Post-op constipation is a common side effect after bariatric surgery. It can occur after any of the four major bariatric surgeries – sleeve gastrectomy, gastric banding, Roux-en-Y gastric bypass and duodenal switch – with an occurrence of between 7 and 39%.
Key takeaways
- Constipation is clinically defined as difficult bowel movements or fewer than three bowel movements a week.
- Little solid food, small amounts of fluid, iron supplements and pain medication can all contribute.
- Drink at least 1.9 litres per day and eat more fibre-rich foods.
- Speak with your provider before adding fibre supplements or medication.
What is constipation?
The clinical diagnosis of constipation is when a person has difficult bowel movements or passes fewer than three bowel movements a week.1 It is important to remember this: before bariatric surgery you might have had a bowel movement every day, but changes are occurring, and remembering the clinical definition can help prevent stress about this common side effect.
What causes constipation
Constipation can occur as a result of a number of causes. After surgery, patients consume little solid food and small amounts of fluid; both can cause constipation. Iron supplementation is also needed after surgery, and this, along with post-op pain medication, can contribute to constipation in some patients.
How to treat constipation
Nutritional treatment should focus on higher consumption of water or non-carbonated, non-sugary drinks, and dietary fibre from fruit, vegetables and wholegrain products.2
- Fluids: increase your fluid intake to at least 1.9 litres per day (hot or cold). Hot drinks can help stimulate the bowels and increase movement, helping relieve constipation. Avoid carbonated or sugary drinks.
- Fibre: eat more fibre-rich foods, such as fruit, vegetables and wholegrains, to help promote bowel regularity.
- Supplements or medication: if there is no improvement, supplements or medication should be considered. Speak with your provider before adding fibre supplements or medication to your regimen – even over-the-counter ones.
The gut microbiome
In certain bariatric surgeries, either a portion of the stomach is removed or the digestive process is changed. This brings disruptions to the gut microbiome, which can remove healthy bacteria and increase issues such as constipation. Replenishing healthy bacteria with probiotics may prevent these issues.
Sources
- Mayo Clinic. Constipation. 29 June 2019. www.mayoclinic.org/diseases-conditions/constipation/symptoms-causes/syc-20354253
- ASMBS Public/Professional Education Committee. Bariatric surgery: postoperative concerns. 23 May 2007; revised 7 February 2008. http://s3.amazonaws.com/publicASMBS/GuidelinesStatements/Guidelines/asbs_bspc.pdf
This article is for general information only and does not replace personal medical advice. Always discuss your situation, blood test results and supplementation with your bariatric team or healthcare provider.