Bowel Function After Surgery

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Constipation is a common problem following surgery. It is important to avoid excessive straining to pass a bowel movement as this will put pressure on the stitches in your vagina. Try to eat plenty of fruit and fiber and drink plenty of fluids to keep your stool soft after surgery.

Stool softeners and/or laxatives are often prescribed after surgery to help prevent constipation. Take these as advised by your doctor. Some women experience burning or shooting pains in the rectum after surgery. This usually decreases within a few days after surgery.

What can I eat?

You may eat and drink normally after gynecologic surgery. You may have a decreased appetite for the first few days after surgery; eating small, frequent meals or bland, well-cooked, soft foods may help. However, if you are not able to eat or drink anything or if you start vomiting, call your surgeon.

Eating lots of foods with fiber and/or using a daily dose of polyethylene glycol (sample brand names: GlycoLax, MiraLAX) can help to prevent constipation, although other treatments for constipation are also available. We recommend starting with a single dose (17 g) of MiraLAX on the day after your surgery and adjusting that dose (up or down) daily until your bowel movements are normal.

How do I treat constipation?

Constipation is common after surgery and usually resolves with time. Constipation means that you do not have a bowel movement regularly or that bowel movements are hard or difficult to pass. If you need to take opioid pain medications, this can make constipation worse.

If you have vomiting in addition to constipation, or if your surgery involved the stomach or intestines, call your surgeon before using medications to treat constipation.

A common approach to constipation after surgery is to take a laxative, such as magnesium hydroxide (milk of magnesia), or a fiber supplement like psyllium (sample brand names: Metamucil, Hydrocil) or methylcellulose (sample brand name: Citrucel). This can be taken with a stool softener such as docusate (sample brand name: Colace).

If the initial treatment does not produce a bowel movement within 24 to 48 hours, the next step is to take a stimulant laxative that contains senna (sample brand names: Black Draught, Ex-Lax, Fletcher’s Castoria, Senokot) or bisacodyl (sample brand names: Correctol, Doxidan, Dulcolax). If the stimulant laxative does not result in a bowel movement within 24 hours, your surgeon might suggest trying an enema. Read the directions and precautions on the package before using these treatments.

If these treatments do not produce a bowel movement within 24 hours, you should call your surgeon for further advice.

Once the bowels begin to move, you may want to continue using a nonstimulant laxative such as polyethylene glycol (sample brand names: GlycoLax, MiraLax) on a daily basis to keep your bowel movements soft. This treatment may be taken for as long as needed.

What if I have diarrhea?

Some people have a few days of loose stools (diarrhea) after surgery, especially after taking medication for constipation. If you have diarrhea more than twice a day or have blood in your stool, you should call your surgeon.