Many patients experience changes in their daily life after having bariatric surgery. Patients can expect changes in their eating habits and food choices, exercise regimens, body measurements, and even mood postoperatively, but one less commonly discussed change is constipation.

Constipation after gastric sleeve surgery has been studied and found to be quite common among patients postop. Here we will discuss causes, treatment, and prevention of constipation after gastric sleeve.

What Causes Constipation After Gastric Sleeve Surgery?

The gastric sleeve or vertical sleeve gastrectomy (VSG) is a surgical procedure where a portion of the stomach is removed. The dramatically smaller stomach size produces weight loss by reducing caloric intake.

Since there is such a small space for food, patients typically focus on protein intake, which leaves little room for fiber-rich carbohydrates, fruits, and vegetables. Fiber-rich foods are vital to having regular bowel movements. Fiber increases the size of the stool as well as soften the stool to make it pass easier.

High protein diets also increase the feeling of fullness, which can be achieved pretty quickly after a meal post, gastric sleeve surgery. This feeling of fullness can prevent patients from drinking water throughout the day. Decreased fluid intake can cause dehydration and further exacerbate constipation. Like fiber, water intake is important in softening stool and moving it along the gastrointestinal tract.

Dietary and fluid intake is the more commonly discussed cause of constipation after gastric sleeve, but some medications are just as likely to slow down bowel movements.

General anesthesia, which is given during the surgical procedure and narcotic pain medications given afterward, slows down the wavelike movements of the intestines known as peristalsis, which helps to push food and fluids along through the gastrointestinal tract to be eventually evacuated.

How to Prevent Constipation After Gastric Sleeve

Thankfully for gastric sleeve patients, many of the daily habits that help in achieving weight loss are also helpful in preventing weight loss. Eating high fiber foods, maintaining adequate hydration, and routine aerobic exercise are all habits that will help keep constipation at bay. As mentioned before, fiber and fluids help to soften and push stool through the gastrointestinal tract. Exercise prevents constipation differently than fiber and fluid by promoting peristalsis, the wavelike movements of the intestinal tract, which helps to move stool out of the colon.

Tips for Preventing Constipation:

• Set a reminder or alarm at regular intervals to take small sips of fluids throughout the day.
• Add lemon, cucumbers or mint to liven up plain water.
• Include high fiber plant-based proteins such as beans, lentils, and tofu in meals and snacks.
• Choose protein-rich veggies like broccoli, brussels sprouts, and asparagus.
• Snack on nuts and seeds.
• Take the stairs instead of the elevator.
• Walk or bike to work if possible.
• Park the car as far from the front door as possible

When to Seek Help For Constipation After Gastric Sleeve?

Constipation after gastric sleeve can last anywhere from several hours to days. When constipation lasts more than three days and becomes increasingly uncomfortable, patients should seek medical help. Bariatric health professionals can help to recommend appropriate over the counter treatments such as stool softeners, laxative, and suppositories.

Always follow up with a bariatric health provider before using over the counter treatments to ensure that they are safe to use.