Wednesday, 14 September 2016

One problem most have after WLS - Pooping

Just so you get an idea of what sort you need to see happening

Pooping - the main grumble after WLS

The Reasons Why It Happens

  1. You have had a major bowel operation. The operation and anaesthetic can slow gut movement
  2. Little or no food being eaten post-op then that amount stays a lot less than you are used to for ages afterwards.
  3. Not enough hydration (glasses of water)
  4. Lower fiber in food eaten
  5. Less exercise immediately post-op
  6. Stress, and you only know what your stress reasons are
  7. Position on toilet

What can help you get better Poops


Water

1. Water. You need to drink 8+ glasses of water to get a comfortable poop. I carry bottled water with me when I go out. At home I take note of what I am drinking to make sure it is enough. I refill the glass as soon as I finish it. Yes, I know how hard it is to drink enough as the urge to do so is often absent. Sometimes when you feel hungry it is actually because you are thirsty; drink a full glass of water and see. Coffee actually dehydrates you but it is a bowel stimulant so may help you go.

Exercise

2. Exercise each day. This may only be 3 10 minute walks just after your operation but it does help. 3 years post-op I often have to hit the toilet not long after I do the 1/2 hour walk into town. The exercise massages your abdominal muscles over your bowel and make it move more. They strengthen your muscles also. Being sedentary slows down your whole body. If I do a lot of exercise I may go to the toilet more than once in a day.
Massage your abdomen

3. Massaging your external abdomen
can encourage your bowels to keep everything moving along. You start upwards on your lower right side, across just under your ribs and down on your left side as this is the way your food goes through your bowel. I push in a little more in this left lower area and have been known to bend over my hand to get a little more pressure. This can work very well but be careful just after your operation as you don't want to cause any problems with internal stitches.

Stool to get better angle
4. "A stool in the toilet. What do I need than for?" This actually gives you a semi-crouching position. Why do we need that? There is an internal ligament that helps keep your bowel closed when you are moving around. It bends the bowel so it is blocked off a bit more. The squat position moves this ligament and you have a straight drop. Think long drop toilet instead of S-bend - much easier to use if it's a bit hard down there. For many weeks I used a step stool to raise my knee level (semi-crouch) each morning - it was easier on me.

Regular toilet time with no interruptions 
5.Regular toilet habits. It isn't easy at the start and it becomes more difficult if the kids/significant other are lined up at the door saying that they have to go. I am lucky as most days it is the first thing I do on waking. If it doesn't' happen then a walk may do to get a result. Last resort I take my sure fire remedy (kiwifruit) later in the day. So, literally pick a certain time each day that used to be your norm and re-establish that bowel habit. Have a drink of water before going to sleep, and on waking, can also help here.

Not only infection but to help constipation.
6. Diet is an important part of improving your bowel habits. Some of it is due to fibre - both soluble and insoluble -  that the food contains. Sometimes it is the vitamins and minerals in them that strengthen all muscles including the bowels. Some create more movement and gas in the bowel. Probiotics in some foods repopulate your bowel with good bacteria used for digesting your food properly. My favourite way is to have 1-2 kiwifruit if I am a bit hard. I love the sweet/tart flavour and I have a good result either later in the day or the next morning. Remember to check with your surgeon or dietitian when certain foods can be introduced.
Bananas help in so many ways

Helpful foods

Beans have helpful fibre (beware of gas eruptions)

Fibre and breakfast - a twofer

Oats and linseed - fibre and oils

Kiwifruit - works wonders
Wholefoods are better for you than processed food as you know exactly what you are putting in your body. You have more control over the amount of carbs, protein, fats, vitamins/minerals, salt and fibre that you eat. The portion size is correct as is the frequency of when you eat. MyFitnessPal is a quick and easy way to check on your intake as you can track your intake. They automatically tell you what it contains and let you know what your daily totals are. It can show if you have reach your target or not.

The Times Nothing Works.

What to do.
  • Ask the chemist (pharmacist) as some OTC items work well
  • Ask your doctor as you may need suppositories/enemas to help clear the backlog
  • Head for the ED if you can't stand or walk due to the pain as it may be causing further bowel problems.
  • See your surgeon as the problem may have been caused by something to do with your op
Start with the top person and work down as all you may need is some extra fiber or mild laxative to get back to normality.
Enemas to clear bowels

Soluble fibre to soften things
Suppositories to help at the bottom end
Softener and lubricator

 Good luck and get on it early. It literally gets harder, and causes even more problems, if you take a wait and see approach. Most people go every 24-36 hours and that is your aim.