Laxative after hysterectomy surgery. Nutrition for constipation. Constipation after appendicitis: causes

Why does constipation occur after surgery, how to get rid of it? The causes of impaired intestinal motility can be injuries and the negative effects of general anesthesia. To prevent the development of complications, proper rehabilitation is necessary. Constipation occurs especially often after intestinal surgery. Its appearance is facilitated not only by a decrease in the tone of the organ walls, but also by prolonged bed rest, changes in diet and the use of painkillers. The method of treatment depends on the cause of the development of the pathological condition, the general condition of the body and the type of surgery undergone.

Causes of constipation

Why does constipation occur after gallbladder removal? This organ is involved in almost all stages of the food digestion process. Bile enters the intestines, where it accelerates the absorption of nutrients. Indications for cholecystectomy are: inflammatory processes, the presence of stones and malignant tumors. Improving bowel function after surgery is facilitated by following a special diet and taking medications prescribed by a doctor. The accumulation of bile in the body prevents the rejection of fatty, fried and heavy foods. It is recommended to eat 5-6 times a day in small portions.

On the first day after surgery, you should not eat or drink water; the next day you are allowed to consume rosehip decoction, dried fruit compote, low-fat kefir and weak tea. On the 4th day you are allowed to take liquid or semi-liquid food - mashed potatoes, boiled pureed fish, vegetable soups. This nutritional principle will have to be followed for 8 weeks. Spicy, fried and smoked foods should be excluded from your diet forever. The range of prohibited foods is quite wide; following a strict diet allows you to avoid changes in intestinal acidity.

Constipation after surgery to remove the uterus can be caused by the development of adhesions. In the early postoperative period, it is also recommended to avoid eating rough and heavy foods. You are allowed to eat porridge, kefir, vegetable salads and soups. It is better to avoid cabbage and legumes. The sooner a woman returns to an active lifestyle, the lower the risk of adhesions and constipation. If necessary, the doctor prescribes mild herbal laxatives.

Laparoscopy is a low-traumatic surgical intervention in which access to organs is provided by performing small punctures. The risk of developing serious complications is low, but constipation does occur after such an operation. In the first days after the intervention, you should avoid any physical activity, visiting the bathhouse or sauna, or taking a hot bath. Proper nutrition and relaxing procedures help quickly get rid of constipation. After laparoscopy, the patient must carefully monitor his health, take care of the suture and change the dressings in a timely manner.

Constipation after removal of hemorrhoids is largely due to the patient's fear and the presence of pain. With the long-term presence of this condition, the rectum ceases to function normally, so it is necessary to begin to deal with the problem before the sutures heal.

Any surgical intervention requires anesthesia. Both general and local anesthesia have their own side effects. Even an experienced anesthesiologist cannot predict what consequences general anesthesia may have. Constipation occurs due to decreased tone of the intestinal walls, abdominal and pelvic muscles. Painkillers negatively affect the functions of the liver, kidneys and gallbladder. Their incorrect operation can lead to deterioration of intestinal motility.

The faster the body gets rid of toxic substances, the easier the early postoperative period will be. It is necessary to observe a special drinking regime and eat properly. The restoration of intestinal microflora is facilitated by the intake of prebiotics. Getting rid of constipation caused by anesthesia is quite simple. At first, you can adjust your stool using oil microenemas, which have a quick effect.

Diet therapy

After removal of the gallbladder, the flow of bile from the body becomes difficult. The process of bile excretion occurs through the preserved bile ducts. They open when food enters the stomach. Therefore, it is important to organize regular fractional meals in small portions according to the regimen. Products that irritate the gastrointestinal mucosa are prohibited, such as:

• fried, fatty, smoked, spicy;
• cold dishes, for example, jelly, ice cream;
• conservation;
• baking;
• alcohol, soda;
• peas, garlic, radishes, beans, sorrel.

All dishes must be steamed, stewed or boiled. In this form, food will not irritate the mucous membrane, which will reduce the amount of bile produced. This in turn will reduce the load on the gastrointestinal tract without the gallbladder.

As the body recovers, it will get used to the absence of this organ, and the general condition will improve. It will be possible to gradually expand the diet, but the products should remain healthy, nutritious, and fortified. Frequent and fractional meals in small portions are required. The daily menu should include fermented milk products, slimy porridges, and fiber products.

