How to Fight Constipation After Bariatric Surgery Like A Pro

Medically Reviewed by Katelyn J. Mock, US-Registered Dietician (R.D.)

Question – How do I get rid of constipation that persists even 10 days after surgery?

It’s been almost a week since my vertical gastric sleeve in Tijuana – Mexico. Though I don’t feel any pain or discomfort, I have been constipated for the past 10 days. What should I do?

Constipation is a common problem after bariatric surgery. Reduction in dietary fiber intake is likely to be a contributory factor.[1]Sorena Afshar, Seamus B. Kelly, Keith Seymour, et al. “The Effects of Bariatric Procedures on Bowel Habit” Obesity Surgery 2016; 26(10): 2348–2354.
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This can be very common. I recommend you to drink as much water as you can, at least 48 oz to 64 oz of water per day. – Aranza (Our Nutritionist)

Constipation Post VSG (Gastric Sleeve)

Water Intake

  • It is recommended that you increase your water intake.
  • Make sure you’re getting at least 64 oz of caffeine-free fluids daily.

Fiber Intake

  • Increasing fiber intake to 25-30 grams a day helps as well.
  • Add some fruit, spinach, and avocado to a smoothie. Avocado is loaded with soluble fiber.

Stool Softeners

  • MiraLAX is also a good laxative to introduce at this stage when portions are small. Mix in a tablespoon 1-2 times a day in smoothies, soups, etc.
  • MiraLAX is quite gentle; don’t be worried about becoming dependent at this point.

Getting Back to Normal

  • It is common for people to have constipation because their diet has changed so much, and portions are quite small.
  • Once you get into more of a routine with foods, liquids, and regular bowel movements, you can decrease the MiraLAX and eventually stop it altogether.
Dealing with Constipation After Bariatric Surgery
Dealing with Constipation After Bariatric Surgery

Question – I am 7 months out of gastric bypass and am having trouble with bowel movements

I have to take Dulcolax almost twice a week to be able to have one. What should I do?

The basic ways of dealing with constipation are the same for constipation caused by gastric sleeve and by gastric bypass.

  • It is very normal to not have a daily bowel movement after gastric bypass surgery.
  • Some people go 1-3 days long term between bowel movements.
  • Early pre-op, it can be common to not be able to pass stool for 3-5 days.

It was suggested to me to mix half dose of Miralax with a little Kefir (its a probiotic yogurt) it helped within a day or two. I do it daily still to stay regular. I’m 7 weeks post op. – Amy F (A Mexico Bariatric Services Client)

How to Prevent Constipation After Gastric Bypass Surgery

Here are some tips to help keep you regular:

Hydration

High Fiber Foods

  • Choose high fiber foods. In breakfast, for example, have hot oatmeal, barley, or quinoa (cook in soy or dairy milk or mix in some peanut butter for extra protein).
  • Choose non-starchy vegetables and fresh fruits as sides/snacks whenever possible.
  • Make protein energy balls with old fashioned oats, nut butter, chia seeds, ground flax, and a little honey to keep them held together.

Stool Softeners

  • Add MiraLAX to water, tea, protein shakes, applesauce, etc. for a gentle stool softener

Physical Activity

Nutritionist Explaining Constipation After Bariatric Surgery

This Post Addresses

  • Constipation after gastric sleeve surgery
  • Is constipation normal after gastric sleeve surgery?
  • Laxatives after gastric sleeve
  • What to take for constipation after gastric bypass surgery?
  • Constipation after bariatric surgery
  • Gastric sleeve bowel movement

References

  1. Sorena Afshar, Seamus B. Kelly, Keith Seymour et al. “The Effects of Bariatric Procedures on Bowel HabitObesity Surgery 2016; 26(10): 2348–2354.

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2 Comments

  1. At 4 months post-op, I encourage people to focus on high fiber sources in their diet as the main and safest way to treat constipation. Some brands of laxatives that are bulk formers, meaning they add extra fiber which helps absorb water and form a soft bowel movement or BM, are Benefiber, Citrucel, FiberCon, and Metamucil.
    High fiber foods to regularly include with your meals/snacks are fresh vegetables like broccoli, cauliflower, celery, kale, and other leafy greens, fruits like berries, pears & apples with the skin, figs, prunes, dates, whole rolled oats, wheat bran, and high probiotic foods like whole milk plain yogurt, kefir, kimchi.
    It important to increase your water intake along with your fiber intake. If you do not have enough sugar free, decaf fluids daily, constipation can become worse and the stool may be hard, compacted, and difficult to pass. Exercise and taking a walk can also help to stimulate the large intestine to get a bowel movement going.
    It is important to remember that bowel habits do change after surgery and it is normal to have a decrease in the number of bowel movements you experience, however most individuals should still be having at least 3 BM’s per week.
    If you continue to have significant constipation, there are other types of laxatives like oral osmotics (Miralax), oral stool softeners (Colace), Oral stimulants (Dulcolax), and rectal suppositories (also Dulcolax) that are available, however laxatives do come with some risks such as interactions with certain medications, fluid disturbances, dehydration, electrolyte and mineral imbalances, among others. It is always advised to speak with your primary doctor about what laxatives are safest for you, considering your medical history.

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