surgeon’s instructions to the “T”!
Also, slow down on your pain medication. Don’t keep popping pills every time you feel even the slightest pain. Make sure you only take the necessary amount. Not only does this reduce the impact on your bowels, but it keeps you from getting addicted to painkillers. Take it from us when we say only Gregory House can pull off painkiller addictions.  

But What If I Do Need Treatment?

Well, like we told you earlier, constipation can be easily remedied with a combination of the above preventive steps and a range of medication, such as:
  • Bulk Fiber Laxatives: Laxatives are medicines that help induce bowel movements. These particular laxatives add bulk to your stool, encouraging water retention in the colon (which is necessary for bowel movements). These may take anywhere between 12 hours to 3 days to act, so beginning right after surgery is a good idea.
  • Fiber Supplements: Though not medication per se, fiber supplements can help bowel movements by impacting them the same way natural fiber does. Taking fiber supplements with painkillers is a good idea, but don’t overdo the supplements as that can increase constipation.
  • Stimulant Laxatives: These laxatives stimulate bowel contractions to move the waste out. They often work within a few hours, so they can be taken as needed.
  • Suppositories: Suppositories are inserted into the rectum, and work as both a laxative as well as a stool softener. They cause the colon to contract and push out the stool, while softening it so that bowel movements become easier. This medication acts quite quickly. A
  • Stool Softeners: Also called “emollient laxatives”, these guys soften your stool by helping to mix in fluids, resulting in easier bowel movements. Generally used in the case of hard, dry stools despite normal bowel contractions, stool softeners act in 1-3 days.
  • Combination Laxative Stool Softener: This medication, as the name suggests, does the work of both a laxative as well as a stool softener. It induces bowel contractions and keeps the stool soft, generally taking effect within 6-12 hours. This makes them a great option for the day after surgery.
  • Enemas: Enemas involve the injection of liquids (generally water or saline) up the rectum and into the colon to stimulate bowel movements. Generally the last resort, enemas are usually tried only once before other treatments are sought out.
Most of these medications are available over-the-counter, but the importance of not self-prescribing cannot be stressed enough, as it’s better to stay safe than sorry in any case. It’s important to read directions carefully, or even better, consult with your doctor or a pharmacist before starting a course. If you still face constipation despite these treatments, medical care must be sought.  

Exercises That Help Reduce Constipation

Passing gas is one of the major good signs that indicate your constipation is reducing. You can help move things along by doing the following exercises which are believed to induce the passing of gas:
  • Pelvic Tilt: Lying on your back with your knees bent or sitting in the “diamond pose”, move your pelvis back and forth using your stomach and glutes. Make sure you keep breathing and repeat this 5 times.
  • Abdominal Tightening: Take a breath and then gently suck in your belly as you let it out. Follow this cycle 5 times, ensuring that you’re breathing and not holding your breath the entire time.
  • Bridge and Twist: Lying on your back with your knees bent, tighten your glutes and stomach muscles, slowly raising your hip off the ground. Holding this position, twist left and right and then slowly lower yourself. As this exercise is a little more intense, only do it 2-3 times or as per your comfort.
  • Bowel Massage: As the name suggests, massage your bowels with your fingers, by making small circles along the bowel. Make sure you move right to left and use two fingers with a gentle pressure to draw your circles. To make it more effective, lie on your left side while doing the exercise.
 

Complications From Constipation

If constipation is experienced for a prolonged period and still left untreated, it could result in a variety of complications. Constipation can result in a condition called “impaction”, which causes your stools to harden and dry to such an extent that you cannot perform bowel movements. The only solutions in such a case are enemas, surgery (in advanced cases) or “digital disimpaction” (where a doctor or nurse uses their fingers to dislodge the stool). Sometimes, straining during bowel movements can cause stress on the area of surgery, especially sutures and incisions. In extreme cases, incisions have known to open up. Open heart surgery patients can experience arrhythmia when straining during bowel movements. Severe cases of constipation can also result in the removal of segments of the intestine, resulting in the need for a colostomy. Constipation, “impaction” and straining can together result in rectal prolapse, hemorrhoids, shortness of breath and unusual heart rhythms.  

A Few Tips to Manage Constipation

If you are experiencing constipation after surgery, a few “do’s” and “don’ts” can go a long way in helping you find relief and comfort! Of course, it’s important to remember that all these tips are subject to your surgeon’s advice.

Do’s

  • Eat slowly and in small amounts, chewing your food well.
  • Try to walk after a meal and then ensure you sit up in a chair for 30-60 minutes instead of lying down.
  • Drink warm, non-caffeinated and non-sugary liquids.
  • Lie on your left side (as opposed to on your back) to help the movement of gas through your bowels.
  • Try to sit upright in a chair at least 3 or 4 times daily for at least 30 minutes.

Don’ts

  • Lie down immediately after eating. Wait for 30-60 minutes.
  • Eat foods that encourage constipation and gas such as cabbage, broccoli, meat, dairy and carbonated drinks.
  • Drink from a straw, as this results in intake of excess gas.
  • Stay in bed for long periods.
  • Don’t chew gum or suck hard candy.
Sometimes, a feeling of nausea is an accomplice to unhealthy bowels, especially when making the switch from a liquid diet to soft foods. Ensure you take plenty of liquid, eat small amounts of food, and chew well to help counter the feeling.  

The Tail End

Constipation can be quite painful and uncomfortable, especially if it becomes chronic. It could take you anywhere between 3-5 days to perform bowel movements after your surgery and if you’ve always valued regular bowel movements (as you should!), the time after surgery can be really frustrating. However, the frustration and annoyance that constipation causes are more serious than the condition itself when treated right. The above storehouse of knowledge can really go a long way in helping you recover from constipation but remember that only your doctor/surgeon can be your best source of advice and front line of defense, so always check with them first! Unless it’s your thing, having something stuck up your rectum can be nowhere close to being pleasurable. Treat your constipation today and enjoy the freedom!