Our Registered Dietitians at Ignite Nutrition specialize in a number of different areas, including gut health and women’s health. For many people, these two areas can overlap. In particular, women who have had a hysterectomy have a high likelihood of experiencing digestive issues after their surgery. I’ve certainly seen this in my experience working with women who have GI issues. Today, we’ll explore the connection between hysterectomies and digestive issues, and how nutrition can play a role in managing symptoms.
What is a Hysterectomy?
A hysterectomy is a surgical procedure to remove the uterus. It may be done for a variety of reasons, including gynecologic cancer, fibroids, endometriosis, uterine prolapse, abnormal bleeding, and chronic pelvic pain. In fact, hysterectomies are one of the most common surgeries performed among women.
Digestive Issues After a Hysterectomy
Because a hysterectomy occurs close to the bowels, the surrounding nerves and pelvic floor could potentially become damaged during the procedure. In addition, removal of the uterus can cause other organs like the intestines and bladder to shift downwards. For this reason, changes in bowel habits are common after having a hysterectomy.
Some of the gastrointestinal symptoms commonly seen after a hysterectomy include:
- Gas and bloating
- Constipation
- Straining for a bowel movement
- Stool incontinence
These symptoms may occur immediately after your surgery, but for some people, these symptoms can persist even after they’ve recovered from surgery.
Diet and Hysterectomy
For women who have experienced changes in digestion and bowel habits after hysterectomy surgery, diet can play an important role in managing these new and varied symptoms.
As a dietitian specialized in both gut health and women’s health, here are some of my favourite post-hysterectomy diet tips!
Fibre
Fibre plays three main roles in your digestive system:
- Maintaining gut motility (how quickly things move through the gut)
- Maintaining appropriate stool consistency
- Feeding your gut bacteria
Women should aim for about 25 grams of fibre per day. Research shows that many people living in North America struggle to hit this target and generally only consume about 15 grams per day. I’ve definitely seen this struggle with my own patients as well – it can be difficult to meet those goals!
Fibre comes from plant-based foods such as whole grains, fruits, vegetable, pulses (like chickpeas and lentils), nuts, and seeds. There are two main types of fibre: soluble and insoluble.
Soluble fibre is a type of fibre that dissolves in water and forms a gel. This helps create a soft, well-formed stool and adding bulk. For people struggling with stool incontinence, this can help improve the sensation of a bowel movement and potentially reduce stool incontinence. Soluble fibre can be found in oats, legumes, psyllium husk, chia seeds, flax seeds, and avocado.
Insoluble fibre is a type of fibre that doesn’t form a gel in the digestive tract. Instead, it helps stool move through the bowels more quickly and helps keep bowel movements regular. If you’re struggling with constipation, increasing insoluble fibre can be a great way to get things moving! Insoluble fibre can be found in wheat bran, whole grain breads and cereals, flax seeds, fruit with the skin, pulses, and nuts and seeds.
Dietary Variety
You’ve probably heard the saying “variety is the spice of life”, but did you know that research shows that people who have more dietary variety have better overall health and wellbeing? Dietary variety is determined by the number of different foods you eat at least once per week. In particular, focus is placed on whole foods like whole grains, vegetables, fruit, dairy, lean proteins and vegetarian protein sources like beans, chickpeas and lentils. My favourite suggestion to give my patients to increase dietary variety is to aim to get 30 different “plant points” per week. Getting a wide variety of plant-based foods weekly ensures that your gut bacteria are being well fed by fibre. While we still don’t know exactly how, a healthier gut microbiome may be associated with better digestive health.
Meal Timing and Spacing
If you’re struggling with gas and bloating, meal timing and spacing can be important to consider. Skipping meals or eating large portions may worsen gas production. For this reason, it’s best to try eating small, frequent meals throughout the day rather than eating large meals.
