Bowel Issues Following Bariatric Surgery

Diarrhea, or loose stools, is rarely an issue after patients have a standard gastric bypass, a gastric sleeve or a gastric band. Occasionally they will experience a few days of loose stools while they recover from surgery but this improves without any therapy.

Diarrea is a side effect of some bariatric operations such as the duodenal switch, biliopancreatic diversion or a gastric bypass that creates a short common channel for absorption of food.

However, if you have several high volume explosive stools a day associated with fever and crampy abdominal pain you should contact your bariatric surgeon’s office since antibiotic use during your hospitalization can change the bacteria in your stool leaving only the C. Diff bacteria to grow and cause these symptoms. A stool test can determine if C. Diff is the cause and treatment with an antibiotic called Flagyl can solve the problem.

Constipation

Constipation is a more frequent complaint from bariatric surgery patients.

1). During the first week after surgery the use of pain medicines such as Percocet or Vicodin that contain narcotics will slow bowel function causing constipation. The solution is straight forward. Stop the narcotic pain medicine and use Tylenol or Tramadol. In a day or two bowel function will return.

2). After the first week or so following surgery constipation is usually the result of inadequate fiber intake. Very little fiber is consumed early after a bariatric operation. Adding 25 grams of fiber each daywill usually correct the problem in a week or so. Many fiber products are difficult for bariatric surgery patients to consume since they often form into a gel after being swallowed. I recommend Benefiber since it is tasteless and dissolves in liquids. Benefiber should be added to nearly all fluids consumed for a total of 25 grams each day.

3) For more immediate relief as the fiber is doing its work you can use the following three over-the-counter preparations:

A). Miralax - You can repeat this several times as necessary until constipation is relieved.

B). Milk of Magnesia

C). Colase stool softener

As you return to more normal foods three to six months after surgery you will be able to decrease the amount of supplemental fiber as long as your stools stay soft.