The basic principles of a healthy diet will speed up the restoration of the functions of internal organs, the body will no longer need the removed gallbladder, and the person will be able to feel healthy.

How to get rid of post-operative constipation?

Treatment is prescribed only after identifying the cause of this symptom. First of all, you should increase the amount of fluid consumed to 2.5-3 liters. This promotes softening and faster excretion of stool. The diet should include wholemeal bread, bran, buckwheat and oatmeal.

Laxatives allow you to quickly improve bowel movements, but each drug has side effects and contraindications. In addition, they do not help eliminate the cause of constipation. Active substances act in the large intestine, increasing osmotic pressure and enhancing peristalsis.

It is necessary to begin treatment with herbal-based drugs, available in the form of tablets, drops and suppositories. The feces soften due to the swelling of the fibers contained in the preparations. They are quickly eliminated from the body along with feces.

The drug Fortrans is indicated for long-term constipation in adults; it should not be taken if you have heart, liver or kidney diseases. The elimination of unpleasant symptoms is facilitated by the restoration of microflora with the help of probiotics, which reach the intestines in their original form. By increasing the number of beneficial bacteria and eliminating inflammation, the drugs quickly get rid of the problem. Glycerin suppositories allow you to quickly get results, but you should not abuse such drugs. The tone of the intestinal walls decreases, because of this it becomes unable to empty itself. Taking laxatives after surgery can contribute to exhaustion and dehydration. For treatment at home, you can use folk remedies for constipation.

After surgery, you cannot tolerate the urge to go to the toilet.

Constipation after surgery is a common phenomenon experienced by people who have undergone surgery on the gastrointestinal tract and neighboring organs: intestines, appendix, gallbladder, pancreas.

We will now look at how to open the intestines and what to do in such a situation to relieve constipation in an adult or child.

What operations cause constipation?

The following surgical interventions and the phenomena that accompany them can lead to constipation:

• surgery to remove the uterus;
• abdominal type of operation;
• surgical interventions on the rectum, large and small intestines;
• operations to remove nodes formed as a result of hemorrhoids, removal of fistulas after hemorrhoids have been cured;
• During laparoscopy, constipation may occur due to the administration of narcotic drugs to euthanize a person;
• during gastric resection, constipation may also occur in the postoperative period;
• constipation can also occur after surgery necessary for appendicitis;
• Constipation may also occur after pancreatic and gallbladder surgery.

Narcotics and painkillers reduce the tone of the abdominal muscles, including the intestines. Problems with stool begin in the first few days after surgery and, if you maintain a normal lifestyle and follow all the recommendations prescribed by the doctor, they disappear after a week.

Video

After laparoscopy

Laparoscopic technique refers to minimally invasive techniques that allow operations to remove affected tissue through small holes. The method allows you to avoid injury, the development of severe complications and speeds up the course of rehabilitation. But constipation always accompanies laparoscopy, especially if the gallbladder is removed. The doctor chooses the tactics individually. General recommendations:

• refusal of serious physical activity and sports;
• refusal of high-temperature procedures.

Additionally, diet and medications are prescribed for symptomatic treatment. After laparoscopy, it is important to assess the patient’s well-being and inspect the suture daily and change the dressing.

Constipation symptoms

If a person does not have stool in the first few days after surgery on the gastrointestinal tract, this does not mean that constipation has occurred. In the first days, patients are usually advised to drink and only on the third or fourth day are they allowed to eat grated light food. So it is quite normal that in the first 2-3 days the patient will have no stool, since the intestines simply cannot process it, and it starts when normal food begins to enter the body.

Heaviness in the abdomen, bloating and nagging pain, which indicate fullness, signal constipation.

But the following signs will signal constipation itself:

1. Bloating and gas formation.
2. Fatigue, fatigue may appear, and performance may decrease.
3. With prolonged stagnation of the intestines, a rash appears on the face, which is evidence of intoxication of the body.
4. When trying to empty the intestines, the patient experiences sharp pain in the rectal area, since the feces are already very dry and begin to irritate the intestines and can even lead to cracks in the rectum and anus.
5. If the act of defecation is still successful, the patient continues to feel heaviness in the stomach and a feeling of incompleteness of the process.
6. The person loses his appetite and may experience headaches, pain and nausea.

Constipation is also dangerous because it slows down the recovery process after surgery and can lead to complications.

Consequences of postoperative constipation

If you do not quickly adjust your stool after surgery, the consequences of prolonged constipation can have a bad effect on the patient’s well-being.

