Post op day 4
I have been progressively improving. Today I am not as fatigued as yesterday and I hope that continues. Pain is completely manageable without pain medication. I have been off the narcotic analgesic since post op day 1. I was on Norco (codeine plus Tylenol). However, my GI tract is very unhappy. I have continued rumbling and a mix between diarrhea and constipation. It really sucks to have both. GI distress is a common side effect post surgery. The more significant the surgery and the longer you needed to be under anesthesia the worse it can be. It is recommended that immediately after surgery you start out with light meals such as clear liquids and broth. You might be able to then move to a soft bland meal and progress from there. Often it is recommend to follow the BRAT ( banana, rice, apple, toast) diet the first day. If you can tolerate that well then you can expand your diet.
However, even with careful adjustment of your diet you can experience GI distress. This can happen due to a few reasons. Anesthesia can cause decreased motility (movement of your GI tract) which will can cause constipation. In addition the opioid medications used for pain control can cause constipation. It may help to try to decrease use of the opioid pain medications as soon as possible and switch to non opioid pain medication such as plain acetaminophen (generic Tylenol) or Ibuprofen (generic Advil or Motrin). You should still avoid aspirin.
Things you can do:
1. Try to get up and move. Movement helps increase GI motility.
2. Drink plenty of fluids: water helps with softening the stools
3. Limit medications that can cause constipation (opioid pain medications, scopolamine for example)
4. Limit caffeine intake or other stimulants
5. Don’t smoke
There are also some herbal remedies that may be helpful. I must qualify that I am not formally trained in herbalism or botanical medicine. I have over the years needed to learn about herbs and food to help many of my patients. I have many patients that have food sensitivities, limited food intake, or do poorly with medication and need other options. Refer to reference section for the list of books and resources I have used in the past.
Here is a brief description of some supplements/herbs you might try. It is important to clear any use of supplements with your doctor. Some of them can interact with medications you might be taking or are anticoagulants. Some of them are not recommended to take while pregnant. Also, some with interact with your chemotherapy. For a more complete description of each refer to the Supplements/herb page. There you will also find some recipes as well as how to use the supplement.