There is nothing – absolutely nothing! – like being constipated after surgery. Oh dear heavens is it ever wretched. (Unfortunately!) I’ve had to walk several girlfriends through the process in the last month. So, I thought I’d share my (tried and true) step-by-step tips for preventing and eliminating constipation.*
Post surgical constipation stems from taking narcotics. See, here’s the thing: pain medicine (e.g., morphine) slooooows down the passage of digesting food and therefore bowel movements moving through the intestine. FYI, antidepressants, anticonvulsants and iron supplements can also contribute to constipation. For the record, I know that it’s an unsavory topic, but when have I ever been one to shy away from the unsavory?
Back to poop. Many people would agree that the post-surgical, pain-medicine-induced constipation is as bad as the pain from surgery itself. I mean it is AWFUL. Ever since my pesky (horrendous!) bout with post surgical constipation, I have had prolonged issues with it. The Silver Lining is that I’ve found some things that really do work.
Constipation Prevention:
Enzymes: increase the level of digestion in the stomach, increasing the amount of food broken down. Therefore less undigested food is passed into the colon, and food nutrients are more available for absorption. I take enzymes with every meal.
When you have to go, GO. Don’t wait. The thing of it is that if you put off the urge, then water gets absorbed from stool and it becomes harder to move it.
Exercise: The more I move my body, the more food moves through my body. It’s a pretty simple and effective concept that works wonders!
Foods:
- Fruits. Fresh or dried fruits, especially those with skin or seeds (apples, plums, pears, peaches, tomatoes, berries, raisins, and dates) are best.
- Any and all veggies, but especially broccoli.
- Flaxseeds (ground)
- Beans-beans-beans. Lentil salad rocks and rolls!
- Whole Grains. Fiber One and All Bran rock my world. Oatmeal is not too far behind. Adding ground flaxseeds to my cereal and I’m a sure thing.
Fluids! Fluids! Fluids!
- When I say fluids, I mean WATER. Adult beverages (i.e., alcohol), caffeinated beverages (any and all) are dehydrating. When I am backed up, I drink three LITERS of water a day!
- Pineapple juice can help as well.
Probiotics: Though I don’t know (and no one seems to know) whether or not probiotics relieve constipation, what I’ve found is that they tend to prevent me from becoming constipated. I take them everyday.
Everyday, Run-of-the-Mill Constipation
When I first notice that I’m constipated, I begin by assessing my eating habits, fluid consumption and exercise levels. Sometimes, guzzling a couple of liters of water and a run followed by jumping on the trampoline are all I need to get movin’.
If that’s not enough, I try:
Magnesium. Because magnesium is required for normal muscle function (including intestinal muscles!), when a person is deficient in magnesium, constipation can occur. So, adding a supplement has helped me on many occasions.
Natural Stimulant Laxatives
Post Surgical Constipation
When it comes to post surgical constipation, go BIG from the get-go (pun intended)! Please oh please oh please take Colace AND Senekot the minute you start the pain medicine. For some (ridiculous) reason, most hospitals only prescribe Colace. Here’s the thing: Colace is a stool softener and Senekot is a stool mover. To relieve constipation, you need a softener AND a mover. This truly drives me batty in the hospital!
Enemas may also be in order. I know it sounds horrendous. It does. However, if you have post surgical constipation (and if you’ve had it, I know you know what I mean!), then you’ll do ANYTHING to find relief.
* It’s really important to let your doctor know if you become constipated. It is imperative to understand why you become constipated and collaboratively how to relieve it.
What works for you?
A "potty issue" (how to move it), and you have managed to be informative on what for many could be a delicate issue. Thanks Hollye.
Thanks, Carolee!
I had an appendectomy 4 weeks ago. For 3 weeks I was able to go without a problem. 4 days ago I hit a brick wall and I couldn’t go. I’ve increased water, fiber, veggies, fruits and it didn’t help so I took some Milk of Magnesia and for the next 1 1/2 days I had explosive loose stools and now since yesterday I have the urge to go but can’t! I’m worried about obstruction or impaction. I don’t know what to do next. I can’t get in to my gastroenterologist until the 23rd.
Hi Nicole,
Trust your intuition.
My recommendation would be to not accept the 23rd as a date to see him/her. Begin with a phone consultation. Maybe s/he has a Physician Assistant or Nurse Practitioner.
Sending my very best wishes to you. Be well!
When I was going through Chemo I encountered this problem. My oncologist recommended an herbal tea you can get at any grocery store called "Smooth Move". It is a miracle worker. Just one or two cups needed. I would start drinking it before each chemo. Hands down works better than anything else I have ever tried.
