No Bowel Movement After Days, Weeks, Surgery, Laxatives, Enema

Athough bowel habit varies from one person to another, it is still considered to be normal if there are at least three bowel movements in a week and not more than three bowel movements in a day. Even individual habit can vary – sometimes a person who has a bowel movement everyday may find that a day is missed due to some dietary and lifestyle change. However, when there is no bowel movement beyond a certain time or with intervention then it needs to be investigated further.

What does no bowel movement mean?

The lack of a bowel movement is a sign of constipation. However, it is important to consider a few factors when labelling it as constipation.

Firstly there is the time aspect. Passing a bowel movement fewer than three times in a week is considered as constipation. Secondly there is the act of defecation and type of stool that also has to be considered. When stool is eventually passed, and if there is difficulty or straining then this is a further indication of constipation. Hard and dry stool, especially where stool is like small balls, is another feature of constipation.

Therefore the absence of a bowel movement is not immediately considered to be constipation, even if there is no bowel movement for a day or two. People who are constipated may also feel the sensation of fullness in the bowels but are unable to have a bowel movement. When there is no bowel movement for a week or more then there is a greater risk of complications arising, such as fecal impaction.

Read more on weak bowel movements.

Causes of No Bowel Movement

Most of the time constipation is not associated with any disease. Instead it may arise due to:

  • Inadequate water intake
  • Poor dietary fiber intake
  • Sedentary lifestyle
  • Unknown causes (but not due to any disease)

At other times constipation may arise due to the following causes:

  • Irritable bowel syndrome (IBS)
  • Bowel obstruction
  • Bowel strictures (narrowing)
  • Anal fissures
  • Colorectal cancer
  • Nerve disorders such as stroke, multiple sclerosis, autonomic neuropathy including diabetic nerve damage.
  • Muscle disorders such as anismus, pelvic floor dysfunction and weak pelvic muscles.
  • Hormone disorders such as diabetes and hypothyrodism as well as hormone disturbances with pregnancy.

Read more on small bowel movements.

No Bowel Movement After Surgery

It is not uncommon for bowel movements to stop after surgery due to a number of factors. In fact, constipation after surgery is a common complaint particularly where the procedure was performed under general anesthesia. It is never advisable to strain to force out stool, especially after surgical procedures like abdominal surgery, as the increased pressure with straining can affect wound healing.

No bowel movement after surgery may arise due to one or more of the following conditions:

  • Drugs: Anesthesia and opioid painkillers can reduce muscle and nerve activity which is necessary for pushing stool and coordinating its movement and  facilitating the evacuation of stool.
  • Inactivity: Recovery after surgery may mean days or even weeks with very little physical activity. This can further slow down the bowels.
  • Diet: Fasting before surgery is usually advised and a person may be unable or unwilling to eat sufficient food or foods with sufficient fiber after the procedure.
  • Dehydration: Loss of fluids and electrolytes during surgery as well as insufficient fluid and electrolyte intake after surgery may affect the formation of normal and soft stool.

Constipation may arise following any major trauma, which includes surgery depending on the type of procedure. Similarly severe postoperative infections can also lead to constipation.

Laxatives and Enemas

Laxatives and enemas are two options that may be considered for constipation which does not respond to dietary and lifestyle changes. Both these measures are expected to result in a bowel movement within hours to days. However, there are instances where there is no bowel movement after using a laxative or enema. There are several reasons why this may occur.

  • Laxative:
    – incorrect type of laxative
    – very low dose
    – short duration of use
  • Enema:
    – incorrect procedure
    – incorrect solution
    – insufficient solution

There are other factors that may yield both laxatives and enemas ineffective beyond the reasons mentioned above. Fecal impaction is one instance where laxatives and enemas may be ineffective if used/conducted without medical guidance. A person who is not eating any food may find that laxatives and enemas are not helpful, although the former may cause watery stool. Similarly any drugs that are being used may render laxatives and enemas ineffective.

It is always important to seek medical advice if there is no bowel movement with an enema or laxative. Do not attempt to continue using these methods (laxatives and enemas) without consulting with a doctor. It is also important to not increase the dosage of laxatives unless advised by a medical professional. Remember that it is important to treat the underlying disease that causes constipation, once this disease has been conclusively identified.

What to do for no bowel movement?

Constipation is a symptom of many different conditions. It must first be assessed by a medical professional before any of the following dietary and lifestyle remedies.

  • Increase water consumption significantly. Ideally a person should consume at least 2 liters (approximately 68 ounces). If a person is losing fluids through excessive sweating, vomiting or urinating, then the water intake must be increased appropriately.
  • Eat more fiber-rich foods. Fruits and vegetables are often high in fiber. It should be consumed with other high fiber foods like whole grains. Fiber supplements can be useful but it is often better to acquire sufficient fiber through foods rather than supplements.
  • Walk around more often. Moving around also helps with bowel movements. It does not have to be a structured exercise program but should be a part of daily life. Walking may be particularly useful after eating a meal.
  • Exercise regularly. Apart from walking around, exercise should be included at least 3 to 4 times a week. Certain workouts may help to stimulate a bowel movement when it is absent. Many people find that abdominal exercises like crunches are particularly useful as it increases the pressure within the abdomen and stimulates bowel movements.

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