Eating Behaviours
Did you know that for many people, bloating isn’t caused by what they eat. But rather, how they eat? If you’re struggling with bloating after your hysterectomy, try slowing down and ensuring you chew your food well. By slowing down, you’re less likely to swallow as much air, which can improve symptoms of bloating.
Low FODMAP Diet
One of the most prevalent dietary factors associated with bloating is poor absorption of short-chain carbohydrates called FODMAPs. Consumption of food containing FODMAPs may result in fermentation leading to gas production. A low FODMAP diet, in which high FODMAP foods are limited for a period of time, may be recommended to reduce bloating and gas. It’s important to talk to your doctor or dietitian before starting a low FODMAP diet, as it’s quite restrictive.
Take Home Message
If you have recurrent bowel symptoms after a hysterectomy, discuss it with your family doctor to ensure that you get properly screened for other gut disorders that may be contributing to your symptoms.
Do you feel like having a hysterectomy has caused digestive issues? If so, schedule an appointment with one of our gut health dietitians to learn more about how dietary interventions may help manage your symptoms.
Categorized: Gut Health & IBS, Women's Health
I can’t eat anything I threw it back up … How to get my bowels going
Hi Latonya, I definitely suggest talking with your doctor and dietitian to get this sorted – post op can definitely lead to increased constipation and indidivudal care may be needed to help resolve – I hope you feel better soon!
A lot of help you are to just tell everyone to talk with their primary care doctor! Most of them don’t have answers and it’s always guessing games try this try that with no real answers. All doctors do not tell the truth of what can happen after this surgery. A lot will say it’s age it’s
Menopause which happens quickly after this surgery ovaries left or not.
Find a good specialist and hopefully ladies we can get real answers!
Unfortunately our blog can’t give individual medical advice, though its goal is to empower people with the science to ask the right questions and provides support through our counselling practice on an individual scale.
I totally agree with you. No one told me about the nausea, extreme gastric cramps and painful passing of winds.
I already have a gut issue and now it just seems worse. 😕
Although I respect the ‘everyone is different’ but I have heard comments that people are back on their feet after 3 days, impossible. Unless they are robots.
I hate it when people want to glamourise a major op
Amen
I have gone through my hysterectomy procedure on 31 st march 2023. Everything was fine and i was eating and having my bowl movement well. Since yesterday i got pain in my chest and feel like there is something struck in between my chest. The pain was severe and i have to visit hospital. They gave me painkillers and gastric injection. I came back in evening and was fine since today morning. But having my breakfast pain started again. Kindly suggest something.is it gastric pain or gallbladder stone pain.
I’m sorry you’re having some issues! Definitely speak with your doctor for medical advice.
I had an hysterectomy recently in September 2023. Since then, I had a sharpe pain in my chest when eating breakfast. The pain caused me to go back to the hospital. Currently, I am burping a lot with gas pain still radiating in my abdomen.
I’m sorry you’re struggling post hysterectomy! We definitely see it’s a tough recovery for our patients from a digestive perspective. I hope your doctor and dietitian are providing guidance to help reduce those symptoms!
I have had digestive issues since my total vaginal hysterectomy ! I feel as though my bowel has moved and lost motality.
This is a common digestive symptom! Be sure to talk with your doctor or dietitian about how to improve this post-hysterectomy!
I had my “simple laparoscopic ” hysterectomy 6 months ago, and have been miserable since then. I had no idea, and it was never mentioned, about possible GI issues. To this day Ive unintentionally lost 28 lb, and several clothes sizes. Ive been shoved down a medical rabbit-hole of tests looking for a cause. The stress is off the charts, and im unable to work because Im ‘chasing’ my symptoms : gas, burping, constipation. I never know when or which product im trying will take effect. Its changed my quality of life , for sure. Wish Id been warned ahead .
I am so sorry it has disrupted your life so much! Definitely request to see a gastroenterologist or GI dietitian to see if they can help you get those symptoms under control.
I know what you mean. I had my procedure on 19 September 2024. I am in so much pain. Not sure where the pain is from… My incision, post op gas or my diverticular.
