In Part 1 we discussed how weight gain is the result of an imbalance in the body. We talked about causes of bacterial shifts that occur quite easily, including having WLS. Some bacterial shifts are positive, some negative. These negative bacterial shifts provide insight into surprising causes of weight gain after WLS.

However, before we dig into bacterial shifts Part 2 will highlight an important function that would impair recovery if not corrected.

One very important function that impacts gut bacteria

The almighty Gut motility...Bowel Movements..Constipation...Poop!  

Whatever you want to call it…

You need to poop daily!

There’s a wide variety of what’s considered “normal”. In fact, it can be from three times a day to three times a week.

In functional medicine it’s understood that your general health, mental health, and gut health improve when bowel movements are more frequent.

Unfortunately, many WLS patients struggle with constipation. In fact, studies show WLS alters stool frequency with constipation being quite common.

Surprisingly, some people are constipated and don’t even realize it. For example, they poop daily, a formed stool. Seems normal right?

Maybe not…

Let’s talk about what you see in the toilet.

Many practitioners like myself use the Bristol Stool Chart as a reference.

Many people experience type 2 stools and think nothing of it. Surprisingly, If you are seeing Type 1 or Type 2 stools in the toilet, YOU ARE CONSTIPATED!

In fact, the perfect poop is TYPE 4!

The longer stools sit in your intestines the more toxins, hormones and fluids you reabsorb. Constipation can be quite frustrating to deal with. Most WLS patients are willing to try anything to poop normally. But getting to the root cause of constipation can help speed things up.

Let me share a few “out of the box” ideas.

The many causes of constipation:

• Alignment
• Diet
• Food sensitivities
• Supplements
• Hydration
• Vagus nerve damage
• Parasites
• Dysbiosis
• SIBO
• Vitamin Deficiencies

Your doctor will likely provide solutions such as: Miralax, laxatives, stool softeners, Linzess, or Amatiza. Although they may provide relief, they are a “bandaid” instead of a solution. Let’s look at solutions that get to the root cause.

Solutions to constipation:

• Perfect poop posture- alignment is important so utilizing a stool or a Squatty Potty helps. You can also consider chiropractic adjustments.
• Diet ideas- Smooth Move Tea, fermented food, healthy fats, insoluble fiber(nuts, beans,broccoli, cauliflower,etc.)
• Food sensitivities- when your body reacts to food it can change motility causing constipation or diarrhea.
• Supplements- iron and calcium supplements increase constipation, but probiotics, digestive enzymes, L-Glutamine, magnesium glycinate/citrate, psyllium, buffered vitamin C and Aloe juice relieve it.
• Adequate fluids- hydration is key. Drinking half your body weight in water is the goal.
• Vagus nerve stimulation- the vagus nerve can be damaged during surgery. Thinks like humming, singing, gargling can help repair it.
• Gut healing- if you have parasites some will cause constipation. Talking to your doctor about a stool test can help reveal this.
• Gut Balance- correcting bacterial balance where the good bacteria crowd out the bad bacteria.
• Healing overgrowth- small intestinal bacterial overgrowth(SIBO) with methane dominant gases are most likely to cause constipation.
• Correcting deficiencies- Vitamin D and B1 thiamine can be associated with constipation. You can talk to your bariatric program about testing your level.

Correcting motility issues is the first step in dealing with weight gain. If your gut isn’t moving, neither will your weight. Next, let’s discuss those surprising causes of weight gain after WLS by identifying our first imbalance.

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