Constipation is a common complaint among Americans; however, after a laparotomy, surgeons advise patients to avoid straining with a bowel movement because this can disrupt the placement of sutures and impede the development of scar tissue that will ultimately cement the repair. Since all patients fast before surgery, patients can relieve constipation before it starts by instituting basic lifestyle changes post-operatively. Patients who become constipated despite lifestyle changes may require medications.
Begin with Lifestyle Change
Step 1
Increase fiber in your diet as soon as your surgeon clears you to resume a normal diet. According to the American Dietetic Association, this means eating more whole grains, beans, fruits and vegetables and fewer fatty, sugary and processed foods.
Step 2
Drink at least eight glasses of water or other fluids each day--unless you take diuretics or have medical problems such as kidney or heart failure that require a fluid restriction. For some people, constipation results when the bowel absorbs too much water from the stool, making it hard and difficult to pass.
Step 3
Walk and perform other physical activity, to the extent your doctor allows. Doctors now encourage patients to get out of bed soon after surgery, in order to reduce the risk of constipation, as well as more serious problems such as blood clots.
Step 4
Take a fiber supplement, if your doctor allows. Common over-the-counter fiber supplements include Metamucil, Benefiber, Fibercon and Citrucel. Use as directed and maintain adequate fluid intake, otherwise this strategy can backfire and trigger worse constipation or even a bowel obstruction.
Add Medications, if Necessary
Step 1
Purchase over-the-counter oral bisacodyl. You won't find the name bisacodyl on the drugstore shelf, so look for brand names such as Correctol, Dulcolax, Fleets and Alophen.
Step 2
Take the recommended dose by mouth, without chewing. If you take antacids or drink milk, wait one hour before and after taking bisacodyl.
Step 3
Contact your doctor if you do not have a bowel movement within six to eight hours or if your constipation recurs within one week.
Tips and Warnings
- According to the National Institutes of Health, most cases of constipation respond to changes in diet. Visit a bookstore or make an appointment with a registered dietitian to learn about how to incorporate fiber into your daily diet.
- Patients who are allergic to aspirin or bisacodyl should not take bisacodyl. Contact your doctor if you feel constipated but have diarrhea, vomit-especially foul-smelling material or experience abdominal pain that is constant or severe. These could be signs of a dangerous bowel obstruction.
Things You'll Need
- Whole grains, beans, fruits and vegetables
- Fluids
- Bulk laxative (optional)
- Stimulant laxative
- Lubricant
- Disposable gloves
- Telephone
- Library or bookstore (optional)
References
- "Harrison's Principles of Internal Medicine, 17th edition;" A.S. Fauci, E. Braunwald, D.L. Kasper, S.L. Hauser, D.L. Longer, J.L. Jameson and J. Loscalzo (Eds.); 2008
- American Dietetic Association: Health Implications of Dietary Fiber
- MedlinePlus: Bisacodyl
- National Digestive Diseases Information Clearinghouse: Constipation
