Regular Bowel Movements

Question
Thank you in advance for answering this question for me.

A year ago February I had a VSG.  I've lost a lot of weight but still have not reached my target goal.  I have my protein drink each morning and make sure to put fiber it.  Here is where my question comes in.

I'm having trouble with my bowel movements.  My body doesn't handle that part of the digestion as it did before surgery.  It's like there is no sense of urgency or the strength factor of elimination.  On checking out of the hospital, my surgeon gave me stool softeners.  I had no idea the reason behind the softeners until the first time I had to go to the bathroom.  I wouldn't advise taking this each day as I was told to do.  It makes everything just that much more difficult to come out.  It's very very sticky, like paste.

I started drinking prune juice each night and for a time, things seem to be working out.  Only, I'm a diabetic and my sugar levels went through the roof, so I had to stop drinking it.  I eat plenty of green veggies and beans, too!  So I don't know what else to do.

Question:  What can I do to have regular bowel movements?

Thank you, again!

Ethel

Answer
Ethel,
I think you are describing constipation rather than bowel movements that are too loose.  I can give you some general guidance but this really is the type of thing to discuss with your surgeon because there is no single right answer that suits every person - whatever bowel plan you start on needs to be followed up and rechecked in personal live discussion in case it is not working.

Generally speaking, constipation is fairly common for all types of weight loss surgery, because patients tend to run mildly dehydrated and they take in less food bulk because of overall smaller eating.  In order for the bowels to work easily, the body needs first PLENTY OF FLUID, and second FIBER BULK.

So my first piece of advice is to drink plenty of fluids so that you are well hydrated all the time, even when you wake up.  Drinking 64 ounces per day is a good place to start, but what is really important is to monitor the frequency and appearance of your urine - if you are well hydrated then you will "pee" frequently and your urine will be light in color, not yellow or dark.

Once you are well hydrated, you will probably benefit from taking extra fiber.  In practical reality a patient after weight loss surgery cannot get enough dietary fiber to help the bowels work well (and much fiber is starchy so it works against weight loss anyway), so it is useful to take extra fiber in powdered form.  Metamucil is the old standby, but most folks find that benefiber is easier to mix and swallow.

Once again, I recommend that you check out this plan with your surgeon and plan follow up with him/her on your bowel function.

Best of luck!
Dr JP

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