Constipation After Bariatric Surgery

Constipation is a common ailment that can afflict anybody at any age. However, constipation after bariatric surgery is somewhat more troublesome because your digestive system is already delicate after the surgical and metabolic changes. Therefore, it’s vital that you keep a track of your regular bowel movements after bariatric surgery and take preventive or curative action in consultation with your surgeon.

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Bowel movements after bariatric surgery

Bowel movements after weight loss surgery may be slightly irregular for many patients in the first few days or weeks. The normal digestive tract function to move food smoothly from one end to the other is likely to be disrupted. This happens because of the major changes to your dietary composition and the alterations to the digestive tract. Ignoring constipation after bariatric surgery can create problems, such as hernias, hemorrhoids, or straining of the muscles.

Bowel movements after gastric sleeve

Hard stools can restrict your bowel movements after gastric sleeve surgery. If you experienced this condition even prior to your surgery, you are at a higher risk of severe constipation after gastric sleeve. Fortunately, it is usually possible to overcome this problem simply by adding more fiber to your post-op diet and increasing your water intake. If the bowel movements after gastric sleeve are still difficult, your surgeon may prescribe some medications for gastric sleeve constipation relief.

Bowel movements after gastric bypass

Gastric bypass involves changes not only to your stomach, but also your small intestine. Therefore, large bowel movements after gastric bypass are more likely to be affected. The emphasis on nutrition supplements is higher, which may also sometimes slow your bowel movements after gastric bypass as a side effect. However, with timely remedial changes to your diet, it is usually easy to resolve constipation after bariatric surgery. Medications can also help you adjust to the new “normal” in post-op bowel function.

 

Constipation after Bariatric Surgery: Is it common?

Constipation and bariatric surgery have some correlation, but it does not mean that every patient who undergoes this procedure will face difficulty with their bowel movements. Mild degree of constipation after bariatric surgery is fairly common, but the condition will resolve without medical intervention in about four to six months. Here are some of the salient points to keep in mind about constipation and bowel movements after bariatric surgery.

• Constipation after gastric bypass is relatively more common and may require reconfiguration of your iron and calcium supplements.
• Constipation after gastric sleeve is relatively less common, but a high protein diet can sometimes contribute to this condition.
• Ask your surgeon in advance about what can a bariatric patient take for constipation, and follow their advice on diet and medications.
• Constipation after bariatric surgery more commonly occurs due to less intake of water, less fiber in the diet, and use of diuretics.
• Less frequent bowel movements after bariatric surgery do not always mean constipation – you have to adjust to your “new” normal.
• Balanced nutrition, sufficient hydration, and physical exercise are three time-tested measures to counteract post-bariatric constipation.

RELATED: Acid reflux or GERD after gastric sleeve

What causes constipation after surgery?

Constipation may occur after any type of surgical procedure, but constipation after weight loss surgery is relatively more common. It is important to know what causes constipation after surgery. Here are some of the well-known causes of constipation after bariatric surgery.

• Digestive tract changes: One of the primary causes of gastric bypass or gastric sleeve constipation is the surgical alterations to digestive track as well as the ensuing metabolic and hormonal changes in the body.
• Change of diet: Your body needs time to adjust to the new post-op bariatric dietary changes. In the first three months, you will gradually move from a liquid to a semi-liquid and soft food diet, and eventually a normalized, solid diet.
• Less fiber intake: To achieve your weight loss goals, you are likely to focus more on lean proteins in your diet rather than fibrous foods. This can cause harder stools, resulting in difficult bowel movements after bariatric surgery.
• Weak muscles: The prolonged condition of obesity followed by a weight loss surgery may cause your abdominal muscles to become weak. This can hamper the normal bowel movements after gastric sleeve or gastric bypass.
• Other causes: Lack of exercise, the use of pain medications or antidepressants, regular use of nutrition supplements, intake of caffeinated beverages, and not drinking sufficient water is also what causes constipation after surgery.

