Passing gas after surgery...

[MikeyJ]

Generally speaking, how long after laparoscopic surgery should the patient begin passing gas? Is there a general rule as to how long before the doctor should be notified? And finally, any nursing interventions to promote passing gas?

[carolmaccas66, BSN, RN]

I also had the horrific neck and shoulder pain. I felt like I'd been hit by a truck. None of the nurses took it seriously and I was told it would eventually go away. They gave me nothing for it at the hospital. Mind you, I know what the nurses are like in that hospital - no team work and very, very slack.

Luckily I had a script at home for pain killers, my Dad went out and got them and managed to get some sleep that night.

Yes do NOT underestimate that pain. Whoever said it, was it really worse than childbirth?

[milzer2012]

When I had a total abdominal Hysterectomy some 6 years ago, a wonderful.

Amazing angel (read Nurse) gave me warm Prune Juice as soon allowed. While the taste was not so good, it worked! I was also up walking as soon as I was able, even though the staples pulled, and I was bent over in the shape of a C.

[BittyBabyGrower, MSN, RN]

OMG....I had my GB out last year with a scope..sure, it was an easy surgery, home withing 4 hours of going in, but that pain....I thought I was gonna die! Thank goodness for vicodin! That pain lasted 3 days. There was no way I could have made it thru that without meds...and I have a pretty high pain tolerance!

[steelydanfan]

TiredMD said:

Although there is really no good evidence for it, we traditionally describe a "normal" postoperative ileus as lasting 2-3 days, and "paralytic" postop ileus as >72hrs. The small bowel will normally return to normal function before the colon, which is why we hear bowel sounds before the patient starts passing gas or pooping.

The duration of the ileus will be dependent on a number of factors, including the type of surgery, the type of anesthesia, any postoperative narcotics being used, and whether or not the patient is being fed.

As mentioned above, walking is a commonly accepted method to speed the return of bowel function, and some studies seem to bear it out. Interestingly, gum chewing has also been shown to reduce the time to ileus resolution, as has early feeding, NSAIDs, and laxatives.

The General Surgeons love asking about flatus. Personally, I don't. Too often patients either don't know they are passing gas or don't like to admit it. There is also some question as to whether flatus is a true marker of ileus resolution.

I try to get them out of bed as soon as possible, keep them on a good bowel regimen, and wait for stool. Ortho doesn't see nearly as many paralytic ileuses as General Surgery, so that usually does the trick.

Oh, come now. Do you REALLY have pt.s who don't know if they have passed gas?