Excellent suggestion, Jennifer. Thanks!
my post-surgical backup has been after abdominal surgery, multiple times. so the muscles are not fused, the whole area is in shut-down, and it's scary just to contemplate pushing. i have shed many a tear, just wishing and hoping my body would take care of this basic function.
you are so right–water, water, water! and roughage! the tendency toward mild, easily digested food is understandable, but not helpful. i'd been suffering from an inability to pass anything, when a friend invited me over for enchiladas. oh, my goodness! that worked!
now that it's many years since any surgeries (knock wood), i still have occasional back-up problems, probably because of the many intrusive procedures. i'm a pretty straight-ahead western medicine girl, but i went to an accupuncturist who gave me some very helpful herbs: peach kernel pills (aka tao ren wan, run cheng wan). you pop half a dozen of these beebees and in the morning… all's well.
bless you for broaching this subject, which is painful, common, and serious!
Enchiladas! All those beans helped, I imagine. Whatever it was, I am SO glad that it worked! Thanks for sharing your herbal remedies as well! Take good care, Susanne.
Very, very timely. Bless you for being so forthright. Really.
My absolute pleasure. Truly. Thank you for writing!
I am so glad to have found this! I had an emergency appendix removal 2 days ago, & haven't "gone" since that morning. It was my first surgery, & the nurses keep stressing how important it is to not become constipated for too long. I was at a loss until now, thank you for this information!
Oh my goodness, you are so welcome, Holly! Hope that your plumbing gets working soon!!! Best wishes!
Thank you for the information on a delicate issue!!
Always my pleasure! xx
I recently had a hysterectomy, and the first week I was going semi normal with the stool softener and lots of fluids. The second week I hit a brick wall. I was walking as much as responsibly possible still taking the stool softener, no longer needing pain meds, I thought I should be ok, but not so. I was terribly constipated. After two days of not being able to even pass gas, I called my doctor and she recommended milk of magnesia, which worked but, three days after I stop taking it, I’m constipated again.it’s gotten so bad that after forcing myself to go there’s blood in the toilet. Of course when I told the dr this, she said I should get a colonoscopy. So now I’m worried it’s something bad. Any thoughts on this?
Dear Isabel,
Thank you for your note. So sorry to hear this news.
Before worrying, the blood could be from hemorrhoids. This happens to me quite a bit.
I would get a second opinion and please ask for a palliative care consultation. They were the only ones who could help me after my disastrous bout with constipation. Palliative care is ALL ABOUT pain and symptom management. They saved me many times throughout my treatment.
Please take good care.
All my best!
Hollye
I had surgery a week ago. On day 6 now of no movements. I just sat on the toilet for an hour in pain! Do doctors perscribe anything or better! I’m dying.
Hi Amanda,
I’m so sorry to hear the news. Please try the suggestions that I have in this post…but after a week, you really may need to call in the “big guns”. Please ask for a palliative care consultation. They were the only ones who could help me after my disastrous bout with constipation. Palliative care is ALL ABOUT pain and symptom management. They saved me many times throughout my treatment.
Please take good care.
All my best!
Hollye
Glad to know I’m not alone I’m pure miserable think I would feel better if I could go feel like I had a baby but no baby just hang in there not alone
You are definitely NOT ALONE, Toni! Please take good care.
OMG! I’ve had many different surgeries, and most recently a recurrent incisional hernia repair (12/18/14). There is NO discomfort like that which comes from post surgery constipation!!!! Thank you for this helpful information.
Thanks so much for your note, amy. I really appreciate it. Hoping that you are well. Please stay in touch and take good care!
I had gallbladder surgery a week ago. Why don’t the nurses warn you about this serious side effect?! I’ve tried nearly everything this week to get relief. I was finally able to go but after being backed up for a week, I think it’s going to take some time to feel regular again. My poor belly is so bloated and in pain 🙁
I have NO IDEA why more information isn’t more readily available, Teresa. It drives me bananas! Hoping that you are feeling better now. Take good care!
Thanks for this! Have had horrible constipation after three previous abdominal surgeries and am presently in the trenches a fourth time. Great tips for sure. I’ve found heat and . . . well . . . some very gentle rectal massaging can also help get that first bit of gas out and pave the way for continued movement.
Great advice. Thank you. I am taking morphine and a raft of other pain killers and the constipation, dehydrated mouth and copious quantities of pee are making my life a misery. The hospital recommended stool softeners as you said so now I know what to do!! Thanks so much.