To avoid constipation, you should eat as recommended by your doctor.

This is expressed in the following symptoms:

• severity of healing of postoperative sutures;
• the development of stagnant processes that lead to intestinal injuries is possible;
• the body will be saturated with toxins that enter the blood from feces through the intestinal walls;
• ruptures of an established colostomy are possible if intestinal surgery was performed.

These consequences of constipation are a frequent reason for repeated operations, as well as the use of a large number of medications, which can further weaken the body, but are a necessary measure to save the patient’s life. Therefore, it is important to get rid of constipation as soon as possible, or better yet, start preventing it altogether from the first hours after surgery.

How to prevent and treat constipation?

Measures to prevent and treat constipation are the same. They are aimed at restoring the functionality of the intestines, the tone of its muscles, as well as alleviating the patient’s condition.

Since the intestines work much worse after surgery than before, they need help. Medicines prescribed for constipation help normalize the patient's stool and normalize bowel function. But all of them must be prescribed by a doctor, since each type of operation has its own nuances.

You can use the remedies given in the table, some of them are suitable for both prevention and treatment and can be used by the patient independently, while others are used only for the treatment of constipation and are prescribed by a doctor.

Facilities	Operating principle
Prevention and treatment of constipation
Exercise and warm-up. Exercise cycling and walking, pulling in the abdomen to tighten the abdominal muscles	They help restore muscle tone that was reduced by medications administered during surgery.
Drink a glass of clean water every morning twenty minutes before breakfast	Helps to start the work of the stomach and intestines, which were stopped during sleep, the production of enzymes begins, which will improve and speed up the digestion process.
Taking probiotics and prebiotics (Bio Guy, Bifiform, Hilak Forte)	These medications help populate the intestines with beneficial bacteria, which will improve the digestion process and the movement of feces through the intestines.
Drink 1.5-2 liters of clean water per day	Water helps soften the stool, making it easier for it to move through the intestines and leave the body naturally without damaging the integrity of the mucous membranes.
Massage the abdomen strictly clockwise with light, smooth movements with your hands. You can sometimes press lightly with three fingers on the left just below the navel	Helps to activate intestinal activity, promotes mechanical softening of feces, which facilitates the process of excretion of feces
Diet. Consumption of light porridges (except rice), fermented milk products, compote juices, honey and jam, as well as fresh vegetables and fruits in small doses. But you should avoid eating astringent and strengthening products; this includes pears, pomegranates, fatty meat and fish, and broths based on such products.	Products rich in fiber, as well as bifido- and lactobacteria, help the intestines in the process of moving feces, and also facilitate the process of forming a fecal bolus, making it softer.
Treatment of constipation
Laxatives. It is best to use mild laxatives. Duphalac, Exportal, Normaze, Mucofalk are good options. It is also good to use glycerin suppositories at the very beginning of the development of acute constipation.	Taking mild laxatives will not lead to intestinal atony, but they will help get rid of constipation and alleviate the patient’s condition, and will also help the intestines restore peristalsis. A more aggressive laxative (especially a senna-based laxative) will only make the situation worse.
Enemas are best used in small volumes and only as a last resort.	The Microlax enema also helps with the passage of feces well and does not irritate the intestines.

Massage and exercise therapy

After surgery, constipation can be caused by low physical activity. The patient should give preference to moderate physical activity. It is important to take walks in the fresh air every day. In addition, you need to perform a set of simple exercises.

Moderate physical activity improves the functioning of the digestive system. A set of exercises is selected by a doctor. Exercise therapy is aimed at strengthening the abdominal and pelvic floor muscles. A daily walk in the fresh air helps prevent the formation of stagnant processes.

The video shows a technique for performing acupressure against constipation:

Causes and symptoms

Many people experience constipation after surgery due to the following factors.

• Medicines. Painkillers, diuretics, muscle relaxants and anesthesia drugs can cause constipation. In particular, opioids can significantly worsen peristalsis.
• Changing your diet and diet. Some people require complete abstinence from food before surgery. Other patients need to change their diet or limit their consumption of certain foods after the surgical procedure. Some foods can cause constipation. In addition, this problem can be caused by a lack of fluid in the diet.
• Lack of physical activity. Lack of mobility is a common cause of constipation. People recovering from surgery often need to rest for long periods of time. At the same time, a low level of physical activity slows down the digestive system.

