Needing help with constipation. I have been extremely constipated. I am very bloated and look like I'm pregnant.

My colleagues have already told you about narcotics, anesthesia, and the constipation that frequently accompanies this and any surgery. You are right to be concerned about "pushing" or straining, as this can cause bleeding (and if you had a tummy tuck, for example, could cause sutures to tear).So you're correct to be careful regarding this concern.But nobody has really told you how to start your gut working normally. The answer is based on the problem. I assume your normal bowel habits are "normal" to perhaps slightly constipated, with BMs every day or every other day. Many patients, both women and men, tend to be a bit on the constipated side as we age, and we often take stool softeners, fiber supplements or high fiber diets, or that occasional "prune delight" drink to keep the gut functioning. Now, throw some anesthesia and narcotics at this situation, and your gut slows down. The bowel movement is still present in your colon, and more time there equals more fluid absorbed, especially if you don't drink quite enough after surgery. Your tissues swell and your body absorbs fluid by the quart, making you somewhat dehydrated, adding to the absorption of fluid from your stool. The BM moves slowly to your sigmoid colon, where even more fluid is absorbed, and eventually (yes, at about 4 days) your GI tract is effectively "plugged" by that over-large,  over-firm, fecal impaction. Your first step would be to rehydrate that stool "plug" via Fleets enema or two, lubricate your rectal and anal area with glycerine suppositories, and then progress to stimulant suppositories. Once the "plug" is passed, everything else should work (since you've stopped your narcotics).Taking laxatives and stimulants orally might work, but since the hard fecal plug is really the issue, softening up the upstream BM really won't work, and causing the gut to push or spasm harder just makes you miserable. You need to get the fecal plug out to get the process (re)started. So start with the plan as I've described, and call your doctor's office if this doesn't seem to help. They have had this call before, trust me! Best wishes--I hope things work out in the end! Dr. Tholen

You are already doing everything that I would recommend. Since you've stopped your pain meds, things should improve. If they don't, call your surgeon. You don't want to stain. It can break blood vessels and cause bleeding. So sorry that you are so uncomfortable. Some bodies just have a severe reaction to anesthesia and surgery.My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Constipation is likely due to your pain medications.  You are doing the right things, but I also recommend that you discuss this issue with your surgeon.

Thank you for your question.Unfortunately constipation is common after having surgery.It is most likely  caused from the anesthesia & pain medication. Drink plenty of water and eat  high fiber foods.Now that you are off the pain medication you should start to feel some relief. Contact your surgeon for some additional options that may help. Best of luck.

This is a common occurrence after surgery. Your "gut" is not working like it normally would. Peristalsis (contraction and relaxation of smooth muscles that propel food) is sluggish and the narcotic pain medication cause constipation as well. You are doing all the right things; I would add mineral oil to the mix. Try 1-2 tablespoons with meals ( 3x per day) for the next couple days. This will soften the stool and you will not have to bear down to have a bowel movement. Also, now that you have discontinued your pain medication, this will help too! 

I’m
sorry to hear that you’re uncomfortable. Post-surgery constipation
is quite common, as the anesthesia and narcotic based pain medication
can really slow down the digestive processes. It sounds like you’re
taking all the right steps to encourage a bowel movement. Given that
you just stopped your pain medication, the body may need a little
time to adjust. Keep walking and drinking water, and consider eating
prunes. Based on what you’ve already taken, I wouldn’t recommend
any additional laxatives or suppositories. You need not worry about
your straining disturbing your implants.

is common but most of the things you are doing work well for most people.  Since you've stopped your pain medications, if you cannot get relief, you must let your surgeon know.  And heavy straining can lead to vessels breaking and bleeding so try your best to avoid pushing really hard.

Often constipation is related to the use of pain meds post-op. I have patients use still softeners while taking the pain meds. You might want to consider cutting back on the pain meds.  Best to confer with your surgeon.

 Unfortunately constipation is very common after plastic surgical procedures. I usually suggest high-fiber food, focus on adequate hydration,  frequent ambulation and weaning off narcotic medications soon as feasible. Medications may also be useful depending on the specific situation, patient allergy, and surgeon preference.Generally, it is advisable for patients seek assistance from their operating plastic surgeon if the constipation persists past 4 to 5 days. Best wishes.

The narcotic medications that are commonly prescribed after cosmetic procedures can cause constipation. It causes the gastrointestinal tract to slow down peristalsis and allow the intestines to absorb more water. In effect, this dries out the stool and makes you constipated. I would try magnesium citrate first. If this does not help, I would recommend a fleets enema. These can be found at your local Walgreens or CVS.