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.