Annoying symptoms such as constipation and bowel impaction after gastric sleeve are not something to ignore or hide under the rug. Above all, bowel impaction can lead to critical issues, including the formation of hardened stool within the body, resulting in agonizing stomach cramps and trapped gas.

The development of constipation is a complex phenomenon involving the interplay of several factors. Studies have shown that a significant proportion of bariatric surgery patients – one in four to be exact – experience constipation during the first six months after the procedure.

Furthermore, obesity itself can be a factor that leads to constipation. This correlation is attributed to several factors, such as bad dietary habits that imply consuming high-fat, low-fiber foods, besides the lack of adequate physical activities. 

The Problem of Bowel Impaction After Gastric Sleeve

Bowel Impaction Gastric Sleeve

Bowel or fecal impaction after gastric sleeve refers to the hardening of the fecal matter within the colon and rectum, making it hard to excrete bodily waste from the anus. Obviously, the bowels face a challenge when the stool becomes impacted or dense, leading to intense discomfort and distress.

Bowel impaction is usually the result of persistent constipation. However, constipation doesn’t just lead to fecal or blow impaction. Indeed, it can cause other serious problems, such as rectal prolapse, which occurs when the rectum slides out of place and protrudes out of the anus.

Moreover, persistent constipation can also lead to hemorrhoids, which refer to the Enlarged and swollen veins in the lower rectum and outer anal area. rectal prolapse and hemorrhoids can cause significant discomfort and pain, but thankfully, doctors provide different treatment options to deal with these problems.

However, if you’ve undergone a gastric sleeve recently and started to experience persistent constipation or bowel impaction, your treatment plan might be a bit different from those who develop these problems in normal circumstances or on regular bases.

Causes of Bowel Impaction After Gastric Sleeve

Constipation remains the single most common cause of bowel or fecal impaction after gastric sleeve. The factors that can lead to constipation in the first place involve the following:


Anesthetic agents used during the surgery can cause paralysis of the intestines, resulting in persistent constipation in the days immediately following the surgery. Expectedly, these anesthetic agents can temporarily stop muscle contractions that typically push food along the intestinal tract.

Lack of Exercise

As known to many, a lack of exercise and physical activity makes the abdominal muscles weaker and increases the risk of constipation. The colon responds to physical activity and muscle tone, which helps maintain regular bowel habits. Getting up and being physically active as soon as possible after gastric sleeve surgery is essential to prevent this risk.


Pain medication, for instance, can cause constipation as they slow down intestinal movement, leading to the reabsorption of excess water through the gut lining. Iron supplements can also contribute to constipation. Hence, a high dosage of these supplements requires special attention from healthcare providers to avoid bowel issues.

Food Intolerance

Enzyme and hormonal changes following bariatric surgery may lead to intolerances to specific food groups, such as lactose or dairy protein, which can disrupt regular bowel habits and lead to bowel impaction.


Dehydration is a long-term complication that can arise after the surgery because the stomach’s capacity limits the amount of fluid intake. When dehydration occurs, water is drawn out of the colon, causing the stool to harden.

Reduced Stomach Capacity

Bariatric surgery is known to drastically reduce stomach capacity, leading to a significant decrease in food and liquid intake. This, in turn, results in less waste elimination. After surgery, liquid meals are prescribed for some time, and patients eventually progress to soft foods. As a result, the amount of bulk in the intestine decreases significantly, which can affect bowel movements.

Low Fiber Intake

Inadequate fiber intake is a common issue for people who consume smaller meals after gastric sleeve surgery. Not getting enough fiber in the diet can lead to constipation and other gastrointestinal issues. Doctors often suggest a gradual increase in fiber intake after the surgery to prevent both diarrhea and constipation.

Find out about: gastric sleeve 10 years later

Treatment of Bowel Impaction After Gastric Sleeve

Bowel Impaction After Gastric Sleeve treatment

If the bowel impaction is continuous or persistent after gastric sleeve surgery, you must contact your doctor urgently. Some patients require hospitalization and medical supervision to treat their cases.

However, if bowel impaction is mild, your doctor can prescribe selected types of laxatives to turn the hard stool into a smoother form. In any case, you can take proactive measures to prevent constipation and other gastrointestinal issues after the surgery. Such measures include:

Avoid the Bad Meals

Some foods can cause constipation due to their high starch/low protein content, such as bananas, rice, and potatoes. It’s better to exclude these foods from your post-op diet and pay a closer look into the portion size.