Symptoms of postoperative constipation include the following:

• the frequency of bowel movements suddenly decreases;
• the need to empty the bowels occurs less than three times a week;
• you have to strain a lot to pass stool;
• stool becomes hard and lumpy;
• even after defecation there is a feeling that the intestines are not completely emptied;
• the rectum seems to be blocked;
• bloating or gas develops;
• there is a need for additional actions that help empty the rectum, for example, pressing on the abdomen during bowel movements;
• pain appears in the abdomen or rectum.

Symptoms of the disorder

Doctors identify the following main signs of constipation after surgery:

• defecation occurs no more than three times a week;
• feces are dry, hard, and difficult to leave the body;
• lack of relief after defecation;
• presence of painful syndrome during bowel movements.

In the presence of constipation, a number of complexes can arise. In addition, the immune system is significantly reduced. When defecation is delayed, rotting occurs. Toxic substances spread throughout the body. The patient may experience insomnia. He becomes irritable. In the absence of timely treatment, bleeding occurs.

With constipation, the patient does not feel relief after going to the toilet

Complications of constipation after surgery

If constipation is not treated after surgery, this problem can cause serious complications, including the following.

• Seams coming apart. This can happen if people strain too much during bowel movements.
• Hemorrhoids. This condition is characterized by swelling of the veins in the anal area as a result of overexertion during bowel movements.
• Anal fissures. Anal fissures occur when large amounts of stool or stool that is too hard leads to tears in the lining of the rectum.
• Fecal plug. Chronic constipation can cause the formation of fecal compactions that block the intestinal lumen.
• Rectal prolapse. Excessive straining during bowel movements can cause part of the intestine to come out of the anus.

Nutrition

Treatment of constipation after surgery is always accompanied by a special diet. It is recommended to include foods rich in fiber in your diet. It will promote the production of enzymes that have an irritating effect on the intestinal walls, thereby improving peristalsis.

In order for the digestive tract to recover faster, you must adhere to the following nutritional recommendations:

1. On the first day, provide the body with complete nutritional rest.
2. Follow the diet prescribed by your doctor for at least 20 days. Since operations on different organs require different dietary restrictions, the diet should be prescribed exclusively by a doctor.
3. Avoid rough foods - fatty, fried, salty, smoked foods are prohibited after any surgical intervention.
4. Fractional meals.
5. It is better to boil or steam dishes.
6. Before consumption, food should be crushed, this will make it easier for the body to digest.
7. Having breakfast at the same time - a schedule can have a therapeutic effect on the intestines, which will have a beneficial effect on its functioning.

Treatment and recommendations

If constipation is left untreated, it can cause significant discomfort and lead to complications. This is especially common after operations.

However, it is important to remember that before using any therapeutic strategies to relieve constipation, you should check with your doctor, as some treatments may not be safe for people who have recently undergone a surgical procedure.

The recommendations below are related to the mild impact on the body of patients who have recently undergone surgery. However, they should only be used with a doctor's permission.

Keep Movable

Walking may make bowel movements easier

As soon as the attending physician gives the go-ahead, you need to start moving. You can take walks around your home or hospital grounds, or do other physical activities. Motility helps food pass through the intestines more easily and stimulates bowel movements.

A 2014 study by Chinese scientists found that lack of physical activity and a sedentary lifestyle are associated with constipation. Walking and other light exercise can relieve a person of unpleasant symptoms.

People who are unable to get out of bed can simply move their legs or arms to improve blood circulation and help bowel movements.

Use laxatives

For postoperative constipation, the doctor may prescribe medications that soften the stool.

Sodium dioctyl sulfosuccinate and other agents use water in the intestines to moisten the stool. Moistened stool passes out of the body more easily.

After anesthesia

Anesthesia is necessary to provide deep pain relief during the operation. Constipation is the most common complication, as during general anesthesia the following occurs:

• complete relaxation of all human muscles;
• intoxication of the body with narcotic drugs that cause kidney and liver dysfunction.

As a result, intestinal function is disrupted. The recovery period in this case depends on the rate of removal of toxic substances from the body. For this purpose, a special diet and plenty of drinking are prescribed. To stabilize the microflora, you will need to take bacterial preparations. Microenemas with salt, oil solutions and chamomile decoction will help improve the condition of the intestines and bowel movements.

What should you eat and drink before and after surgery?

Food and fluids consumed before and after surgery can have a significant impact on the prevention and treatment of postoperative constipation.

