Article By: Whittany Gibson, RDN
Whittany is a Registered Dietitian Nutritionist who specializes in bariatric nutrition counseling, providing education and support prior to and following weight loss surgery.
After weight loss surgery, your weight loss may be moving fast, but something else may be moving too slow. I’m referring to your bowel movements. Many people might feel shy about addressing their bathroom habits with their providers, but keep in mind, all of your providers talk about poop. It’s okay! It’s natural, we all do it, and we need to “go” on a regular basis to be healthy, preferably daily. In many cases, your poo can be an indicator of health concerns or status. But following bariatric surgery, constipation can be a real issue! Reasons mostly include the drastic reduction in calories, mostly coming from the foods that are fiber rich such as fruits, vegetables, whole grains, nuts, seeds and legumes. It is ingrained in your brain from the start to “eat protein first”. And in most cases, there’s no more room for the fiber rich foods. As you get farther and farther post-op, you should slowly be able to incorporate more of those fiber-rich foods. But within the first three months, it can be pretty slow moving and many weight loss surgery patients can experience some severe constipation if not addressed early. Be patient and use some creativity. Here are some ways to help avoid or alleviate sluggish bowels.
1) Increase fluid intake. Ensure you are getting plenty of clear fluids throughout the day. You want to aim for the minimum of 48 oz per day but with warm climates and exercise, you will want to aim for a minimum of 64 oz per day. Clear fluids can include plain water, sugar free flavored water, low sugar or no sugar added sports drinks, broths, herbal teas, sugar free popsicles, and sugar free Jell-O. Without adequate fluid intake, your body doesn’t want to function at its prime, including your bowels which need fluid to move things along. You will particularly want to ensure you are getting adequate fluids if you are increasing fiber, which is the next tip.
2) Increase fiber. The average recommended fiber intake is 25-30g per day for most people. This is particularly hard to reach after bariatric surgery. I typically try to make sure my patients are getting the protein and fluids they need first and if they can reach these goals easily, we move to tracking fiber. As mentioned in the introduction, fiber rich foods consist of fruits, vegetables, whole grains, nuts, seeds, and legumes. Figs, prunes, pears, and raspberries are examples of fruits higher in fiber. Beans are also great for boosting fiber intake and are a great source of plant-based protein. I also like to suggest adding in fiber-rich supplements like plant-based protein drinks and powders that have at least 4g of fiber per serving, adding in ground flaxseed into soups, salads, protein smoothies, puddings, you name it. If it mixes, add it in. Psyllium is another type of fiber that can be added to liquids or foods. It can be used to treat constipation, diarrhea, helps to control blood sugar and blood pressure, and aids in lowering cholesterol. It is available in different forms such as capsules, powder, husk, and granules and can easily be added to your daily regimen.
3) Get regular exercise. Move more! Just a simple walking routine aids in digestion and ultimately gets your bowels moving more regularly. Aim to walk after meals, particularly one hour following a meal for at least 15 minutes. Walking after meals has also been shown to decrease symptoms of heartburn and acid reflux.
4) Try a daily supplement. Fiber supplements are available in many different forms. Fiber capsules, powder, gummies, you name it. The key is to find what fits into your routine, your eating patterns, food choices, and also depends on your ability to consume it. For example, you don’t want to depend on taking a fiber supplement if you are already having issues with meeting your fluid goals. Remember, fiber needs fluid. Many of my patients are having a lot of success with papaya enzymes which are beneficial for gut health. Papaya enzymes, or papain, are extracted from the raw fruit of the papaya plant which can be used to help fight inflammation, swelling, and pain but can be particularly helpful in supporting digestive health. Daily probiotics can also be an option. Probiotics including acidophilus are best used as a daily regimen. Foods that contain natural probiotics include fermented foods like kimchi, sauerkraut, kefir, miso, and yogurts.
If you need additional help with getting things moving, you can include other gentle daily options like Milk of Magnesia, Colace, or Miralax. But also remember, all these options still require plenty of fluids so hydrate well! I like to suggest food fiber first but ultimately you need to choose what works for you. Just use your creativity and a little planning and you’ll be on the right track.
BariMelts provides general recommendations, not to be construed as medical advice. Please consult your doctor.