Some of the most common questions I get from gastric bypass patients are about poop. People want to know what to expect, what’s normal, and how to deal with constipation and diarrhea after gastric bypass surgery. While everyone’s different, here’s what you might expect.
The First Few Days
It’s not uncommon to experience some diarrhea the first few days after gastric bypass surgery. Not everyone has diarrhea, but many people do. Some people have described it as “explosive;” I know I had trouble making it to the bathroom fast enough a few times. If you have diarrhea, you should be able to use over-the-counter medication for diarrhea like Immodium, but check with your doctor to make sure. If diarrhea persists more than a couple days, call your surgeon. Make sure you’re drinking plenty of fluids since diarrhea can lead to dehydration.
Your stool may appear dark or even black in color in the beginning due to old blood in your intestine, which is left from surgery. If you notice bright red blood in your stool, that is new bleeding and you should call your surgeon right away.
The First Few Weeks
While some people have diarrhea in the early days post-op, others go for a week or more without a bowel movement. If you’re taking in mostly or only liquids, you probably won’t have much solid waste (although you can still have some). Don’t worry about it unless you begin to feel like you need to poop but can’t. If that happens, you might want to try a stool softener or something like Miralax to help you go. Talk to your doctor if constipation persists.
Keep in mind that when your diet is much different than what you’re used to, it’s normal for your stools to be different in color, consistency, and/or smell than what you’re used to. As your diet becomes more normal, so will your poop.
You should be taking an iron supplement (the American Society for Metabolic and Bariatric Surgery recommends beginning your iron supplement the day after you come home from the hospital) and some types of iron, especially ferrous sulfate, are infamous for causing serious constipation (carbonyl iron is much gentler on the stomach and usually does not cause constipation). Iron supplements may change the color of your stool, as well, making it darker in color or even a greenish color.
If you have black, tarry stools after the first couple of bowel movements, that suggests there is bleeding high in your digestive tract, and you should contact your doctor.
The First Few Months
Many people, though not all, struggle with some constipation in the first few months, primarily due to lack of fiber in the high protein diet they are advised to eat. You can use a fiber supplement, like Benefiber, which you can add to protein shakes or other drinks, to increase your fiber intake. Make sure you’re drinking at least 64 ounces of liquid a day if you take a fiber supplement, because if you take a fiber supplement without drinking enough liquids, you’ll end up making your constipation worse instead of better. You might also want to try eating some beans, which are a good source of both protein and fiber. Many people use over-the-counter products like Miralax to help keep things moving regularly, as well.
The Long Haul
In the long run, your bowel movements will probably be similar to the way they were before your gastric bypass surgery, although some people continue to struggle with constipation long-term. Talk to your doctor about any ongoing bowel issues or concerns.