{"id":15914,"date":"2020-10-28T09:00:09","date_gmt":"2020-10-28T13:00:09","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=15914"},"modified":"2025-04-08T13:50:06","modified_gmt":"2025-04-08T17:50:06","slug":"constipation-after-surgery","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/constipation-after-surgery\/","title":{"rendered":"What you need to know about constipation after surgery"},"content":{"rendered":"

Recovering from surgery can be an unpleasant process, whether you\u2019re going through the rehab associated with a knee replacement or simply waiting for your body to feel normal following an outpatient procedure. During recovery, the last thing you want is an additional discomfort. However, whether your surgeon discussed it with you or not, many people experience constipation after surgery. Knowing what to expect and making a plan can diminish the effects of this uncomfortable surprise. Read on to find out how.<\/span><\/p>\n

Is it normal to be constipated after surgery?<\/span><\/h2>\n

\u201cIt\u2019s quite common, even expected, for patients to be constipated immediately after surgery,\u201d says<\/span> Jemiel Nejim<\/span><\/a>, MD, an anesthesiologist at Hospital for Special Surgery in New York. There are a variety of factors that contribute to post-surgery constipation (also called post-operative constipation), each of which generally has a larger effect on the incidence of constipation than the type of surgery itself, excluding intra-abdominal and bowel surgeries.<\/span><\/p>\n

While many surgeries including obstetric, gallbladder removal, and tonsillectomy can cause constipation, intra-abdominal and bowel surgeries are well known to cause post-operative constipation.<\/span> \u201cBowel and some abdominal surgeries may cause an ileus in which the normal pulsations of the bowel stop working,\u201d says<\/span> Michael Philbin<\/span><\/a>, MD, a surgeon at Edina Plastic Surgery in Edina, Minnesota.\u00a0<\/span><\/p>\n

Lack of physical activity, pre-surgery dietary changes (including water restriction), and anesthesia given during surgery all contribute to constipation. In addition, medications used to control pain post-surgery <\/span>can cause constipation<\/span><\/a>. For example, <\/span>research<\/span><\/a> indicates that 40-60% of patients taking opioid medications, commonly prescribed for pain post-surgery, experience constipation as a side effect.<\/span><\/p>\n

What causes constipation after surgery?<\/span><\/h2>\n

With other procedures, there are several underlying factors that can cause post-surgery constipation.<\/span>\u00a0<\/span><\/p>\n

Anesthesia<\/span><\/h3>\n

The anesthetic regimen administered during surgery is likely to have an effect on constipation during recovery. \u201cAnesthesia is a broad term that describes a number of different medications,\u201d Dr. Jemiel Nejim says. \u201cBoth the type of anesthesia and the surgical duration affect the likelihood of postoperative constipation. Surgeries that last longer in duration tend to be associated with a higher predisposition to constipation.\u201d\u00a0<\/span><\/p>\n

Some practices focus on using regional anesthesia over general anesthesia, which helps to reduce the number of drugs used and thus may reduce the likelihood of constipation after surgery.<\/span><\/p>\n

Postoperative pain medications<\/span><\/h3>\n

Post-surgery constipation is also often a result of opioid pain medications, given either as part of the anesthesia or for pain relief following the surgery, according to Dr. Philbin.\u00a0<\/span><\/p>\n

According to Inara Nejim, Pharm.D., a clinical pharmacist at Hospital for Special Surgery, \u201c<\/span>Medications<\/span><\/a> from the opioid drug class, such as<\/span> Percocet<\/span><\/a>,<\/span> oxycodone<\/span><\/a> or <\/span>tramadol<\/span><\/a>, are a cornerstone foundation in managing postoperative pain, and one of their well-known side effects is constipation.\u201d<\/span><\/p>\n

Behavioral factors<\/span><\/h3>\n

Even in daily life, dehydration is one of the most common causes of constipation. Following surgery, the body requires plenty of fluids to aid in recovery. Without them, constipation is likely to occur, so make sure to drink lots of water.\u00a0<\/span><\/p>\n

The same goes for nutritional intake: Not everyone may have an appetite after surgery, but continuing frequent oral intake, especially fiber-rich foods is key to helping things move along.\u00a0<\/span><\/p>\n

Finally, a lack of physical activity, another known cause of constipation, is common after surgery. Dr. Philbin recommends working with your doctor to understand when, and for how long, you’re able to safely begin to move about during recovery to help alleviate inactivity-related constipation.<\/span><\/p>\n

When should I worry about constipation after surgery?<\/span><\/h2>\n

While constipation immediately following surgery is common, especially if you are subject to some of the above factors, there are some warning signs to look out for that could indicate a more serious problem.<\/span><\/p>\n

According to Dr. Philbin, you can expect constipation to last for a few days, depending on how active you are allowed to be and the amount of post-op pain meds needed. Abdominal pain due to bloating after surgery is also quite common and could be a result of trapped gas or excess fluids, according to Dr. Jemiel Nejim. These fluids tend to be excreted naturally within a few days. Mild tummy bloating can be helped by eating smaller, frequent meals and increasing physical activity. In addition, taking simethicone medications, which work by breaking up big gas bubbles in the gut into smaller bubbles, making them easier to pass, can help with bloating and gas.<\/span><\/p>\n

If you experience significant pain or bleeding, or if constipation lasts longer than three days, seek medical treatment. Prolonged constipation can lead to hemorrhoids, anal fissures, and in very rare instances medical conditions such as ileus or intestinal obstruction, which require further medical interventions.<\/span><\/p>\n

What helps with constipation after surgery?<\/span><\/h2>\n

The good news is that there are plenty of ways to alleviate constipation caused by surgery, especially if you make a plan with your doctor ahead of time. Whether via pre- or post-surgery dietary changes or by knowing the over-the-counter treatment options, being prepared will make the process a little easier.<\/span><\/p>\n

Before surgery<\/span><\/h3>\n

\u201cIf someone has concerns before surgery regarding potential constipation, the best thing to do is to speak up and openly talk about those concerns before surgery,\u201d says Dr. Jemiel Nejim. This is especially true for those who already suffer from chronic constipation. If there are medications that traditionally work well for you, identify these with your medical team prior to surgery. If allowed by your physician, increase your fiber intake or begin a regimen of stool softeners prior to surgery if constipation is a concern.<\/span><\/p>\n

After surgery<\/span><\/h3>\n

According to Dr. Inara Nejim, one of the best ways to prevent complications of untreated constipation at home is by having an honest conversation about medications during the discharge process\u2014and during follow-up phone calls. A nurse will usually go over all of your prescriptions and can explain how to effectively manage constipation at home using diet and over-the-counter medication.\u00a0<\/span><\/p>\n

If you are going to start a fiber supplement, make sure you also increase your fluid intake accordingly, as bulk fiber supplements can worsen constipation if you don\u2019t drink sufficient fluids. Your doctor should advise you on a gradual treatment approach to reducing constipation, beginning with stool softeners and gentle senna-based laxatives\u2014and if no benefit, advance to other stimulant laxatives such as <\/span>Dulcolax<\/span><\/a>.\u00a0<\/span><\/p>\n

Diet<\/span><\/h4>\n

If your symptoms of constipation are minor or haven\u2019t lasted very long, it may be possible to alleviate the condition with<\/span> home remedies<\/span><\/a>, like adding key foods that are known to help with constipation:<\/span><\/p>\n