Posted on February 4, 2020
Super uncomfortable topic, I know. But going #2 is a fact of life, and one that becomes important after surgery.
Why? Having regular bowel movements means your systems are working well. Straining to have a bowel movement can tear sutures or cause bleeding after some surgical procedures. Being constipated can be super painful.
So what can you do?
This blog is my recommendations to my patients. Please know every surgery is different and surgeons may offer different advice. So take this as useful things to think about.
- If you have an issue with constipation, be proactive.
- This means assume you may have issues after surgery, so stock up on what works for you. Prunes, bulking agents like Metamucil, stool softeners like DSS. A patient just said she used a tea called “smooth move” which did wonders for her. I tend to favor the stool softeners as opposed to bulking agents when post surgery.
- All narcotic medication tends to constipate.
- Vicodin, Percoset, Codeine. So when taking medications try to wean yourself off as quickly as you can.
- Try taking other forms of pain relief if you can.
- For example, in my practice for abdominoplasty I use Exparel, a long acting numbing medication which can significantly decrease the pain, which I inject during the surgery into the muscle sheath. I also use muscle relaxants. This allows for less oral pain medication needed.
- Move.
- This doesn’t mean necessarily doing laps around the block, and this is something to DISCUSS with your surgeon, as all surgeries are different. But getting out of bed can help.
- It is normal to not have a bowel movement for a day or two after surgery.
- Frequently you haven’t eaten and surgery is not a “normal” day for your body. Do all the things listed above: stool softeners, try to take other forms of medication, move. If you have not had a bowel movement by 4-5 days after surgery, particularly if you are feeling bloated or are in pain, then sometimes it is helpful to jumpstart things with a suppository. If that fails after two attempts, then maybe go up to an enema. If you are at this point you should be in contact with your doctor.
Again, this is something to discuss with your doctor. There is a chain of interventions. It is not something to ignore.