A hysterectomy is the surgical removal of the uterus — and in many cases the surrounding tissue and organs. When a hysterectomy is performed, you lose the ability to menstruate and the ability to conceive and have kids.
More than 300,000 women get hysterectomies each year. Reasons, why women get hysterectomies, include pelvic pain, excessive monthly bleeding, fibroids, and different types of cancer. There are four different types of hysterectomies:
- Total hysterectomy — removal of uterus and cervix only
- Supracervical hysterectomy— removal of the upper part of the uterus only
- Total hysterectomy with bilateral salpingo-oophorectomy — removal of the uterus, cervix, fallopian tubes, and ovaries
- Radical hysterectomy with bilateral salpingo-oophorectomy — removal of the uterus, ovaries, fallopian tubes, cervix, upper portion of the vagina, and some surrounding tissue and lymph nodes
Depending on the type of hysterectomy you get, you may experience constipation during recovery. Recovery requires you to be sedentary — which means the body doesn’t get the same amount of activity as before surgery. Remaining as active as possible will help prevent constipation. For those experiencing constipation after a hysterectomy, there are several different techniques to help avoid being uncomfortably bloated and full.
Why Do I Get Constipated after a Hysterectomy?
Constipation is fairly common after a hysterectomy. Gynecological and digestive system complaints post-surgery are interrelated. Postoperative constipation can affect up to a third of women. Many women experience cramping, impairment of defecation, and irregular bowel movements after their procedure.
The post-op hospital diet can also affect your system. Due to the minimal amount of food and drink you’re given, you could see a delay in your normal bowel movements. These bowel problems should go away in several days to about a week after your hysterectomy.
Constipation can occur for many reasons:
- Anesthesia — Though we think of anesthesia as something that puts us to sleep, it also paralyzes our muscles. In addition to paralyzing your legs and arms, it paralyzes your intestines as well. This affects the muscle contractions that usually push food through your intestinal tract, which prevents the movement of feces.
- Pain medication — After surgery, doctors often use opioid medications to manage pain. Studies show that about 40% to 95% of patients who receive opioids postoperatively experience constipation as a side effect.
- Reduced fluid intake — In preparation for surgery, most patients are NPO (nothing by mouth). After surgery, some are instructed to drink minimally and in some cases not to eat solid foods. This combination works against the body and its normal routine of elimination. Not enough fluid means less fluid in the feces, which leads to hard, dry, immobile stools.
- Less mobility — Inactivity is a general cause of constipation. Women recovering from surgery often need to rest for prolonged periods and avoid vigorous exercise. The lack of movement slows down the digestive system.
If you don’t adequately address your constipation, there are several complications that you can develop:
- Hemorrhoids — Swollen veins in and around the anus due to bowel movement straining
- Fecal impaction — Hard stool becoming lodged in the intestines
- Anal fissure — Hard stool causing tissue in the anus to tear
- A surgical incision reopening — Straining pressure causing stitches to burst open
- Rectal prolapse – The straining from a bowel movement leading to parts of the intestine being exposed out through the anus
How to Get Relief from Constipation after a Hysterectomy?
Your post-op instructions could have you limit your physical activities or be on total bed rest. This will not help you to get back into your regular bowel movement routine. But these tips can aid in reducing the symptoms of constipation.
Liquid diet
After your procedure, hydration will help get your bowels moving again. You should drink more than your normal amount of fluid intake preop while you’re recovering. In addition to water, broths, soups, and smoothies will help awaken your digestion system to get things mobile again. The more fluid you have in your intestines, the softer your feces. This makes it easier for your body to pass the fecal matter through your digestive system and avoid constipation.
Get mobile
Find ways to implement simple acts of movement during your recovery. Get up and take short walks to the bathroom and kitchen during your first few days post-op. The sooner you move, the sooner your body adjusts after the anesthesia used for your hysterectomy. The movement also helps reduce your risk of blood clots. Often, simple movement like walking will help get your bowels moving. As you recover, light exercise will also help you avoid slowly gaining weight after your procedure.
Fiber-rich diet following recovery
Fiber-rich foods like beans, nuts, fruits, veggies, and whole-grain bread are essentials for your diet after your hysterectomy. These foods will not only help prevent constipation but also give your body the essential nutrients it needs to heal faster from your surgery.
There are certain foods that can lead to constipation and you should avoid as much as possible post-surgery. They include:
- Dairy like milk and cheese
- Processed foods like fast food and cold cuts
- Refined grains like white rice, pasta, and white bread
Speak with your doctor about taking fiber supplements or laxatives for constipation relief after your hysterectomy. These are useful remedies for helping to get your bowels moving. But be careful — some of these may stimulate the inner lining of the bowel too much, and you could end up experiencing bowel contractions and/or diarrhea.
How Long Should Post-op Constipation Last?
Most people will have constipation symptoms for only a few days postoperatively. This is especially true if they start treatments fairly fast. Laxatives usually work within 24 hours, and stool softeners usually take a few days. Treatments affect people differently depending on the type of anesthesia used, how long the anesthesia was used, and your overall health. You should let your doctor know if your constipation lasts for several days.
We Also Care for Your Colorectal Issues
Nevada Surgery & Cancer Care (NVSCC) not only uses the latest in laparoscopic surgical techniques for our hysterectomies but also uses the latest techniques for colon and rectal surgery. If you experience colorectal issues long after your hysterectomy, visit us today so we can properly diagnose and treat your issue.
Additional Sources:
British Journal of Obstetrics and Gynecology: “ Bowel dysfunction following hysterectomy.”
Cleveland Clinic: “ Hysterectomy.”
Hospital for Special Surgery: “ Managing Constipation after Surgery.”
Surgical Associates of the Midcities: “ Constipation After Surgery.”U.S. National Library of Medicine: “ Bowel Function After Minimally Invasive Hysterectomy.”