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Post Op 2.5 months Constipation... Advice needed!!!



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Hey everyone! This is Ashley. I had surgery on October 6th and had to start my pre-op diet in the beginning of June of this year... My heaviest weight is 356 lb... The day of surgery I was at 313 lb... And as of today I am at 264 lb!!! I was so thinking excited when I hit the 90 lb mark of weight loss ! Can imagine what if you like once I lose 100 !!! My goal weight is about 180 lb. Some about 85 lb away from that goal I believe ... More than halfway there just from the pre-op diet and 2 of post-op!?!

It took me a while to be more comfortable with trying new foods as I was terrified of throwing up or having dumping syndrome... I had the gastric sleeve and things have been going much better than expected! I'm able to eat very healthy but lots of different types of foods which is really exciting! I even ate a sliced apple the other day which some people can't tolerate the skin and I did create!

The reason I'm reaching out to y'all is because I'm dealing with chronic Constipation. The only time that I can really go to the bathroom without any pain is if I take milk of magnesia... I tried to avoid it but The 2 weeks ago after realizing I hadn't gone to the bathroom in 2 and 1/2 weeks but I had no stomach pain or anything so I totally lost track of it! I had a bowel movement " naturally" If you can even call it that took two days to get out last Sunday and Monday... It was an extremely painful experience and extremely hard to the point where put it this way. I had to plunge the toilet a couple times just to be able to get it down.... Details are gross I know but this is what this page is all about getting help for our gross details! I just now took more milk of magnesia because I haven't gone since that severely constipated situation...

I have been very good about eating very healthy and drinking a lot of Water and getting my Protein intake. I have however unfortunately not been great at taking Vitamins and keeping up with them. I ordered some more vitamins today and decided to get back on track. Even before surgery I was deficient of Vitamin D very severely as well as low on Iron to the point of anemia. So I'm wondering if my nausea that I've been having isn't just constipation but also Vitamin deficiency and if maybe that's why I'm constipated as well... I also ordered benafiber tablets to see if that helps...

Do you guys have any advice on how to go better? What do you do when it's been a few days and you haven't gone? In the past? If I don't go for three or four days pre-surgery I had to get stomach cramps and pains and things like that and that's not happening this time around. Advice is welcome. There is hope if we just stick together. I love you all so much. You are like a family to me! I look forward to your responses!!

Sent from my Pixel 6 using BariatricPal mobile app

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Constipation is a very common issue with WLS patients (both bypass and sleeve). A lot of us take something like Miralax, stool softeners, or magnesium tablets every day to keep on top of it. I've been taking a capful of Miralax every day for years. I still get backed up maybe once a month now, but a night or two of milk of magnesia solves that.

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I have chronic Constipation so I take Trulance everyday, then miralax twice a day plus senna tablets at nights 3 times a weeks or else nothing will move. It really is miserable.

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This is such a critical issue that my team literally put it at the very front of their bariatric pre-op binder. I'm attaching their guidelines for dealing with Constipation. There are no copyright marks anywhere in their document, so I'm going to assume this falls under fair-use guidelines.

Sorry for all the poop emoji's! I think it was their way of trying to lighten the mood on a serious subject that people feel strange discussing.

One thing you'll see over and over in this is if you're having trouble, call your team. It may feel weird to talk to your nurse about this, but constipation is one of the most common questions they get. They are very used to talking about it.

For what it's worth, my surgery was a few weeks before you and I still take one colace and one peri-colace daily.

BM Guide.pdf

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Keep trying things, this affects all of us but each body gets relief differently. I watch the timing of the Vitamins too. If you take Calcium with Iron they bind up and cancel each other for example. Drink 64 oz of Water, try everything said including Probiotics and or Prebiotic foods like kombucha, yogurt, sour kraut, kimchi. You will find a sweet spot, it just takes time to work out the new plumbing system. I wouldn’t let it back up more than a week. I use a multi prong approach with probiotics, magnesium supplements, and benefiber each evening, caffeine in the am. It got me back to regular most mornings. Best of luck experimenting! (I was motivated by a very bad blowout at work that I never want to repeat lol.)

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Thank you so much for the information! My doctor just told me to avoid caffeine for at least a year post op. Honestly, because I take ADHD medicine, I'm doing fine without it... I actually got off the medicine that I used to take for energy due to my sleep apnea because my energy has been naturally coming back which is pretty cool... I think that's another reason though, now that I think about it that I could be getting constipated as well... I should drink three to four cups of coffee a day and once I got that first cup down I was good to go to the bathroom... I will use some of your suggestions. I got benifiber coming in tomorrow and my mom said don't take Fiber with the Multivitamins as it can cancel them out. So I will take it at night and then I will take the multivitamins with Iron and the Vitamin d dissolve both tabs in the morning...

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My team recommends Miralax and Colace (if needed).

I have IBS and sometimes… copacetic is needed. But I always start with Miralx first. So far between the two it’s been manageable.

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First congratulations on your weight loss so far. Yay!

Secondly, Constipation is a common problem & a pain in the butt (meant the pun). Try adding some non swelling, soluble fibre to your diet like Benefibre & ensure you’re meeting your fluid goals. Try to keep on top of it with medications, & try to avoid not going for extended periods of time - too painful & stressful. I didn’t mind if I didn’t go every day but I took a stool softener if I hadn’t gone after three days so I would have some action on the fourth day.

Maybe track your pooping (not Sheldon Cooper style 😉 but just when you go) so you can avoid prolonged periods if constipation.

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I use Just Better Fiber. I mix it into EVERYTHING I drink, usually, several tablespoons throughout the day. It helps immensely. When it gets really bad, I use Miralax, but that's pretty infrequent as long as I keep up with the fiber.

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I eat very little carbs but I make sure they're SUPER PACKED with Fiber. Fiber Gourmet products have been a life saver for me, its been helping me normalize my bowel movements!

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Sorry you are going through this. I too had the same problem. What I did was increase my fiber so I usually get around 15-20 grams per day and I drink about 70-80 oz of Water. I use Benefiber and try to find foods that have a decent amount of fiber in them. This has helped me tremendously. It was so bad that I had to use enemas at least weekly until I started taking more fiber and water. Now I am very regular.

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On 12/18/2022 at 8:13 AM, SpartanMaker said:

This is such a critical issue that my team literally put it at the very front of their bariatric pre-op binder. I'm attaching their guidelines for dealing with constipation. There are no copyright marks anywhere in their document, so I'm going to assume this falls under fair-use guidelines. Sorry for all the poop emoji's! I think it was their way of trying to lighten the mood on a serious subject that people feel strange discussing.

BM Guide.pdf

Here's the BM Guide without the poop emojis.

BM Guide.pdf

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Looks like you’ve got tons of advice here but I will add what worked for me. I had this issue once and I took milk of magnesia the first time it worked like a charm but the NP said to start taking benefiber daily to prevent it from happening again. I took a spoonful of the generic powder one from Walmart dissolved in my crystal light each morning. I continued that until my servings got much closer to normal serving size and I was actually eating some fruits and veggies. At that point I weaned off of it and I’ve been fine since. Many people do have to remain in something preventative forever though.

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