Avoiding Constipation after Bariatric Surgery

Patients often complain of constipation after bariatric surgery. Constipation can happen a few weeks after surgery or complaints may continue for months or even years. 

Why do people often have constipation following bariatric surgery? This symptom is usually the result of too little fiber in the diet following bariatric surgery.

After a gastric bypass, gastric sleeve or even a gastric band, patients are asked to take liquids for several weeks and slowly transition through puree to soft and eventually to regular foods. However, often these foods are low in fiber. Also since portion sizes are smaller less total fiber is consumed.

The solution?

1)     Fiber – 25 grams every day. If you are consistent your stools should be softer and more regular in 2 weeks.

2)     Choose soluble fiber that dissolves in water and is tasteless such as Benefiber or another soluble fiber product suggested by your pharmacist.

3)     Avoid gooey fiber products (such as Metamucil) or tablets (such as Fibercon) since they may be difficult to pass through the modified stomach.

4)     Make sure sugar or other calories are not added to your fiber product. You do not want the extra calories.

5)     Take the supplemental fiber every day whether you feel you need it that day or not. This is a long term solution not a quick fix.

6)     Taper to smaller amounts of supplemental fiber slowly as your regular diet includes more fiber.

7)     Stool softeners may help but you need enough fiber to make sure you have stool to soften.

Other suggestions:

1)     Avoid narcotic pain meds where possible as all narcotics slow bowel function and cause constipation.

2)     Discuss adding fish oil to your medicines with your doctor. Fish oil may improve your cholesterol and help constipation as well.

3)     For temporary and rapid relief I would suggest as much Miralax as needed. Other products such as Milk of Magnesia can provide relief as well.

Being proactive by taking enough supplemental fiber soon after surgery can help you avoid this problem altogether!