Below are tips to help people maintain regular bowel movements. Still, it is better to discuss the possibility of using these and other preventive measures with your doctor.

Drink significant amounts of liquids

If you are dehydrated, avoid drinking drinks containing caffeine.

Dehydration can cause constipation. To maintain hydration, people should drink water regularly throughout the day. Diluted fruit juices, especially plum juice, can also help.

It is also helpful to avoid drinks that contain caffeine, such as coffee and cola. These products can make dehydration worse.

Consume foods rich in fiber

Fiber helps stool pass through the digestive tract.

Adults who consume about 2 thousand calories daily need to eat at least 25 grams of fiber every day.

Foods rich in fiber include the following:

• fruits;
• vegetables;
• whole grains;
• nuts and grains;
• beans and lentils.

If after surgery a person does not have a good appetite, then to provide the body with the necessary amount of fiber, he can drink cocktails containing fruits and vegetables.

It should be emphasized that people who begin to consume fiber more actively also need to increase the volume of fluid they take.

Avoid some foods

Certain foods are more likely to cause constipation. If this problem occurs, you should limit or completely stop consuming the following foods:

• dairy products;
• processed food;
• refined grains, such as white bread, white rice, or white pasta.

Snack regularly

Eating food can stimulate intestinal motility. Therefore, doctors recommend eating small and frequent meals to relieve constipation.

Postoperative problems with bowel movement and ways to solve them

If constipation occurs after removal of appendicitis, hernia, hemorrhoids or other surgery, measures should be taken immediately to eliminate it in order to avoid the development of complications. Stool retention can be a consequence of postoperative trauma, but more often occurs due to the harmful effects of general anesthesia. Anesthesia causes weakening of all muscles of the body, of which the intestinal muscles are no exception. In order for muscle tone to be restored, you need to wait a certain time. It is during this period that disturbances in intestinal motility and, as a result, constipation appear. To prevent the development of this process, it is important to follow some postoperative rules:

• drink a glass of cold water on an empty stomach;
• for some time after surgery (removal of a hernia, appendicitis or other type of operation), take laxatives. Most often, Duphalac or Normaze (lactulose) are prescribed; they are absolutely safe and are not absorbed into the blood;
• It is very important to enrich the intestinal flora with beneficial bacteria. In this case, various probiotics are prescribed that restore the necessary balance of microflora (Hilak Forte, Simbiter, Bio Gaia, etc.);
• Following a special diet is the key to successful bowel function. In the morning, it is good to eat oatmeal or whole grain porridge cooked in water. During the day, they eat a lot of fermented milk products, fresh vegetables (which do not cause flatulence), bread with bran, small pieces of boiled meat or lean fish. It is forbidden to eat vegetables and fruits that cause increased gas formation, strong tea, coffee, and carbonated sweet drinks.

How long does constipation last after surgery?

In most cases, people see relief from constipation within a few days after surgery, especially if the condition is treated quickly.

Stool softeners and fiber laxatives usually begin to work within a few days, while motility stimulants and suppositories take 24 hours to work.

The duration of postoperative constipation depends on several factors, including the following:

• the general health of the patient;
• duration of anesthesia;
• types of medications taken.

If constipation does not disappear after a few days, you should tell your doctor about it.

Prospects

Many people experience constipation after surgery. Causes of this problem include pain medications, anesthesia, or lack of mobility.

The outlook for patients experiencing postoperative constipation is generally good. Most see improvements within a few days of starting therapy.

It is necessary to coordinate with your doctor the use of any medications for the treatment of constipation, especially after surgery and in cases where a person is taking other pharmacological products.

Folk remedies

Herbalists divide medicinal plants into two groups - those with a high level of laxative effect and those with a less pronounced laxative effect.

The first group includes:

• rhubarb root;
• cassia leaves;
• buckthorn bark.

To the second group:

In addition, traditional healers recommend drinking for constipation:

• cucumber pickle;
• oat decoction;
• plum tinctures and decoctions.

But the first place in the treatment of constipation in folk medicine is given to ordinary drinking water. To quickly empty your intestines, you need to drink a glass of water on an empty stomach; to enhance the effect, you can add a spoonful of honey to the water.

If surgery was performed for hemorrhoids, it is recommended to regularly take baths with chamomile or other anti-inflammatory herbs. The water temperature should be no higher than 40 degrees.