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Constipation after gastric sleeve

Constipation after VSG surgery is not a serious cause for concern, but if left untreated, it may create more serious complications. Your bariatric surgeon and nutritionist will be able to provide you guidance for sustainable gastric sleeve constipation relief. If you continue to experience significantly irregular bowel movements after gastric sleeve, you may need additional medical interventions.

Early-stage constipation after gastric sleeve

Severe constipation after gastric sleeve occurs more commonly in the days immediately following the surgery. The procedure is performed using general anesthesia and pain medications in the first week may also suppress the nerve signals to the digestive tract. Moreover, your body will need time to adjust to the smaller stomach pouch and changed diet. Until that happens, you may experience constipation after bariatric surgery.

Long-term constipation after gastric sleeve

A sleeve gastrectomy will reduce your stomach size by about 75 to 80%. While the new small pouch will make you full faster, it also means that you want to consume less fiber and fluids during the day. Gastric sleeve constipation may occur because these two vital supporters of normal bowel movements are reduced in supply. Unless you maintain good levels of fiber and fluids, you may experience long-term bariatric surgery constipation.

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Pooping after gastric sleeve

Pooping after gastric sleeve surgery can become somewhat uncomfortable if you are experiencing infrequent or irregular bowel movements. If this condition persists or becomes severe, it can affect your health as well as quality of life. Consult with your surgeon for safe and non-invasive solutions to constipation after bariatric surgery. Here are some of the signs of abnormal pooping after VSG.

• The frequency of bowel motions has significantly reduced compared to your pre-operative condition.
• The stool is hardened and you usually need to strain your muscles to pass the stool painfully.
• You feel bloated, uncomfortable, or fatigued through the day, or experience less hunger when constipated.
• The poop is of different color or passes with an unpleasant odor each time after your gastric sleeve surgery.

What can I take for constipation after gastric sleeve

Gastric sleeve constipation relief can be obtained with a combination of natural remedies, over the counter laxatives and prescription medications. Depending on the severity of your condition and the post-operative stage you are in, your surgeon can make the appropriate recommendations for relief from constipation after bariatric surgery. Here are a few tips to consider:

• Drink at least 64 oz. of water and other fluids every day to enable softer stools after gastric sleeve.
• Include sufficient fiber in your diet, and if necessary, take fiber supplements so as to consume 15g of fiber per day.
• Use over the counter laxatives when needed and take to follow the label instructions for safe results.
• If you have no bowel movements after gastric sleeve for 4 or more days, call your bariatric support team for advice.

Constipation after gastric bypass

Large bowel movements after gastric bypass may become difficult or irregular in the first few months following your surgery. While constipation after bariatric surgery is usually mild and transitory, you should consult your surgeon if the condition persists or becomes severe. It is important to diagnose the underlying cause and treat gastric bypass constipation effectively before it becomes chronic.

Why constipation after gastric bypass occurs?

Gastric bypass will create a substantial reduction of your stomach size as well as reroute your small intestine to lower your calorie absorption. These changes can contribute to temporary constipation after weight loss surgery in many cases. The use of pain relief medications, iron and calcium supplements, and reduced consumption of dietary fiber and water may also exacerbate the problem of constipation after gastric bypass.

How to obtain relief from gastric bypass constipation?

Medications and stool softener after gastric bypass can provide temporary relief, but these are not sustainable solutions. You should focus on increasing your fiber intake, which will add bulk and soften your stools. Poor hydration levels can also contribute to constipation, so increase your fluid consumption. Finally, regular physical activity will improve blood flow and stimulate healthy bowel movements after gastric bypass surgery.

READ THIS TOO: Gastric bypass complications

How often should you poop after gastric bypass

Pooping after gastric bypass may become slightly uncomfortable for a few days or weeks following the surgery. Pre op liquid diet constipation may be just the beginning of this condition, which may continue for up to six months post-operatively. If you are concerned about how often you should poop after gastric bypass, here are a few things to know.

• Bowel movements after gastric bypass will vary between patients, depending on several factors.
• There is no “ideal” number of times you should poop after gastric bypass to avoid constipation.
• For some patients, pooping twice a day is normal, while for some others, pooping once is two days is normal.
• Change of bowel habits does not necessarily mean constipation after bariatric surgery, and you may determine your own “new” normal.

