Constipation is pretty common after gastric bypass surgery, especially in the first six months or so post-op. Not all patients experience constipation, but it’s common enough that everyone should be prepared for the possibility.
Numerous factors contribute to the development of constipation after gastric bypass surgery. Probably the biggest factor is the lack of fiber in the diet, especially in the first few months after surgery. Patients are advised to focus on protein first and they can’t eat enough volume of food to get many fruits or vegetables in. Patients often limit whole grains, especially in the first few months, which further limits their fiber intake. Fiber acts almost like a broom to sweep out the large intestine, moving fecal matter through the bowel. Without fiber, constipation frequently occurs.
In the early post-op days, many patients have trouble getting enough fluids in, and a lack of fluids leads to hard stool and constipation. Also, while patients are still taking pain medications right after surgery, constipation is a common side effect.
As patients become able to drink more fluids and eat more fiber, constipation may become less of a problem. For some, it is an ongoing issue, however.
Patients find different ways to cope with constipation and what works for one may not work as well for another. I use Miralax daily (I get a prescription for it from my nurse practitioner, which makes it cheaper than buying it over the counter) and also take 500 mg magnesium oxide daily, which I’ve been told will help with constipation. Most of the time, this works for me. In the rare event I still have a problem, I use Dulcolax suppositories, which aren’t much fun but do get the job done. Other post-ops have told me they have good results with Benefiber, Colace, Senekot, Smooth Move tea, and prunes. You may need to experiment a bit to see what works for you. Of course, you can also ask your physician for advice.
If you ever find yourself severely constipated and a Dulcolax suppository or a Fleet enema doesn’t do the job, you need to call your doctor right away or go to the ER. Rarely, people get bowel obstructions and they can become very serious if not treated. At the ER, they will have super-strength enemas that almost always get the job done, and if those don’t work, you might need surgery.