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What Causes Excessive Gas And Abdominal Distension After An Hysterectomy?

Posted on Mon, 25 Apr 2016

Question: Had hysterectomy 3 days ago. Just started passing gas yesterday and am worried about a post-op ileus (had one after gallbladder surgery). I've been walking a bunch (actually they told me to slow it down in hospital worried I was going to over do it). I am taking Percocet every 6 hours for pain (hurts enough to wake me up when it's time for pain med). Should I try to tough it out and not take them? Should I get an OTC stool softener or laxative? When should I start worrying? Last time I didn't have a BM for over a week and just was not paying attention till the pain hit about 0200 on the 8th day.

Answered by Dr. Ramadevi Wani (2 hours later)

Brief Answer:
Abdominal distension is a worrying sign.

Detailed Answer:
Hi,
Welcome to Healthcare Magic.
I am Dr Ramadevi Wani. I will be answering your concerns today.

Passing gas is a good sign. It means that the bowel movement is taking place. Since you have passed gas, you should not worry about post op ileus. What diet you are taking ? Have you started soft/ normal diet? You can take over the counter stool softeners like Metamucil, Citrucel or Colase. There is no problem with it. It helps in easy bowel movement. Do you have abdominal distension? If so consult your doctor before taking Percocet.

I hope this answer is helpful.

Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Naveen Kumar

Follow up: Dr. Ramadevi Wani (12 hours later)

My abdomen still looks swollen, but I also have 4 incision sites (robot assisted vaginal hysterectomy). Looks no different than it did just after surgery.

I've been eating regular diet since day of surgery. Today is the first time since that first night that I've felt sick to my stomach. Didn't eat real well today (banana and noodles) but I'm still drinking over twice what I normally do, I am so thirsty.

My husband went out this AM and got me bisacodyl and docusate. I took one of each this AM and plan to take one more of each tonight before bed. I remember getting a docusate the morning after surgery in the hospital.

I thought with my last ileus I was passing gas, but I guess I could be wrong. It hurt so bad (worse than either surgery) and I don't want that to happen again. So you are saying that if I'm passing gas I need not worry how long it takes me to have a bowel movement?

Answered by Dr. Ramadevi Wani (10 hours later)

Brief Answer:
Consult doctor if you don't pass motions by tomorrow.

Detailed Answer:
Hi
Welcome back.
You have two good signs. The first thing is you are passing gas regularly. Secondly you have not noticed any change in abdominal girth. I do not foresee any paralytic ileus developing.

Since you have started normal diet by day one, you should have had bowel movements by now , What is your normal pattern of bowel movements ( prior to surgery ).
The laxatives initiate bowel movements within 12-72 hours. If you don't start bowel movements by tomorrow you need to consult your doctor to confirm that there is no ileus.
I hope this helps. If you have further concerns do write to me. I will be happy to answer.
Best wishes,
Dr Rama

Above answer was peer-reviewed by : Dr. Prasad