As if it’s not enough to have gone through the anxiety and discomfort of surgery, some people then find that afterwards going to the loo becomes a source of worry and unpleasantness too! Although constipation does not affect everyone who has undergone surgery, it is indeed quite common.
The reasons why!
There are several pretty straight forward and mostly unavoidable reasons for this.
The main cause of constipation after surgery is pain medication. It has this affect on digestion by increasing the amount of time it takes stool to move through the bowel, they also stop the proper contractions taking place in the intestine. This type of medication (opiod) also reduces gastric secretions and decreases the need to go to the toilet. Additionally, patients are often given antibiotics after surgery to avoid infection. As we know these can really upset your gut bacteria in the long term and lead to dysbiosis and contribute to constipation.
Secondly, most people who have undergone surgery have had some form of anaesthesia. Most people think that anaesthesia is something that simply puts us to sleep. It does do this but it can in some cases actually paralyze the muscles in your intestine in the same way that it may your arms and legs. It may therefore take some time for your intestine to ‘get going’ again.
Mobility and a lack of exercise are also primary causes for constipation. Exercise is recommended when you have constipation as it acts as a trigger for bowel movement. So suddenly being bed bound for a couple of days let alone possibly a few weeks can have a big impact on bowel movement.
Your intake of food and drink before and after surgery can also be a cause. It is likely that a patient is advised to not eat or drink before surgery and then after surgery to eat minimally. A lack of fluid makes the stool hard and difficult to push through the bowel and a lack of food means effectively a lack of stimulation for bowel movements. Every time you eat you actually trigger a cascade of digestive functions throughout your digestive system, so not eating stops this.
For patients staying in hospital for a long time to recover, simply the change in foods and lack of privacy may also contribute to becoming constipated.
And finally, the stress and anxiety of going through surgery itself can effect bowel function. Stress is well known for shutting down or at least slowing down digestion and absorption in any daily circumstance, and will do in a surgical situation too. Surgery also often affects a person’s appetite.
Water is essential to help keep bowels moving. Read this post on how to make drinking water fun.
Tips to help
The general rules for alleviating constipation are the same as in a regular situation. For tips on this, click here. As a brief overview the following things are important:
- Increasing your non-sugary and non-caffeinated fluids
- Increasing your soluble and insoluble fibre – if you have had colorectal surgery however, please do check which fibre is advisable.
- Trying to get up and move as much as possible. Even a little bit is better than none and if you can manage a walk outdoors that is ideal.
- Take some magnesium - this is a muscle relaxant and therefore helps to relax your bowels. Just double check with your doctor that you are not on any medication where you should avoid magnesium.
- Avoid foods which bung you up! Such as bananas, cheese, rice and potatoes
- Take a probiotic!
Being constipated after surgery can lead to further complications such as straining and therefore opening wounds, and in these cases especially it is more likely that a patient will be given laxatives especially in certain surgical situations such as gynaecological surgery.
However, it’s important to point out that not all surgery is the same! There are some instances where a practitioner will prefer for the patient to have a slow functioning bowel. For example where a patient has had colorectal surgery it is actually better for recovery and lessens the likelihood of infections if stool is not too soft or watery.
Obviously every patient, their circumstances and the effect that surgery has on them is different so each case should be looked at individually. And it's wise to double check with your doctor as to how to approach the situation. The good news is that there are lots of things you can do to help with this problem. Read the following blogpost for more information on other causes of constipation.