No bowel movement since I had surgery, it's been 5 days now.

Question

I had my surgery June 19th. Brachioplasty, tummy tuck and some lipo around hips and “saddle bags”. I haven’t had a bowel movement since I had surgery 5 days now. I’m very nervous about it since I have taken opioids for pain and I know they cause constipation. I don’t want want to have to “push” for obvious reasons. I’ve been taking colase, does nothing. An advice? I’m scared!

Erik Miles, MD, FACS · Answer

Postoperative constipation is common, especially when narcotics are used heavily.  Suggestions vary among practitioners, so it would probably be best to start with your surgeon’s advice.  Try to wean yourself from the narcotics. Stay hydrated with plenty of fluids. If it becomes uncomfortable you can drink a bottle of magnesium citrate. Best wishes.

Paul Vitenas, Jr., MD · Answer

Thank you very much for your question and
congratulations on your recent brachioplasty and tummy tuck. Constipation is a
common side-effect of a major surgical procedure. Most patients will note their
post-op constipation improves after stopping all narcotics or opioids. I
recommend drinking lots of fluids and sticking with a healthy diet. If your
constipation does not improve, or you begin to experience pain, reach out to
your operating surgeon for their advice.

Peter D. Geldner, MD · Answer

Though not uncommon, postoperative constipation can be very troublesome. The common suggestions;lots of fluid, roughage,stopping the narcotics if possible, will help. I recommend Milk of Magnesia to get your gut going. If however, you experience pain, fevers, chills or have bleeding, see your doctor to make sure it is not a more serious problem than simply constipation.

Daniel Barrett, MD · Answer

Dear DeannaS,you are right, opioids can cause this kind of problem. Every plastic surgeon has his own postoperative protocol which he recommends to his patients. I would suggest you to discuss this with your plastic surgeon.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Camille Cash, MD · Answer

Generally you do not want to go more than three days after surgery without a bowel movement.  The narcotics as well as changes to your activity level and diet can impact your regular bowel routine.  Since you have been using Colace without improvement I encourage you to contact your surgeon for further instruction.

Robert J. Paresi Jr., MD, MPH · Answer

Thanks for the question.  Constipation is very common after surgery.  This is often related to the use of narcotics for postoperative pain control.  Narcotics reduce bowel activity resulting in constipation.  The more narcotics that are taken the higher the risk for constipation.  The first solution is to only take the narcotics if you need them.  Most patients are off of narcotics within a week after surgery.  Having a tummy tuck with muscle tightening can also contribute to postoperative constipation.  The second potential solution is a new medication on the market called Movantik which is specifically designed to treat opioid induced constipation.

Robert L. Kraft, MD, FACS · Answer

Constipation is common after surgery, especially a major procedure with prescription pain meds. You can try glycerine suppositories to make things easier and hydrate as much as possible.

Mark Eberbach, MD · Answer

5 days is close to a problem. I suggest a bottle of magnesium citrate to my patients. It is rough for the 2 hour process but then relief. One should be well hydrated before. Check with your doctor about this first.

No bowel movement since I had surgery, it's been 5 days now.

Answers (8)

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