Constipation after a surgical procedure is very common problem encountered in clinical practice.
35% and 45% of patients suffered constipation post operatively.[1]
5 Reasons why people experience constipation in orthopaedic wards.
#1. Decreased gastro intestinal motility after surgery.
Gut motility gets hampered in the post operative period, there fore the constipation. This is more common in patient who have abdominal surgery but none the less even orthopedic patients experience similar disturbance in their bowel movement.
#2. Decreased mobility due to immobilistation.
Decreased mobility do to immobilisation is also a very important cause of constipation amongst orthopaedic patients.
#3. Drugs, especially some pain medication.
Some medications especially belonging to the opioid group of drugs can cause constipation.
#4. Poor diet in the peri operative period.
Most trauma patient who come into the hospital, tend not to focus on what they are eating.
The shock of the trauma and unfamiliar surrounding are enough to affect a person's appetite.
Lack of fibre rich diet can again contribute to the constipation.
#5. Decreased in take of water, dehydration and preoperative starvation.
Dehydration due to elevated environmental temperatures, decreased water intake and prolonged starvation before surgery further compound the problem of constipation in all patients.
Tips :
Early mobilisation in bed, helps with early bowel movement. Move your arms and legs in bed and try out some deep breathing exercises .
Early ambulation as soon as the situation permits also helps.
Paying attention to dietary fibre intake and avoiding processed food and adequate hydration will make sure your bowel movements are regular.
Use of alternative drugs to opioids analgesics. (eg. tramadol) (Note: Discuss with your doctor).
Severe constipation will require medication, Kindly consult your doctor for the same.
References:
Lee, Tae Hee et al. “Risk factors for postoperative ileus following orthopedic surgery: the role of chronic constipation.” Journal of neurogastroenterology and motility vol. 21,1 (2015): 121-5. doi:10.5056/jnm1407.
Sonneborn O, Bui T. Opioid induced constipation management in orthopaedic and trauma patients: treatment and the potential of nurse-initiated management. Int J Orthop Trauma Nurs. 2019 Aug;34:16-20. doi: 10.1016/j.ijotn.2019.03.002. Epub 2019 Mar 15. PMID: 31126838.
Davies EC, Green CF, Mottram DR, Pirmohamed M. The use of opioids and laxatives, and incidence of constipation, in patients requiring neck-of-femur (NOF)surgery: a pilot study. Journal of Clinical Pharmacy and Therapeutics. 2008;33:561-6. http://dx.doi.org/10.1111/j.1365-2710.2008.00949.x
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