Fibre is not good for as it stuck in the pockets of my gut.
I am living on toast, soup and cornflakes, but believe me, these items also make me feel sick.
The thought of food makes me feel ill.
I have diverticular disease
Oh goodness that is so frustrating – I hope it resolves for you soon and your team of docs and help to sort it out!
I had a hysterectomy in Sept 2023, in Jan I started having pain in my side after I eat. Gas, bloating, constipation are now common. This is already difficult due to surviving colon cancer. A CT scan was clear. Is it normal for symptoms to occur months later?
I would definitely suggest touching base with your primary care provider; there can be several reasons for progressive constipation and sometimes simple solutions can help, which in turn relieve the gas and bloating! There are also some nutrition basics (on our nutrition basics for constipation) post you could take a look at, but with any sudden change in bowels I always suggest chatting with your doctor first to see what could be contributing.
I wouldn’t say its ‘normal’ for symptoms to occur a few months after a hysterectomy if feeling fine, but there could be subsequent diagnoses like chronic constipation or IBS at play that would be worth talking with your family doctor about 🙂
I had my first bm 3 days po. I’m now 5 days po and my stools are too soft to pass. What can I do to make it easier to have a bm?
Great question! Typically things like a squatty potty or stool to have your hips above your knees, fibre supplements like psyllium to improve stool texture, and working on diaphragmatic breathing can help!
I would say that it is normal for the problems to occur with a delay. As your bowels descends and scar tissue forms and binds the bowels in the months after the surgery, bowel motility gradually deteriorates (irreversibly). Indeed the surgeons never warn you about it – lest you give up on a lucrative (for them) surgery. Unfortunately hysterectomies are too often performed for conditions that could have been addressed in other ways.
I had my total hysterectomy in 2021. I have had diarrhea consistency poop. Sometimes it is like a total blowout. I have to rush to the restroom after eating or sometimes drinking something sweet. What could be the problem?
I would definitely chat with your doctor or dietitian – without more information I wouldn’t want to provide incorrect information – but it’s definitely something that can have some management strategies around it whatever the cause! Your dietitian or doctor will be able to do a proper assessment to better understand what could be the cause.
It’s sad but at same time reassuring that other women have experienced post op symptoms of a hysterectomy that are similar to mine. I had robotic surgery and told it meant a faster recovery. Well maybe for some women that is true. What they don’t tell you about are the GI disturbances this surgery can instigate. I had my surgery July 26, 2024 and suffered from debilitating and painful bloating that sent me to the ER 4 times. No one suspected the link to the recent surgery. I had every test imaginable and came up empty. I thought I was losing my mind. I lost weight and couldn’t go anywhere and became very depressed and discouraged. I was constipated too. I finally found someone who had the same issues as me. She was not warned either. She recommended lots of walking, lots of peppermint tea and my pharmacist also recommended GasX. I also ate more yogurt and drank prune juice.I am finally feeling human again. It seems a lot of doctors are ignorant of this side effect that can last for weeks and months in some women. S
I’m so glad that you’re starting to feel better – we feel like this is such a neglected topic post surgery!
I am having gas pain and abdominal issues such as nausea and no appetite. I have tried everything from peppermint tea to nausea medications to gas x. The surgery will be two weeks ago tomorrow. My ob does not think these issues are related to the surgery. I am seeing my primary doc tomorrow. Has anyone had an ultrasound to see if they were constipated? I am somewhat regular but there is so much pain. I am feeling very defeated and hopeless. Encouraging words and advice would be so helpful
An X-ray is often a minimally invasive procedure to determine if someone is FOS (full of stool). I hope your doctor helped to sort this out!
I had my surgery on November 26,2024 and now recovering. One thing I noticed is the change in the way I eat and now I’m taking a different approach into my diet. Like everyone else, having gas and slow bowel movements but trying to hopeful and positive. The article is very helpful and looking for Hyster Support groups and doing research because I am the only one who can and will advocate for my health.