Sunday, May 8, 2011
Bowel Habits After Bariatric Surgery
While seeing patients in my office I often hear concerns about constipation. This is a frequent complaint in the early days or weeks after the three most frequently performed bariatric operations; gastric bypass, gastric sleeve, and adjustable gastric band.
Although after surgery patients may be using narcotic pain medicines that slow the intestine that may result in constipation, usually the problem is the lack of fiber in the diet. Since patients are only taking liquids for a time after the operation it is very difficult to consume adequate fiber.
I make the following 4 suggestions to my patients:
1). Stop the use of narcotic pain medicines.
2). Add 25 grams of Benefiber everyday to your drinks or meals. Most fiber products become thick and are difficult for bariatric surgery patients to tolerate. Benefiber disolves in liquids, is tasteless, colorless and is not gritty.
3). Use Miralax as necessary if you have not had a bowel movement for several days.
4). Censider using Colase twice daily until the fiber therapy results in soft bowel movements.
Fiber therapy is not an instant cure for constipation but over a week or so bowel movements will become softer and should stay that way as long a the patient is taking enough fiber. As fiber is added to the diet in other ways the amount of supplemental fiber can be reduced.