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Most people experience no serious problems after weight loss surgery, however one common complaint after weight loss surgery is constipation.  Constipation is usually defined as the inability to pass feces or having difficulty passing feces, because it is dry or hardened.  Having hard stools or bowel movements that occur less than once a week is considered being constipated.  Some people believe they are constipated or irregular if they do not have a bowel movement every day. After weight loss surgery, bowel movements may or may not be as frequent as before surgery.

In most cases, post-bariatric surgery constipation is temporary and not serious. Understanding the causes, prevention and treatment will help most people find relief.

Constipation becomes more severe the longer it lasts.  As the length of time between bowel movements increase, more water is absorbed back into the bloodstream, causing the stool to harden in the colon (large intestine).  The body has 28 feet of intestines.  Gas and pain may be associated with constipation.

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

  • A reduction in food and drink consumption
  • Iron supplements
  • 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 bariatric 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: Sitting around too much will cause the stool to sit in the colon too long. 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.

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.  Using the generic form is much less expensive.

If your problem is still not resolved, you may use a Dulcolax suppository, Fleets enema or Milk of Magnesia.

If you still have a problem, don’t hesitate to call your surgeon’s office.
DO NOT TAKE LAXATIVES  on a regular basis. Your bowels can become dependent on these medications and normal bowel movements may not resume.

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 complete evaluation.

That being said, most instances of constipation during the first three months after weight loss surgery are usually attributed to the surgery itself. This is a common side effect of all weight loss surgery types (Lap Band, Gastric Sleeve and Gastric Bypass).

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