Constipation after Bariatric Surgery

constipation after bariatric surgery

Bariatric surgeries offer the best solution for the obese individuals. It helps them achieve a significant weight loss that is accompanied by resolution or improvement in obesity-associated disease conditions. Patients who undergo bariatric surgery can reduce their spending on these diseases, reduce their risks of premature death and improve their quality of life.

Nevertheless, there are side effects/complications that often accompany these weight loss surgeries. One of these side effects is constipation.

What is constipation?

Constipation is a symptom of the gastrointestinal tract in which there is difficulty/inability to pass stool a very hard stool. The food we eat is broken down into smaller and simpler molecules for absorption to take place. Absorption of nutrients majorly occurs in the small intestine while that of water continues throughout the length of the large intestine.

This implies that the longer the remnant of the food particles stays in the large intestine, the more water would be absorbed and the harder the stool will be. In short, when you experience any of the following then you may be constipated:

  • Passing stool less than once/week
  • Straining to pass hard stools
  • Having a sensation of blockage in your rectum while experiencing difficulty in passing stool

Having a sensation that there is still feces in your rectum after you have managed to pass a small quantity of hard stool

Although the causes of constipation are numerous ranging from inadequate water intake and fiber intake to unhealthy bowel habit to serious conditions such as cancer of the colon, people who have just undergone bariatric surgery may experience constipation from various causes about their surgery and diet.

constipation after bariatric surgery

Why constipation after bariatric surgery?

Immediately after bariatric surgery, your surgeon will place you on some medications especially analgesics to ensure that you are not in pain. Some of these medicines have side effects including constipation. However, their results wane as you discontinue these strong painkillers few days after your surgery. Supplements such as iron and calcium carbonate can cause constipation. An iron supplement can also cause the passage of dark hard stool.

The immediate post-operative period may also be characterized by lack of bowel movement as it takes your gut some time to recover from the surgical manipulation especially if you have undergone a malabsorptive surgery. This period of lack of peristaltic movement, coupled with no oral intake during this period, may be characterized by constipation. Again this should be transient lasting for few days after surgery.

Another factor contributing to constipation is the reduced food intake after bariatric surgery. Weight loss surgery restricts the size of the stomach with a reduction in the quantity of food intake. Liquid diet also characterizes this period with no roughage. Absorption of fluid from this liquid diet results in the formation of little feces not bulky enough to stimulate an adequate bowel movement.


If not promptly treated, chronic constipation that results in anal fissures (anal tears), hemorrhoids, and hernia, all from straining. The hard feces can also cause blockage of the intestine with its attendant complications.


Some medications can be used for the treatment of constipation such as suppositories, laxatives, stool softeners or even enema. Consult your physician to prescribe appropriate medication for you. Do not use these drugs beyond the specified period and any side effect should be promptly reported to your physician.

Drink at least 64 ounces of water per day. You may also add some fiber to your diet but get your doctor’s advice on the choice of fiber supplements. Vitamin C can also help reduce the risk of having constipation. Never postpone the urge to defecate because the more you delay it, the harder the stool becomes. Engage in physical activities as they also help to stimulate your bowel movement and increase the tone of your abdominal muscles (the ones you use to bear down).

In conclusion, constipation after bariatric surgery should be a transient problem that should resolve within days to weeks. Adequate fluid intake, physical activity, and proper consumption of leafy vegetables (only after you have been told to commence solid diet) will help reduce constipation.

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