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Constipation after Orthopedic Injury or Surgery

While you were in the hospital, your nursing team and providers may have asked you how often your bowels were moving and given you medication to help your bowels move. It is important to your health and recovery for your bowels to return to your normal routine after surgery. Here are some tips to help get your bowels moving after surgery

How do I know if I’m constipated (Having trouble moving my bowels)?

Constipation is different for every person, but you may be constipated if:

  • You move your bowels less than three times a week

  • You are having a bowel movement less often than you did before surgery

Signs and symptoms that I’m constipated:

  • Small, hard bowel movements

  • You have to push hard to have a bowel movement

  • You have pain or an uncomfortable fullness in your belly

  • You feel sick to your stomach

Why am I having trouble moving my bowels after surgery?

  • You are not up walking as much after your surgery.

  • You are not drinking liquids or eating as much high fiber foods after surgery.

  • You are taking medications after surgery, like pain pills or other medications that can cause your bowels to slow down.

  • You had trouble moving your bowels before surgery.

How can I keep my bowels moving?

  • Drink at least 64 ounces of water, juice or other liquids in the day.

  • A beverage that has caffeine may help move your bowels if you drink it in the morning.

  • Eat more fruits and vegetables. Citrus fruits, prunes and prune juice have a lot of fiber to help keep your bowels moving.

  • Get moving! Walking can help your bowels to move.

  • Try to have a bowel movement in the morning after you wake up, or about 30 minutes after you eat a meal. These are the times your bowels are most active.

  • If you are taking pain medication, remember that it may be harder to get your bowels moving. Plan to drink lots of water, eat high fiber foods, and walk as much as possible.

If you are having trouble moving your bowels after your surgery

  1. Check your discharge instructions for medications to keep your bowels moving.

  2. Medications to get your bowels moving can be found over the counter (OTC) at your local pharmacy or retail store. Follow the directions on the package.

Some medications that are used to get your bowels moving and keep them moving after surgery are:

  • Peri-colace® is a medication with Senna and Colace

    • Senna, taken by mouth, helps get your bowels moving.

    • Colace® (Docusate Sodium), taken by mouth, helps soften your bowel movements so they move easier

  • Miralax® (Polyethylene glycol), taken by mouth

    • This medication will help get your bowels moving.

    • Try taking Peri-colace® If your bowels have not moved in 1-2 days, you can add Miralax® once a day until you have a bowel movement.

  • DulcolaxSuppository® (Bisacodyl), placed into your rectum

    • This medication will get your bowels moving quickly.

    • Use this medication AFTER you have tried other medications like Peri-colace® and Miralax® for your bowels, or if you have not had a bowel movement in 3 or more days.

    • PLEASE NOTE: This drug can make your bowels move very fast. Make sure you are close to a bathroom.

Call your doctor:

  • If you have kidney or liver problems, ask what is safe for you to take for your bowels after surgery

  • If you see blood in your bowel movements or on the toilet paper

  • If you have not had a bowel movement in several days

  • If you have any concerns or questions about moving your bowels or taking medication to move your bowels

References:

Wald, A. (2016). Patient information: Constipation in adults (Beyond the Basics).
UpToDate — http://www.uptodate.com/contents/constipation-in-adults-beyond-the-basics