4-5 Years out of RNY Surgery, is constipation common

Question
HI!

I hope you can answer this. Number one I am an RNY failure. Lost some of the
wieght but gained it all back and was not willing to go back in. However the
surgery was still a miracle to me because for years I suffered severe
constipation and after that surgery everything went through me...which might
horrify some but to me it was a miracle, so much better. As for the wieght I
have to do that on my own. But recently I started getting constipated again.
What can I do about this?Is this common this far out? Also even though I
failed should I be getting b12 shots this far out and if so how much do I use?

Thanks,

Mandy

Answer
Mandy,
Yes, constipation is fairly common after all of the weight loss operations.  The issue seems to be that the colon (the part of the intestine that forms and clears out stool/bowel movements) needs plenty of fluid and plenty of non-digestible bulk fiber in order to work well.  Bariatric surgery patients tend to run low on water intake, and because of their small eating they tend to run low on fiber as well.

I recommend for you to first be sure you are drinking plenty of fluids, so that you void ("pee") regularly and so that your urine is very light in color, almost like water.  You need to be well hydrated even overnight, because if you are dry at any time your body will suck available fluid out of your bowels.  This leaves you with hard/dry stool and your body is not able to put that fluid back if you catch up later.

Second, I recommend for all of my patients to take some type of supplemental fiber (benefiber seems easiest): 1 Tbsp twice each day.

If these basic maneuvers don't help then you will need to see a doctor in person.

Last comment:  I recommend you get checked out by another bariatric surgeon or program.  Even if there is nothing correctable with your surgical anatomy (and most often there is not), it is still helpful for you to remain engaged with the program to get the most out of your surgical procedure.

Best of luck!
Dr JP

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