What do I do about constipation? I have not gone in ten days! 

DON’T WAIT UNTIL YOU NEED MEDICAL INTERVENTION FOR CONSTIPATION. The words ‘Suppository’ and ‘Manual Extraction’ are very real.

CONSTIPATION is the 2nd most common complication of bariatric surgery. Many of our new post ops end up hospitalized with the ole One Two Punch of 1. Dehydration and 2. Constipation.

Constipation can create serious issues after bariatric surgery

Post surgical constipation stems from taking pain medicine while in hospital (morphine etc.) which slooooows down the passage of food and therefore bowel movements through the intestine, plus the very nature of bariatric surgery traumatizes your GI tract  by stopping its flow during surgery. FYI, antidepressants and iron supplements can also contribute to constipation.

When I had surgery in 2001 you were not allowed to leave the hospital until you had a bowel movement, so they could make sure the synchronized movement called peristalsis had returned to your intestines and colon. Hospital stays are now shortened so you are on your own to monitor your own progress. When it comes to post surgical constipation, go BIG from the start as things get much worse with time and do not clear up on their own.

SHORT ANSWER:  

  1. Take Colace tablets with a big glass of water in the afternoon or evening. You have probably been cleared and instructed to take COLACE which is a STOOL SOFTENER. It works by increasing the amount of water the stool absorbs in the colon, making the stool softer and easier to pass. However, softening is only half of it. You also need need that slow contraction of the colon created by a laxative to SQUEEZE it out.
  2. Thats the job of Dulcolax, a very safe and gentle laxative or stool mover. Take DULCOLAX with a big glass of water before bedtime. It works during the night to slowly contract the colon and push it towards the opening. To relieve constipation, you need both. Soft and just sitting there is NOT going to help you. In the morning your stool will be in a position for you to move it out. 

Well meaning people will tell you to take flax seed or probiotics or some sort of Metamucil or Fiber One and THESE ARE GREAT SUGGESTIONS TO PREVENT CONSTIPATION, but once you are already constipated these won’t do anything. Adding fiber once you are constipated is like adding sawdust to sink that is already clogged!

Do not let people scare you about laxatives – they exist because people NEED them. USE one. This is not 10th grade and we are not taking them to lose weight.

While I am not a doctor, I know what manual extraction is and so do way too many bariatric post ops who wait for things to happen on their own. Do not go ANY LONGER thinking all will be fine on its own. Drop by a CVS, pick up both Colace and Dulcolax and take both of these meds tonight with a big glass of water so you will go in the morning.

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