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and can cause constipation.[2]
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In addition, if you've had a surgery on your stomach or intestines or are prescribed a specialty diet, you may also experience constipation.[3]
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National Institute of Diabetes and Digestive and Kidney Diseases
Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
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There are many ways to relieve constipation after surgery. Diet, lifestyle changes and appropriate medications can help you be more regular and comfortable after your surgery.
Taking Medications to Relieve Constipation
Use a stool softener. One of the first medications to try if you're feeling constipated is a stool softener. These are easy to find over-the-counter and can help get you back on track. The way that stool softeners work is that they draw water into your stool from your intestines. This makes your stool softer and easier to pass. Note that stool softeners do not necessarily give you the urge to go. They only make it easier to go. Take a stool softener one to two times per day or as directed by your surgeon or the directions on the box. If a stool softener does not work, or doesn't provide you the urge to go, you may need to add in an additional medication.
Pick up a gentle laxative. To pair with a stool softener, you may want to consider adding in a laxative. These are the medications that will give you the urge to go. There are two main types of laxatives: stimulants and osmotics. Try using an osmotic laxative first. Stimulants can cause diarrhea and stomach cramping. Osmotic laxatives work by drawing in fluid into your intestines and helping to move stool through your colon. Many times, a combination of a stool softener and an osmotic laxative is a great choice when it comes to relieving constipation.
Add in a lubricant. A less well known way to relieve post-surgical constipation is by adding in a lubricant. This is another option that you can find easily over-the-counter. Lubricants are similar to stool softeners in the sense that they make it easier for your stool to be passed; however, they work by lubricating your colon instead of drawing fluid into your stool. Oil based products, like mineral or cod oil, are common lubricants. They aren't the best tasting, but do help relieve constipation without stomach cramping or diarrhea.
Try a suppository or enema. If more gentle methods of relieving constipation are not working, you may need to change your methods. Using a suppository or enema are other ways to relieve more severe constipation. Suppositories are generally made with glycerin. When inserted, the glycerin is absorbed by your rectal muscles causing them to gently contract. This helps make it easier to go and provides you with the urge to go. Prior to using a suppository, you may want to consider using a stool softener as well. It might be somewhat painful to pass stool that's been compacted for a while. Another option to try is an enema. Although not pleasant, these usually relieve constipation immediately. Check with your surgeon to make sure this is ok, as you should not use them after certain types of operations, particularly on the lower colon and rectum. Purchase an enema over-the-counter and read the instructions thoroughly. Only use an enema once. If no stool is produced, call your physician.
Manage your pain medication. There are a variety of medications that you can take to relieve your postoperative constipation; however, there are other medications you should manage to make sure they don't continue to cause constipation. One of the main reasons patients become constipated after surgery is that they're on prescription pain medications. Although these medications are obviously very necessary, they do slow your bowels down. If you've been prescribed prescription pain medications, only take as much as you need and follow your doctor's instructions for use. Assess your pain level every day. If it's decreasing, ease up on your pain medications. The sooner you can cut back or stop pain medications, the quicker your bowels will get back to normal. Also, if you only have minimal pain, ask your physician if you can take a mild, over-the-counter pain medication instead, which is less likely to contribute to the constipation.
Always talk to your doctor. Regardless of what medication you want to take, if you're feeling constipated and need medications to assist you, talk to your doctor first. Most of the gentle over-the-counter constipation medications are safe and appropriate to use. However, some medications may interfere with prescriptions provided to you after your surgery or are not safe due to the type of surgery you've had. If you're feeling constipated and are unsure of what you're allowed to take, call your doctor or the physician on call. Ask exactly what you can and cannot take, how often to take it and when to call back.
Relieving Constipation Naturally
Increase your fluid intake. One very essential way to prevent and treat constipation naturally is by drinking an adequate amount of fluids. The second you're able to drink in the hospital, start sipping on hydrating fluids. In general, people need about eight 8-oz glasses (2 liters) of clear, hydrating fluids each day; however, you may want to aim for more than that to help get your bowels restarted after your surgery. Try fluids like: water, sparkling water, flavored water, decaf coffee and decaf tea. Avoid caffeinated beverages since these can deplete your body of fluids. Also stay away from sodas, fruit juice cocktails, fruit drinks, alcohol and energy drinks.