Rosie
Hope that this helps! Sending all my very best, Rosie! 🙂
thanks! sounds very helpful
Hi, I recently have had an issue with kidney stones and I had a cystectomy on of last week and it is Monday now, I was put under anesthesia which backs me up quite a bit and was on perkiset for a day. I have been able to go but only a little, and it hurts quite a bit. My stomach is very bloated, I have had senna, and miralax now. And today especially I haven’t been able to eat anything besides toast because I have no appetite whatsoever. I am having lithrotripsy done on Wednesday morning, so tomorrow I am prescribed to take two ducolax pills, what should I do in the meantime for pain?
Hi Claire,
Excellent question. Whenever you have pain, call your doctor. If s/he doesn’t help, then please find someone who will. While I would never in a million years prescribe medication, I think that with the right consultation, you can find MANY additional options that WILL help you.
Sending my very best wishes. Please let me know how it goes!
Very best,
Hollye
I had a tonsillectomy recently and cnt seem to go to the toilet. I tried ducolax but its not working i dnt eat much because of the pain of the throat but drink lots of fluids
Hi Melanie,
I highly recommend talking with your doctor if you are concerned. Each person is different. S/he will be able to guide you based on your procedure.
Sending my very best wishes to you!
Hollye
Thank Goodness I found your blog! I have had episodes of chronic constipation that will come and go. I had surgery this past Thursday. I knew the morning if that I needed to go but couldn’t. So I went into the OR very uncomfortable. Didn’t move til Saturday. It was horrendous. A combination of 1-2 on the Bristol stool chart. I just went again now almost 36 hrs later, took colace Metamucil mirilax prunes water. Etc. I only took one dose of morphine in the hospital and 2 percocets before my car ride home. Didn’t even fill my pain med prescription. I am in agony. I had a hernia repair and wound closure so I am really paranoid about straining. Would love to find something that I can take everyday but I’m taking so much and it produces nothing but rocks!
Nina
Thanks so much for your kind note, Nina.
I take aloe vera juice each and every day. That and I drink TONS of water. These make all the difference for me.
Please be sure to talk with your doctor!
Sending my very best!
Hollye
Thank you for your website. Lots of helpful information. Good to know that a stool mover is needed, otherwise, you have soft stool backed up and just sitting in your colon. Thanks again.
Yes! Probiotics do help constipation! An easy one to start with (before surgery if you can) is over the counter Align. Up until I started taking a probiotic daily I suffered from constipation all my life. Prebiotics feed the bacteria in the probiotic which helps even more. I use Metamucil Clear and Natural clear-mixing powder. You can add to whatever you are drinking. It has inulin in it which is a natural vegetable fiber. All these things work, but after surgery is horrible. I am planning a November surgery and will be using Miralax after surgery in addition to a stool softner as well as getting back on the probiotics. Not looking forward to this at all!
These are great ideas. And very helpful. My issue is, my surgery was a hemorrhoidectomy, internal and external…
So glad that they were helpful, Diana!
I had not had a bowel move movement for ten days after surgery the pain of constipation was worse than the pain of surgery after lactose suppositories and then an enema I went was sooo painful like giving birth
I had similar feelings, Max. My oh my oh my! Hoping that you are feeling better now!
I started having constipation 8 years ago after a general anaesthetic surgery. I have tried many diets and exercises which non worked. I went to few doctors but all them told me its normal , how is it normal to have 2-3 bowl movements a week, suffer pain and bloating not mentioning the bad mood and no social life!! Well i started doing my own research and tried different approaches, Firstly i noticed carbs sweets, and processed food worsen the contraption, so ya i love bread but had to minimise my carbs intake, I started to have more vegetable based meals, and taking Spirulina, Calcium, Iron, zinc on daily basis. Second element that effects my constipation situation is times when i am stressed/anxious or had bad sleep, so i try to have average sleep to ease my constipation. I can immediately see the difference when i stop doing the above routine. However all that, did not solved my constipation problem it just made it little better and yes i still take Laxatives between 2 to 10 times a months to help me with bowel movements. There is another thing i do that help me, As soon as i wake up in the morning i have a large cup of coffee (decaf) and a cigarette, that helps me with small bowl movement which is better than nothing, to be honest i am not a smoker and i really dont enjoy it. I also noticed that when i take antibiotic my bowl movements becomes normal.
Thank you for writing! It means the world to me. How are you faring these days?
Best,
Hollye