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What medicine should I take for absence of bowel movements and cramping after hysterectomy surgery?

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Gastroenterologist, Surgical
Practicing since : 1989
Answered : 883 Questions
I had hysterectomy surgery 2 days , I have terrible trapped gas and cramping, i have been on miralax all day and stool softener to with no bowel movement since before surgery. I tried a dulcolax suppositorie about 6 hour ago with no results, should I try a innama next.
Posted Tue, 24 Dec 2013 in Abdominal Pain
Answered by Dr. Ketan Vagholkar 37 minutes later
Brief Answer: Multistep protocol needed Detailed Answer: Hi, Thanks for writing in. Hysterectomy is a pelvic surgical procedure. The terminal portion of the large bowel as well as redundant loops of the small bowel usually are present in the pelvis. Surgery may it be open or laparoscopic is going to involve dissection which in afew cases may be followed by oozing of blood or fluid.This invariably collects in the pelvis and leads to slowing of intestinal function or ileus. As a result there is this feeling of trapped gas which you are experiencing. Since you are also experiencing cramps it suggests that perhaps a bowel loop could have got stuck in the region. But as you do not have vomiting ,one can wait and watch. I would suggest the following. 1. Stop all stool softners and laxatives for the time being. 2. Start yourself on apurely liquid diet. 3. Watch the abdominal girth . If it is increasing then you need to consult a surgeon. 4. Look for fever. 5.Ensure that the urine output is adequate and clear without any change in color. 6. Since you have not had a bowel movement since last 2 days ,I would suggest a simple enema.Assuming the surgery was well done then this should cure your problem. IF the above do not provide any relief and your symptoms worson then I would suggest you consult a General Surgeon. The work up then would be 1. CBC (blood counts)& electrolyte evaluation. 2. Plain x ray of the abdomen in standing position. 3. Ultrasound of the examinations. The reports of these investigations need to be correlated with a proper abdominal and pelvic examination. I hope this answers you doubt. Regards
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