Drink a natural laxative tea. In addition to plain water, there are some teas that are designed to help give you the gentle urge to go. Try including these teas as part of your fluids after surgery. Look at your local pharmacy or a health food store for natural laxative teas. These are not stimulants and just combine herbs and dried tea to help relieve constipation. Since there are a variety of herbs and teas that can help move your bowels, look at the front description. It should say "gentle laxative" or "bowel regulation." This is the type you're looking for. Try to drink these teas plain without adding sugar; however, just a touch of added sweetness from honey won't hurt. Drink a glass or two of these teas daily, but don't overdo it. Many times, it takes a few hours for these herbal remedies to work.
Reach for prunes or prune juice. An old school natural remedy for constipation that works well is adding prunes or prune juice to your diet. This is a great first remedy to try when you're feeling constipated. Both prunes and 100% prune juice are great natural laxatives. Prunes have a naturally occurring sugar known as sorbitol which acts like a gentle laxative. Start by drinking about 4 – 8 oz of prune juice once a day. Make sure that you buy 100% prune juice. In addition, if the prune juice is warm, it can help alleviate your constipation a bit quicker. If you want to eat prunes for your constipation relief, buy prunes with no added sugar if you can. Measure out a 1/2 cup of prunes to start with.
Add in a fiber supplement. Another natural method to relieving constipation is by adding in a fiber supplement. When combined with an increase in clear fluids, this is a great way to soften your stools and make it easier to go. There are a few different ways that you can add fiber to your diet. The most common are fiber capsules, fiber gummies and fiber powder. All are acceptable as a supplement. Take fiber supplements one to two times a day; however, always read the package instructions. In addition, more is not always better. Too much fiber can cause a lot of cramping, bloating and stomach upset. Always check with your physician about taking additional pills or gummy supplements. They may not be appropriate for you after your surgery.
Avoid foods that promote constipation. There are a variety of natural ways to get your bowels going and making your stools soft; however, there are foods that you should avoid or limit immediately after your surgery. Some nutrients in food, like potassium and calcium, can promote constipation or make it worse. If you're eating foods that have high levels of these nutrients or eating them in large quantities, you could worsen constipation. Foods that can worsen constipation include: dairy products (like cheese, milk or yogurt), bananas, white bread, white rice or processed foods.
Preventing Constipation
Track your bowel habits. Prior to your surgery, start paying attention to your bowel habits. This will help you figure out if you need to proactively treat constipation or just be prepared to treat it after surgery. Knowing that surgery can cause some constipation, you need to be paying attention to your bowel habits prior to your procedure. Note how often you go. Is it every day? Is it two times a day or every other day? In addition, start paying attention to whether or not it's easy to go. Even if you're feeling regular, if you have difficulty passing stools, this is still a part of constipation. If you notice that you're having some signs of constipation, treat it before going into surgery. It could worsen after your surgery.
Eat a high-fiber diet with lots of fluids. To help keep your bowels moving prior to surgery, make sure you pay attention to your diet and fluid consumption. If you're not eating well prior to surgery, this could set you up for more constipation issues after your surgery. A high-fiber diet is one key aspect of constipation prevention. Knowing you have surgery coming up, focus on meeting your daily fiber recommendations. The highest fiber foods include: legumes (like beans and lentils), 100% whole grains (like oatmeal, brown rice, quinoa or whole-wheat bread), fruits and vegetables. Track your fiber content in a food journal or tracking app. Women should aim for 25 grams of fiber daily and men should consume at least 38 grams of fiber per day. Also focus on meeting the minimum fluid guidelines each day. Remember, you should aim for at least 64 oz of clear, hydrating fluids each day.
Stay active. In addition to monitoring your diet prior to your surgery, also keep up with your physical activity routine. This is another essential component to constipation prevention. You should start walking around as soon as your doctor gives you the okay after surgery. Being active after surgery not only helps prevent constipation, it can also aid in overall healing. Regular exercise stimulates your colon. In addition, aerobic exercises with light impact (like walking or running) have some force on your colon to help promote regularity. Aim for at least 150 minutes of regular aerobic exercise each week. Go for moderate intensity for the best constipation relief. Try: walking, running/jogging, using the elliptical, hiking, dancing, biking or swimming.
Stick to a regular pattern. In general, it's important to try to maintain a regular bowel pattern. Pay attention to your body's signal so that you don't cause constipation. Your body is great at giving you signals when it needs something - like the need to go to the bathroom. If you feel the urge to go, don't delay or push it off. Sometimes, ignoring the urge will make the urge go away. If you continually push it off, you will cause yourself to become constipated. Over time, if you take care of your body and don't ignore it, you'll notice your body will stay consistent. You'll probably end up going to the bathroom around the same time of day every day of the week.
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