I am having a Tummy tuck tomorrow. I drank the fluid to clean your bowels, after 1 hour I vomited. My PS said not to work just stay on liquid diet. But I am worried. Comments?
Bowel Cleansing Before Tummy Tuck
Doctor Answers (10)
Bowel prep is not a standard routine
In a straightforward abdominoplasty, I don't put my patients on a bowel prep. If the procedure is being done in combination with a gynecologist performing a hysterectomy or a general surgeon performing an intra-abdominal procedure or hernia repair, I leave that up to the other surgeon to make that decision. After intra-abdominal surgery, patients often develop what's called an ileus, which is where the bowel motility temporarily shuts down. Patients don't start eating again until they are passing gas.If the bowel has been prepped, then there will be less likelihood of constipation after surgery, particularly if the patient is taking pain medicine like hydrocodone because codeine related products tend to cause constipation.
It is not absolutely necessary
In 19 years of practice, I have never asked that a patient use a bowel prep before an abdominoplasty. There is little to gain from having an empty colon and we have never had any significant issues regarding bowel movements after tummy tucks.
Bowel Preps Can Help
A low residue diet, liquid diet or a bowel prep before surgery decrease the amount of stool in your bowels following surgery. This can make your postoperative recovery slightly easier. After your procedure your bowels will slow down and the transit time or time will increase and you can become more bloated. Listen to your surgeon.
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Individual surgeons have different routines but in most situations, a clear liquid diet for 24 hours is sufficient. I have never had to use a bowel prep solution. Occasionally a patient will request or require a suppository to help with a bowel movement pre-op.
Bowel Prep for Tummy Tuck
It is not essential and I would not be alarmed. Plastic surgeons who prescribe bowel cleansing, like myself, believe it helps with comfort after the surgery. Since that is discomfort from the tightening of the muscles and you will be on narcotic medications, there is a tendency for constipation and straining after the surgery.
By having your bowels emptied there will be a less likelihood for straining and discomfort.
Bowel prep not absolutely necessary for tummy tuck
It is my inpression that the vast majority of plastic surgeons do not use bowel preps. Therefore I would not be overly concerned. Therefore, even the liquid diet is more than adequate in most instances. To minimize postoperative constipation from the narcotic analgesics, I frequently advise my patients to begin stool softeners and mild laxatives soon after surgery.
No need for bowel prep in Tummy Tuck
There are 2 reasons cited for bowel preps:
1- Have empty bowels in case there is injury to the bowel. This is highly unlikely in a routine tummy tuck, unless there is an associated hernia repair or other intraabdominal procedures. In this case I leave the decision to the general surgeon in charge of the intraabdominal part of the procedure.
2- to prevent straining or constipation after surgery which may endanger the muscle repair if the patient pushes too much. The risk is increased with use of narcotics, which are needed for pain control, as narcotics by themselves cause constipation.
I think the use of stool softeners a few days before surgery, and the use of pain pumps, which vastly decrease the need for narcotics, are more than enough to eliminate constipation as a factor.
Don't worry, not essential
We started using Magnewsium citrate prior to abdominoplasty about five years ago and have noticed that patients have a slightly less complicated post-op course with relation to constipation and discomfort, but this is certainly a practice choice and not essential to a great experience with your surgery.
Bowel preps for abdominoplasty
We do not routinely prep the bowel unless there is an associated hernia that is complicated, i.e. revisional, where intraabdominal surgery might be necessary when the hernia is repaired. Often these more complicated procedures are done in conjunction with a general surgeon in a hospital setting.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.