First BM after surgery

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First BM after surgery

Postby SteveR » 15 Jul 2012, 01:47

Im after some help here.
I have my op on Tuesday - but after getting myself into a regular BM pattern, I'm not sure how to deal with this.
Normally I have my BM early in the AM. I achieve this through religiously following my high fibre diet.
My op is in the PM which means no food after 7am. So this means that day I will not eat very much and will find future BM hard.
Should I on the following day just go straight back into my high fibre diet to get myself regular again, or should I not eat as much for a few days to keep my stools small and therefore a chance to heal?
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Re: First BM after surgery

Postby Sue27uk » 15 Jul 2012, 02:52

I had my operation at 1pm, and was not able to eat after 6am (so that meant the last time I ate was 10pm the night before!). Then did not eat until 4pm the following day so I had 18hours of not eating. I was also worried like you! I just ate my regular meals, obviously all healthy foods. I eat brown bread, cereals and 2 portions of veg and 2 portions of fruit per day to keep things moving. It took 2 days to have a bm and wasn't too bad. I would eat what you normally do but take a stool softener too. The CRS gave me movicol which has worked great, he told me to have 2 sachets per day but I had one (as I have IBS). It has been a lifesaver for me! Good luck with your surgery :)
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Re: First BM after surgery

Postby Kat » 15 Jul 2012, 03:27

My surgery was timed much the same as Sue27uk's, it was around lunchtime and I hadn't eaten or drunk anything since the night before. I ate a sandwich a couple of hours after the surgery at the insistence of the nurses ( I stayed in overnight following my surgery). In the week that followed I wasn't really that hungry, I only ate about 1000 calories a day ( I would normally eat between 1200 to 1600 calories a day) but that seemed to be enough to keep things regular and I wasn't using much energy so I only lost a couple of kilos.
Based on what I'd read here on the forums I focussed on eating "soft" foods like soup and cooked veges the first few days. I have also learned all about soluble fibre on these forums in recent weeks so have been focussing on increasing my soluble fibre.
It took me nearly three days to have a bm following surgery. I think that delay was thanks to what was going on in my head rather than in my bowels given I was taking two laxatives (Coloxyl) every night and drinking a glass of Benefiber every morning.
Immediately following the surgery I refused the stronger pain killers as i was scared of getting constipated. The nurses initally gave me paracetemol via the drip but I was still in quite a bit of pain when the doctor stopped by later on in the evening of the surgery and he told me to not worry about getting constipated and to take the Pandeine Forte (Paracetamol & Codeine Phosphate) painkillers but with plenty of laxatives. I took a couple of the stronger pain killers that first evening and one the next morning and then after that just went back to regular paracetemol. I was also initially a bit resistant to using laxatives on a daily basis but the doctor told me to just do what it takes to get the fissure and the surgical wound healed and to worry about stopping the laxatives later.
The first bm post surgery hurt... a lot! On my personal scale of pain I put the pain up there with the pain of childbirth. Every bm was excruciating for the first week or so until the wound of the surgery healed over a bit and then it calmed down. In the first couple of weeks it even hurt to pass wind!
My advice would be to wait and see what your body tells you in respect of how much and what to eat. Keep drinking plenty of water. Keep adjusting the laxatives till you get the right combo for keeping you soft and regular. Also take plenty of pain killers and don't let them wear off. I kept getting surprised by my bms as they were at different times each day those first couple of weeks. Also ask you doctor about taking anti inflammatories. My GP suggested that two weeks post surgery and I have to wonder why the surgeon didn't suggest it to start with as it certaily seemed to settle things down a lot more.
Good luck! Let us know how you go.
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Re: First BM after surgery

Postby Ever the Optimist » 15 Jul 2012, 03:42

Hi again Steve,
Kat and Sue have provided you with some great advice regarding your question. I would say exactly the same!!
I was starving after my op, even though I actually had an afternoon slot, so was able to eat before 7.00am that morning but starved for about 8 hours....
I ate a full hospital meal, went home and then ate again later! Unlike Kat, I seemed to be the opposite. I was SO hungry!!!....
I got my first BM the morning after my op, so pretty much back to business as normal for me!!
I did, and stress, will, continue to eat lots of soluble fibre and remain strict with my diet and fluid intake because it is so vital whilst healing to keep it all soft and to avoid as little pressure as possible during those BM's. Also totally agree if you are getting pain, keep on top with the pain killers BEFORE the pain starts getting bad. You won't need them indefinately - just to get through the worse. I also refused to take codeine based pain killers, which are renowned for constipating. That was the last thing I felt I needed!!!!
Once again all the best Steve :D
Chronic Fissure diagnosed December 2011
Healed by Diltiazem around Feb 2013
Anal Fistula followed burst abscess in June 2012
2 internal troublesome piles remain & suspected, but undiagnosed, ongoing Levator Ani type symptoms & flare-ups
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Re: First BM after surgery

Postby SteveR » 15 Jul 2012, 05:26

Thank you guys for your advice. Its great to talk these things through with people who have been there. You raise these things with other people and they just look at you strange!
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Re: First BM after surgery

Postby Tori-tore » 15 Jul 2012, 13:31

I too had my surgery at 1pm. Because I'm breastfeeding (and really hungry and thirsty all the time) I was allowed two bits of toast at 6am and a glass of water at 10am. I then had a sandwich at 4pm, and scrambled eggs on toast at 7pm.
My normal regimen is to take 15ml lactulose at night, but the surgeon told me this wasn't enough so the night of the surgery I took 30ml. This resulted in me waking at 3am with a sore tummy and having to rush to the loo and an explosive watery BM as a consequence of not enough food and too much lactulose.
However, this wasn't the end of the world because A) I didn't have time to think about it and get worried, and B) it didn't hurt too much. I found as things firmed up the BM's got worse, with day 4 the worst, then greatly improving from there on out. Sorry I don't mean this to be discouraging I'm just being honest. I was so low that 4th day wondering if I would EVER get better, but I think it was a case of being darker before the dawn, and then all of a sudden so so much better :D
be strong and get it over with, soon enough you'll struggle to remember how awful it all was, believe it or not!!!!
good luck
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