How to relieve gas after abdominal surgery

“Passing gas” is a pretty personal part of day-to-day life. So it may seem strange that doctors and nurses want to know if you have released gas after you've had anesthesia.

After surgery, you may be told to let your nurse know if you pass gas. A child may be told that the nurse would like to know if they “toot” or “fart," which may cause some giggles. 

Why focus on passing gas? It's simple. If you can pass gas, it means you aren't developing a condition called post-operative ileus (POI). A POI means your intestines are not moving food through your body properly. This condition can be serious.

This article explains why it's important that you pass gas after surgery and what it could mean if you cannot.

Importance of Gas After Surgery

You may have received medication to put you to sleep during surgery. The medication can slow down or even stop the gut from moving things from your stomach through the digestive tract. When this slowdown happens, it's called a delay in gastric motility or POI.

A POI means that it takes your intestines longer to recover from anesthesia than the rest of you. The slowdown can be mild, or it can be severe enough to need medical treatment.

The ability to pass gas is a clear sign that your digestive system is waking up. If you can pass gas, you either didn't have a POI, or it is improving.

You may have had a bowel preparation to clean the stool out of your body before surgery. If so, it may be several days before you have a bowel movement. Gas may pass long before a stool does, showing that your bowels are working well.

If you had outpatient surgery, your healthcare team may even require you to pass gas before you go home. The staff doesn’t want to send you home with a POI that could become serious. That's the reason it's important to let them know when it happens.

Symptoms

A delay in gastric motility is usually brief. A more severe POI may call for a longer hospital stay. Severe symptoms can include:

• Nausea
• Bloating
• Vomiting
• Abdominal tenderness or pain
• Delayed or stopped passing of gas/stool

Sometimes people have nausea, vomiting, and pain after surgery. Because these symptoms can have different causes, it's a good idea to talk to your doctor any time you have these symptoms while you are recovering.

An Overview of Ileus Symptoms and Causes

Causes

Researchers have several theories about why postoperative ileus happens. POIs may be caused by different factors in different people.

One theory involves your nervous system. Your nervous system has two "departments." The sympathetic nervous system (SNS) normally makes your intestines move less. The parasympathetic nervous system (PNS) makes your intestines move more. After surgery, your SNS may have more control for a short time. 

Another theory is that POI happens when your intestines are handled during surgery. For example, your surgeon may move them out of the way to reach other body parts. Or you may have had surgery directly on your intestines.

If your intestines were handled, your body's immune system may be triggered. White blood cells and other types of cells may rush to the area, causing a slowdown.

Surgery can also unbalance your electrolytes. Electrolytes are minerals needed for key functions in the body, such as normal digestion.

It's also possible that pain medications could raise your risk of a POI. Opioid medications can cause constipation after surgery. If you are taking opioid medications for pain relief, or if you already had issues with your intestines before this surgery, you have a higher risk of developing POI.

Prevention

Preventing a POI is not always possible, but there are ways to lower the risk. 

People who receive anesthesia by an epidural in their spine typically recover faster from a POI. Lighter anesthesias usually cut down on the risk of POI.

Less-invasive surgeries also have a lower risk of POI. These procedures typically use tools inserted through small incisions. POIs may not last as long as they might with more open surgeries with larger incisions. That may be because you are under anesthesia a shorter time and there is a smaller impact on your body.

One simple solution for a POI may be chewing gum after surgery. Several studies have shown that POIs in patients who chewed gum resolved more quickly than in those who didn't chew gum. There was some evidence that their hospital stays were shorter compared to non-gum chewers.

Walking after surgery can also help reduce the severity of symptoms and speed the return to normal.

Summary

Passing gas after surgery is important. If you can't pass gas soon after surgery, it may mean that a post-operative ileus, or gastric delay, is happening.

A post-operative ileus or POI is when there's a slowdown in your body's ability to digest food. It could be caused by changes in your nervous system or the after-effects of having your intestines handled. A POI could even happen because of medications you're taking.

To lower your risk, you could try chewing gum or walking after surgery.

A Word From Verywell

It's okay to feel uncomfortable talking about passing gas. However you normally feel, try to set aside any shyness after surgery so you can share this important information. Your health care team needs to know whether your intestines are working well or whether a POI is occurring—and this bodily function is a healthy sign.

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