Surgery can lead to constipation.
When it comes to healing after surgery, many patients worry about dealing with pain and nausea, says Dr. Constance Chen, a breast reconstruction specialist and plastic surgeon in New York City. But some people have to deal with another post-operative issue: constipation.
“General anesthesia and postoperative narcotics slow down the gastrointestinal system,” Chen says.
Some types of anesthesia can paralyze the muscles, which can make it difficult for food to move along the intestinal tract, she says. Opioids, which are often provided to patients to manage pain, also slow the movement of food and may increase the amount of water absorbed from food, which can make the stool drier and harder.
Other post-surgical factors
Post-surgical constipation is very common, and while it’s often a side effect of anesthesia or pain medication, other factors can cause it, says Dr. Christine Lee, a gastroenterologist at Cleveland Clinic.
The following can also lead to post-surgery constipation:
— Physical immobility.
If you’re planning to undergo surgery, experts recommend these seven strategies to prevent or reduce post-surgery constipation:
Talk to your doctor.
If you have a history of constipation, bring it up with your doctor before the surgery so he or she can help you develop a plan to minimize its effects, Chen says.
“There’s no timetable or formula for determining when your bowel habits have returned to normal,” Chen says. What’s normal is going to be different for everyone, “but most people know when they feel better.”
Be sure you’re not constipated just before the surgery.
Being constipated before your procedure could add to post-surgery constipation, Lee says.
If you’re irregular in the weeks or days leading up to your procedure, use stool softeners or gentle laxatives to get your gastrointestinal system functioning.
You could also try these other strategies to relieve constipation:
— Exercise regularly.
— Eat at least 20 to 35 grams of fiber daily.
— Consume fiber supplements.
— Start each day with a hot drink, like coffee or tea.
— Consume yogurt, which can be a good source of probiotics that help relieve constipation.
Drink plenty of water before and after your procedure.
Consuming lots of water and other fluids before and after surgery can help you stay regular, Lee says.
She notes that after surgery some patients may experience low-grade fever or a rise in body temperature that can add to loss of bodily fluids. “Be proactive and make sure you’re well-hydrated,” Lee says.
As soon as possible, eat foods that are high in insoluble fiber.
Depending on the type of surgery you undergo, your diet may be restricted for a few days. But if your doctor doesn’t put any restrictions on your eating regimen, consume as much insoluble fiber as you can, suggests Melissa Hooper, a registered dietitian based in the Los Angeles area.
Foods high in insoluble fiber include vegetables, fruits (including the skin), beans, whole grains, nuts and seeds. Among fruits, prunes and prune juice are particularly high in insoluble fiber.
Avoid foods that can cause constipation.
While foods high in insoluble fiber can help your gastrointestinal system function well, other options can cause constipation, and you should avoid them, Hooper says.
These foods include cheese and dairy products, processed grains, red meats and fried or fast foods.
Consider alternatives to opioids.
Ask your surgeon whether it’s possible to avoid or reduce the use of opioids to manage pain, Chen says.
Inquire whether you can instead mitigate post-surgery pain with medications not associated with constipation, like:
— Non-steroidal anti-inflammatory drugs.
Start moving again as soon as you can.
If your physician approves, get up and start walking as soon as you’re able to, Hooper says.
“Moving the body will help move the bowels and can also help reduce swelling from fluid retention,” she says.
Hooper recommends talking to your doctor and, if you’re working with one, your physical therapist to develop a safe and effective exercise regimen.
Strategies for avoiding constipation after surgery:
— Talk to your doctor.
— Be sure you’re not constipated just before the surgery.
— Drink plenty of water before and after your procedure.
— As soon as possible, eat foods that are high in insoluble fiber.
— Avoid foods that can cause constipation.
— Consider alternatives to opioids.
— Start moving again as soon as you can.
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