Constipation is a common problem following any surgical procedure. Constipation means that you have not had a bowel movement for more than 2 days, or that you experience straining with very hard stools. The combination of having undergone anesthesia, surgical pain, decreased activity, changes in diet, and most importantly the use of narcotic pain medications, are a sure recipe for this problem. The real dilemma is that the abdominal pain and cramping of severe constipation can be worse than the pain of surgery. In fact, many patients increase their use of pain medications due to the constipation pain. This creates a cycle of pain from constipation and increased pain medication use, which only makes everything worse. Stool softeners may not be enough to help when constipation becomes severe.
The following steps will often help;
- If you are experiencing constipation symptoms, the first resource is to use Miralax or Milk of Magnesia. These are common laxatives that are available at every grocery store. Use the laxative twice a day using the dose listed on the bottle, until your bowels start moving.
- You need to greatly increase your physical activity. This not only stimulates bowel function, but also helps clear your lungs and helps your overall recovery from surgery. Put on your clothes each day and plan on being up and around, not spending the day in bed. I commonly recommend walking around the equivalent of a city block at least twice a day. When the weather is bad, have someone take you to a grocery store every day. Hold onto a cart, and walk up and down every isle. You don’t have to buy anything, and the cart will help your stability. Do this every day while you are recovering.
- You need to increase your intake of fluids. Water and fruit juices are best. A good strategy is to fill a pitcher of whatever you like to drink, and keep it in the refrigerator. Plan to drink that whole pitcher each day, in addition to the fluids you normally drink.
- Take adequate time for bowel movements. Set aside enough time to allow undisturbed visits to the toilet. Don’t ignore the urge to have a bowel movement.
- Limit the amount of pain medication that you use, and start tapering yourself off as soon as possible. Transitioning to Aleve is a helpful step. If pain is limiting your activity, then do continue to use your pain medication, but use it sparingly. If you have been given Valium as a muscle relaxer, this medicine does not affect constipation, and is safe to use.
If these steps are not sufficient to relieve your constipation, please call our office at 253 572-7120, and other medications, and strategies can be employed.
Chronic and long stranding constipation is an entirely different problem. This is treated differently, and often includes; lifestyle changes, changing to a high fiber diet, the increase drinking of fluids, the use of fiber supplements, and some other medications. If you are suffering from long standing constipation, please talk to your physician at your next appointment.