Consume the Right Meals

You should add healthy fats to your diet, which may help you pass stool more easily. One suggestion is to add avocado slices to meat meals. Another good choice is to mix flax oil with yogurt and add it to veggies and salads.

Visit the Bathroom

When you feel the urge to go, just go! Patients frequently ignore or resist the urge to go, sometimes because they are embarrassed to use a public or workplace restroom. However, regularly ignoring this signal can lead to chronic, severe constipation coupled with painful gas and bloating.

Move Around

After surgery, you should begin exercising as soon as your doctor permits. A regular exercise routine, even if it’s just walking for 10-15 minutes once or twice each day, can significantly improve constipation symptoms and help normalize bowel habits.

Choose the Right Position

Take the best position when you’re in the bathroom. Most of us sit on the toilet. However, squatting is better than sitting. If you have a history of prolonged bowel movements or feelings of inadequate emptying, you may benefit from adopting a more squatted position.

Drink Enough Liquids

Drinking liquids is a highly important recommendation that doctors usually give to their patients after gastric sleeve. Liquids and water add more bulk and softness to the stool.

The Danger of Bowel Impaction After Gastric Sleeve

Bowel or fecal impaction after gastric sleeve could lead to dangerous consequences; one of which is bowel obstruction. A large bowel obstruction is a serious condition that hinders the passage of stool or gas through the large intestine. Such obstruction could occur anywhere in the large intestine and can lead to severe abdominal pain and nausea.

According to a study, bowel obstruction is rare and only occurs in (0.6%) of patients, but it remains one of the most concerning complications after the surgery. It’s important, however, to distinguish between bowel obstruction that results from fecal impaction and that which can result from other pathological or surgical causes.

Above all, fecal impaction is a common type of blockage that occurs when a hard mass of stool accumulates in the digestive tract and cannot be expelled in the usual way. In the case of a large bowel obstruction, the intestine may be completely or partially blocked, which can cause a life-threatening infection and raise a lot of regret in your mind.

The Bottom Line

Bowel impaction after gastric sleeve often results from severe constipation. Left untreated, bowel impaction could lead to bowel obstruction, which is a critical condition that requires urgent treatment. Thankfully, most bowel impaction cases after gastric sleeve are mild and can be dealt with using different dietary and lifestyle measures.

International Clinics in Turkey is one of the leading providers of gastric sleeve surgery and follow-up care. You can contact us immediately using the Contact Us button below to get a free consultation.

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Frequently Asked Questions (FAQ)

How Do I Know If I Have a Blockage After Gastric Sleeve?

You can know if you have a blockage after gastric sleeve if you start to notice symptoms such as severe abdominal pain, nausea, vomiting, difficulty swallowing, and acid reflux. Pay attention to any of these symptoms and seek urgent medical attention.

How Do You Get Rid of Constipation After Gastric Sleeve?

You can get rid of constipation after gastric sleeve by using laxatives such as Dulcolax tablets or by simply following the right dietary recommendations given by your doctor or dietitian after the surgery.

Why Is It Hard to Poop After Gastric Sleeve?

It’s hard to poop after gastric sleeve because of the changes to the structure of the digestive tract. Besides, people experience constipation after the surgery if they ignore the importance of exercise and consuming enough fiber-rich foods.

How Long Can You Go Without a Bowel Movement After Gastric Sleeve Surgery?

You can go without a bowel movement after gastric sleeve surgery for 3 days maximum. More than that is a sign of constipation because the bowels deplete the water content in the faces and turn it into a solid mass that is hard to be expelled from the body.

How Do You Get Food Unstuck After Gastric Sleeve?

You can get food unstuck in your throat after gastric sleeve by standing up and walking around for a few minutes after eating. This simple movement might help dislodge the food and ease the discomfort. If this doesn’t work, consider drinking some water.

Can Gastric Sleeve Patients Take Laxatives?

Gastric sleeve patients can take laxatives, but with caution and after speaking with their doctors. Several over-the-counter (OTC) laxatives can soften stool and make bowel movements easier in these patients.

What Causes Bowel Obstruction After Gastric Bypass?

Bowel obstruction after gastric bypass can be caused by small bowel obstruction, which often results from adhesions or internal hernia. Unfortunately, the onset of this obstruction may be sudden and can range from mild to critical.

Read more: Gastric Sleeve Surgery Abroad: Best Destinations & Packages