Constipation after lap band surgery

Constipation after lap band surgery is relatively less common because this procedure does not involve any drastic changes to your GI tract and intestines. However, it’s still critical to guard against the possibility of constipation after bariatric surgery, especially for the first few weeks and months. Your diet and physical activity will also play a vital role in avoiding constipation.

Be prepared to follow your bariatric nursing team’s guidelines for healthy bowel movements after an adjustable gastric band surgery. Drink plenty of water every day, but avoid drinking with meals or 30 minutes before and after meals. Include adequate dietary fiber in your meals. Your risk of chronic constipation after lap band surgery is minimal because this procedure is reversible at any stage.

RELATED READ: Lap band complications

What can a bariatric patient take for constipation

Your nutritionist is the best person to answer the question: “What can I take for constipation after bariatric surgery?” But there are some broad dietary recommendations, which all patients can follow post-operatively to minimize their risk of constipation after bariatric surgery. Here are some tips on what can a bariatric patient take for constipation:

• Focus on more fiber in your daily diet to prevent bariatric constipation and help balance your digestive microflora.
• Fruits, veggies, berries, leafy greens, oat meal, chia seeds, nuts and almonds, lentils, peas and beans are excellent sources of fiber.
• Minimize refined flours in your diet, such as white pasta, white bread and refined rice, which cause constipation after weight loss surgery.
• Drink at least 6 to 8 glasses of water every day to keep your intestines healthy, promote digestion, and fight bariatric surgery constipation.

READ THIS: Gastric sleeve diet: An ultimate guide on VSG diet

Best stool softener for bariatric patients

If the constipation after gastric sleeve or gastric bypass becomes persistent, you may consider the use of laxatives for softening the stools. However, do not exceed over the counter laxative treatment beyond three weeks, follow the manufacturer’s instructions, and consult your doctor when necessary. Here are some of the best stool softeners for bariatric patients:

• Sodium picosulfate: This is widely recognized as the best stool softener for bariatric patients. It is available under various popular brands, such as Dulcolax, Duphalac, Forlax, Regulax, Microlax, and Guttalax.
• Bisacodyl: This is a stimulant laxative commonly used as a stool softener after bariatric surgery. It is available in the form of pills as well as suppositories. It will take about 10 hours to produce an effect.
• Senna: Senna is an over the counter laxative approved by the FDA. This safe laxative for bariatric patients may be taken in the form of tablets. You may also consume tea produced from senna leaves for constipation relief.
• Fiber supplements: The best stool softener for bariatric patients when you want a more natural solution is fiber supplements. These will make your stool softer and bulkier. Psyllium and calcium polycarbophil are popular options.

Gastric sleeve surgery

Mild laxatives, such as fiber supplements, are considered the best stool softener after gastric sleeve surgery. If you are unable to draw sufficient fiber from your post-op VSG diet, you can choose this safe and proven remedy to fight constipation after bariatric surgery. Fiber will keep your stool soft and plump it up because it absorbs maximum water. You can take fiber supplements in the recommended dosage three to four times a day for best results.

Gastric bypass surgery

Saline laxatives may be the best stool softener after gastric bypass to provide you relief from constipation. One of the popular forms is Milk of Magnesia, which works rapidly by pulling maximum hydration into your intestines. Gastric bypass stool softeners will reduce straining and prevent complications such as hemorrhoids. You may want to avoid stimulant laxatives after gastric bypass, if they cause painful cramping due to intestinal contractions.

Constipation and bariatric surgery: Final words

Sedentary lifestyle and unhealthy diet are the most common causes of constipation, no matter whether or not you are a bariatric patient. If ignored, constipation can become the root cause of more serious ailments over time. It’s necessary to recognize the relationship between constipation and bariatric surgery, and follow your surgeon’s guidelines for diet and fitness. With a little effort, you can make the most of your bariatric surgery and achieve an excellent health and well-being for decades to come.