Written by: Debbie McDougall

One of the most common complaints people have after weight loss surgery is constipation.  ‘What is constipation?’, you may ask. Constipation is generally defined as a condition in which there is difficulty in emptying the
bowels, usually associated with hardened feces. Having hard stools or bowel movements that occur less than once a week is considered constipation. Some people believe they are experiencing constipation if they do not have a bowel movement every day. After weight loss surgery, bowel movements may or may not be the same as before surgery which is usually a normal side effect.

In most cases, constipation is temporary without serious complications. That being said, understanding the causes, prevention and treatment will help in gaining knowledge to put one’s mind more at ease. Constipation can become more severe the longer it lasts.  As the length of time between bowel movements increases, more water is absorbed back into the bloodstream, causing the stool to harden in the colon (large intestine) which usually comes with a bit of discomfort. High amounts of gas may also be associated with certain levels of constipation.

In many cases, constipation after weight loss surgery is caused by the following:

  • A reduction in food and drink consumption
  • Iron supplement
  • Medications such as tranquilizers, chronic pain meds or antidepressants
  • Weak abdominal muscles
  • The use of narcotic pain medications during the early post-op phase. (These meds are discontinued as soon as possible after surgery as to not contribute to constipation.)
  • Not drinking enough water: Adequate fluid intake will moisten the stool and keep the feces moving.
    • *Make sure you consume 48-64 ounces of water daily. In the beginning, it is difficult to consume this much water.
  • Avoiding diuretics such as caffeine.
  • Lack of exercise:
    • *This is one of the reasons we stress walking as soon as possible after surgery and until you may exercise (one month).
  • Inadequate fiber intake; When you are back to a regular diet, make sure you have some high fiber foods in your diet.
    • *Beans, oatmeal, fruits with skin, vegetables and whole grains are good examples of fiber containing foods.

For additional remedies that are easily exercised in the comfort of your own home, visit http://everydayroots.com/constipation-remedies to view 16 simple, and proven effective on a case-by-case basis, home remedies that assist with relieving constipation.

Because of potential problems with hemorrhoids, hernias and intestinal blockages, it’s important to prevent constipation before it happens. If you are on an iron supplement, it may be necessary to take a stool softener for the first month or so until you can drink more fluids and eat more fiber. Stool softeners such as Colace are available over–the-counter.

If you find your constipation problem continues, you may use a Dulcolax suppository, Fleets enema or Milk of Magnesia. If the problem continues to present itself, do not hesitate to call your surgeon’s office. Special note: DO NOT TAKE LAXATIVES on a regular basis! Your bowels could become dependent on these medications and normal bowel movements may not resume.

Although most instances of constipation in the first three months after weight loss surgery is usually attributed to the surgery, it is important to recognize that
some bowel function problems are not related to bariatric surgery and a relationship should not be automatically assumed.  A recent change in bowel function that is NOT readily attributable to the bariatric operation or that is not easily corrected may require further diagnostic measures for a complete evaluation.

(images: Kriti Malik, NDTV & Forest County Health Dept.)