Constipation is not an uncommon complaint of people after bariatric surgery, however this is typically a temporary problem and usually resolves as you’re able to consume more fiber and increase your physical activity.

But if you’re feeling uncomfortable and haven’t had a bowel movement in a few days, it’s important to understand what could be causing your constipation and some options that can provide relief. 

Typical Causes of Constipation

• Dehydration
• Not consuming enough fiber
• Digesting foods differently
• Limited physical activity
• Pain medication like narcotics 
• Iron supplements
• Medications for GERD or acid reflux

When reading through this list of potential causes, remember that the first 3 on the list can be easily modified by you before trying any medication intervention. It’s always best to try to get to the root of the problem, rather than only treat the symptom. 

Sometimes you can be working on increasing fluids, fiber, and activity at the same time as taking medications for constipation relief with the intent of reducing or stopping use of the medication altogether once your symptoms improve.

Let's take a look at some ways to be proactive, to try to prevent constipation in the first place.

Constipation Prevention

Consume Enough Fluids

The goal is to drink between 48-64 ounces of fluids daily. If you are consuming 48 ounces or less, make it a priority to slowly increase the amount of fluid you tolerate by sipping consistently throughout the day.

When we get busy, it can be challenging to remember to drink. But, after surgery, if you go an hour without fluids it is incredibly challenging to make it up later since you cannot drink large amounts of water in one sitting.

Start your day with a cup of warm liquid to get things moving. Try some warm tea like Smooth Move tea or some warm water with a little fresh lemon and mint. 

Increase Physical Activity

This doesn’t have to be 30-60 minutes all at once, but it may be helpful to start with a 5-10 minute walk after meals to help improve digestion. Slowly work towards increasing physical activity to 30-60 minutes, 4-5 days per week. This can be accomplished in 3, 10 minute bursts of activity or all at once depending on your preference.

Increase Fiber and Healthy Fats

If you are only consuming protein at each meal, you are forgetting about a very important nutrient that we recommend including! Don’t forget to include 1-2 ounces of fruits or vegetables with meals and 1 TBSP of healthy fats at each meal.

• • A few constipating foods include under ripe bananas, cheese, and red meat.
  • Foods to include with meals that help constipation include pears, plums, vegetables and closer to 4-6 months after surgery kiwi, berries, and apples with the skin, and broccoli.
  • Healthy fats include avocado, olives, extra virgin olive oil, nuts and seeds. 

Supplements and Medications for Constipation Relief

When considering what supplements to take for constipation relief, we recommend Sugar Free Metamucil for added supplementary fiber and Probiotics. While probiotics are helpful, they will not provide immediate relief, but can provide help in the long run when taken consistently. Please refer to our Blog Post on Probiotics for more information.

The nurse practitioners and physician assistants with Central California Surgery, suggest taking a step by step approach to treating constipation, beginning with Stool Softeners.

1. Stool softeners like Colace and Miralax are great options to help provide relief. These options work by drawing water into the intestine to help soften the stool, making it easier to pass.

2. Stool softeners like Milk of Magnesia helps by drawing water into the intestine to help soften the stool which also increases pressure on the intestine to help stimulate a bowel movement.

3. Suppositories like Dulcolax Fast Relief Medicated Laxative (non stimulant) can provide relief from constipation in about 15-60 minutes. 

If you are experiencing pain or discomfort after your surgery and had your bariatric surgery with Central California Surgery, please call us at (209) 248-7168 and ask to speak with a nurse practitioner or physician assistant. They can provide more specific recommendations based on your symptoms.