Nov 7, 2019

Interview Transcript

Dr. Jones: Things your surgeon didn't tell you. This is Dr. Kirtly Jones from Obstetrics and Gynecology, and today on "The Seven Domains," we're going to be talking about constipation after surgery at "The Seven Domains of Women's Health" on The Scope.

Announcer: Covering all aspects of women's health, this is "The Seven Domains of Women's Health" with Dr. Kirtly Jones on The Scope.

Dr. Jones: So I got a call from a friend of mine across the country who just had surgery. She said, "I had terrible constipation. Why didn't they tell me about this?" And I went, "Yeah, why don't we tell people about this?"

So for women who have elective surgery, that means it's not an emergency surgery and it's something that you could prepare for, it turns out that there are things that you could do prior to surgery to help your gut get moving faster, and there are certainly things your surgeon could tell you and prescribe for you that you could use in case you have problems afterwards.

But constipation after surgery is extremely common, with estimates as high as 30% in women who are having surgery after either pelvic surgery or maybe a hip replacement or a knee replacement. So it's common.

And if you can't get around very well if you've had a hip surgery, or if you've had abdominal surgery and you have stitches, being constipated really hurts, and your tummy puffs up like a balloon and you're very uncomfortable. So what can you do?

Number one, if this is elective surgery and you're not having a bowel prep . . . what's a bowel prep? Bowel prep is when you are going to be taking some pills and some fluids to make your bowel completely empty before surgery. If it's just you and you can eat a couple days before your surgery, you should think about trying to eat stuff that will make for a very healthy gut, a healthy bowel.

Now, here's a warning. Here's a warning. The following topics are something that you may want not to listen to at the dinner table, so a little warning.

So what you want to eat is fiber and fruits and lots of fluids in the days before your surgery. Because what happens on the day of surgery, number one, you don't get to eat.

Number two, they're going to give you general anesthesia, which slows your gut down completely. If they're operating in your pelvis and in your abdomen, they're going to be touching your bowel, which makes it stop working.

And number three, they're going to give you narcotics, both during surgery and afterwards, which completely slows your gut down.

So what is in your gut stays there longer and it absorbs more water. So what was hard, if you aren't ready, is going to get like rocks. And if you start with soft stool that's been prepared by a very healthy diet with fruits and vegetables and water, what you'll have is soft stool and a couple of days without moving that along won't make it so hard.

So if you're getting ready, number one, get your gut ready. Number two, if you've had pelvic surgery and now it's your first day post-op, your surgeon can certainly offer you a stool softener starting the first day after surgery.

We talked briefly in another podcast about the importance of caffeine. So if you're a caffeine drinker, it turns out that having a cup of coffee the first day after surgery actually gets your gut moving faster. So that's something, if you're a coffee drinker, and the study suggested even if you weren't a caffeine drinker, having a cup of coffee or some caffeinated beverage the morning after surgery moves it faster.

So a stool softener that your surgeon prescribes the first day after surgery. Stay and start walking. So as soon as you can ambulate, you should start walking because that increases gut motility.

So go home and eat lots of fiber. But remember, what's already in your gut has slowed down and you need to get that moving. So within a day or two after surgery if you haven't had a bowel movement, you could talk to your surgeon or you could buy over-the-counter or something called Dulcolax. And this is something that is a stimulant. So you want to prepare your gut with fiber and water. So those are laxatives in terms of bulk laxatives, but they don't stimulate your gut.

But afterwards, if you're not moving, you should take a stimulant if a couple of days go by and you start getting uncomfortable. That's something that you can do, but you need to be prepared and have this stuff at home.

So having a prescription for a stool softener that you start the day after surgery, and it wouldn't be bad to even start it a couple of days before surgery.

If you don't have a bowel movement within two days after surgery, you could take a stimulant, and there are stimulants that are over the counter like Dulcolax.

Take good care of your gut after surgery and before surgery and it will take care of you. The worst thing is having a sore tummy and then have yourself all bloated up and have three to four days pass and you can't pass anything. So get ready, get set, and go.

Thanks for joining us on The Scope.

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