Coping with Constipation after Weight Loss Surgery

Cara Stewart, RD, LDN, member of the Penn Metabolic and Bariatric Surgery team, provides tips for achieving bowel regularity after weight loss surgery.

It may not be an appropriate topic of conversation in many circles, but constipation is relatively common among people who have had weight loss surgery, especially immediately following their surgery. Irregularity can be caused by a lot of things:

• Decreased fluid and fiber intake
• Reduced physical activity
• Narcotic painkillers
• Iron or calcium supplements
  

Many people report only having a bowel movement every two or three days following weight loss surgery. This can lead to constipation. It is important to keep track of your bowel habits and try to have a bowel movement every day.

To relieve constipation:

If it has been more than three days since your last bowel movement, you can take one dose of milk of magnesia or two Dulcolax^® tablets. Repeat every four to six hours. If you do not have results within 24 hours, you should call your bariatric nursing team to discuss.

To prevent constipation and promote bowel regularity:

• Stay hydrated. Drink adequate fluids to help soften your stool. You should drink at least 48 ounces per day.
• Exercise. Take frequent short walks throughout the day, as tolerated.
• Consume adequate fiber. Because your eating is primarily focused on high-protein foods following bariatric surgery, your consumption of high-fiber food is limited. Take fiber supplements as needed to help you get at least 15 grams of fiber per day.
• Use laxatives when necessary. Stick with Metamucil^® and other bulk-forming laxatives based on whole psyllium. Make sure to follow the mixing instructions for optimal results.
  

- Cara Stewart, RD, LDN