Constipation post-bariatric surgery can be troublesome if occurring after bariatric surgery. It is important to prevent constipation as straining can lead to haemorrhoids and hernias.
What are some causes of Constipation post-surgery?
- Less overall food being consumed
- Less fibre consumed in the diet
- Less fluids being consumed
- A reduction in physical activity (especially during first 6 weeks after surgery)
- An increase in pain medication
- Iron supplements
Constipation Versus “Not-Going”
In the first week after surgery, it is important to know the difference between suffering from constipation versus “not-going”. Constipation is identified by not opening your bowels for more than three days and suffering from abdominal discomfort and pain when passing stools. If you are opening your bowels once every 3 days (or less) after surgery and are not experiencing any abdominal discomfort, it is likely that you are not constipated.
Suggestions to Help Ease Constipation
Ensure you are getting plenty of fluids in. Remember, when we suddenly increase the protein content of our diet, this also increases our need for fluid. Although your high protein drinks count as part of your fluid, be mindful that you may need more to get the bowels working.
- Physical activity:
Moving the body assists in moving the bowels. Physical activity is recommended after surgery for a variety of reasons, however most people do not realise that even 30 minutes of moderate pace walking can help to keep bowels regular, or get the bowels working when constipated. Ensure that you are getting in your daily exercise (minimum of 30 minutes) to assist with constipation.
The recommended amount of daily fibre is between 25 and 30g for adults. In the first two weeks after surgery, it is likely that your fibre intake is minimal due to the inability to consume fruits, vegetables, nuts and wholegrains. During these two weeks, if you have identified that you are constipated, it can be helpful to try the following:
- Prune juice
- Pear juice
- Hot water with lemon
- Small amount of black coffee to stimulate the bowels
After 2 weeks, you may begin to eat pureed food. Some useful fibre containing foods may include:
- Pureed prunes/pear/banana/apple (peeled where possible)
- Smooth peanut butter (must be 100% natural with no added sugar or fat)
- Vegetables (must be peeled and pureed) (e.g. carrot, broccoli florets, cauliflower florets, sweet potato, parsnip)
- Fibre supplement (BenefiberÒ or for coeliac disease – ProNourish Natural Balance FibreÒ or MetamucilÒ).
Remember, not all changes in bowel habits are related to bariatric surgery. It is important to communicate with your GP/surgeon/dietitian regarding your bowel changes as there may be other reasons for these.
Written by Jackie Smith, Dietitian, Perth Surgical & Bariatrics