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Not your usual Constipation

OK so here it is. I am at 4 weeks and on solids, no restriction. I am taking milk of mag about every other day and it works great, but in the meantime i back up again almost imediately. Yesterdays food sat in my main stomach most of the day making me full before i realised it, I concentrated on when the pouch is full or satiated, not really sure how to feel the main stomach unless it is stuffed and uncomfortable. Last night I was just sitting at my computer and I had a little burp that brought up some contents from my lower stomach into the back of my mouth including the acids. I have zero heartburn or reflux since the surgery and I used to have a lot. What can I do to keep things moving on a regular basis? Is something wrong?

Any help is much appreciated.

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Be VERY careful with what you take for constipation when you have a band:

1: Obes Surg. 2004 Aug;14(7):1022-4.

Bolus obstruction of pouch outlet by a granular bulk laxative after gastric banding.

Herrle F, Peters T, Lang C, von Fluee M, Kern B, Peterli R.

Department of Surgery, St. Claraspital, Basel, Switzerland.

BACKGROUND: Constipation is an occasional problem after gastric banding and is often caused by insufficient liquid intake. As a result, the use of laxatives is widespread in such patients. Depending on the laxative, improper use can lead to bolus obstruction above the band, as occurred in this case. Case Report: A 59-year-old female with uncomplicated laparoscopic adjustable gastric banding presented 2 months after surgery with food and liquid intolerance and dysphagia after ingestion of a granular bulking laxative. Despite deflating the band, the bolus could not be washed out. Endoscopic extraction was required, revealing a 4x2 cm bolus of the laxative and a small compression ulcer.

DISCUSSION: Patients not complying with nutritional recommendations after gastric banding may have insufficient liquid intake and, consequently, constipation. Under these conditions, the use of a granular bulking laxative entails the risk of esophageal obstruction above the band.

CONCLUSION: Nutritional counseling after gastric banding should include the recommendation of liquid intake of at least 1.5 l/day. If constipation occurs, osmotic or paraffin oil laxatives should be used instead of bulking laxatives.

Publication Types:

* Case Reports

PMID: 15329197 [PubMed - indexed for MEDLINE]

And drink MORE water! Everyone!

  • 3 years later...

I too took a laxative 3 days ago and since have had pain down under my port...could this be bolus obstruction?

Be VERY careful with what you take for constipation when you have a band:

1: Obes Surg. 2004 Aug;14(7):1022-4.

Bolus obstruction of pouch outlet by a granular bulk laxative after gastric banding.

Herrle F, Peters T, Lang C, von Fluee M, Kern B, Peterli R.

Department of Surgery, St. Claraspital, Basel, Switzerland.

BACKGROUND: Constipation is an occasional problem after gastric banding and is often caused by insufficient liquid intake. As a result, the use of laxatives is widespread in such patients. Depending on the laxative, improper use can lead to bolus obstruction above the band, as occurred in this case. Case Report: A 59-year-old female with uncomplicated laparoscopic adjustable gastric banding presented 2 months after surgery with food and liquid intolerance and dysphagia after ingestion of a granular bulking laxative. Despite deflating the band, the bolus could not be washed out. Endoscopic extraction was required, revealing a 4x2 cm bolus of the laxative and a small compression ulcer.

DISCUSSION: Patients not complying with nutritional recommendations after gastric banding may have insufficient liquid intake and, consequently, constipation. Under these conditions, the use of a granular bulking laxative entails the risk of esophageal obstruction above the band.

CONCLUSION: Nutritional counseling after gastric banding should include the recommendation of liquid intake of at least 1.5 l/day. If constipation occurs, osmotic or paraffin oil laxatives should be used instead of bulking laxatives.

Publication Types:

* Case Reports

PMID: 15329197 [PubMed - indexed for MEDLINE]

And drink MORE water! Everyone!

My surgeon recommends taking Miralax (or the generic version as it is less expensive) every day. It isn't a laxative, but rather a stool softener. He said that by taking it daily, you will keep things moving without any harsh side effects or blow outs.

You can also become chemically dependent upon laxatives to have a bowel movement. Regular use of stimulant laxatives will result in an eventual loss of bowel tone, which can in turn result in Irritated Bowel Syndrome, chronic constipation, and possibly complete bowel incontinence.

  • 1 month later...

I had a similar problem and used milk of mag too. My problem was that I was definitely not drinking enough water. It really has to be at least 8 glasses of water a day, 64 oz, otherwise you will get backed up badly. I upped my water intake and have been monitoring it much more lately to make sure I get enough and I havent had the problem since.

I had the same problem. My PCP prescribed Amitiza. Works like a charm with none of the problems that you get with laxatives and no dependency.

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