3 Patterns of Constipation after Gastric Sleeve & Bypass

In reality constipation can be complex, yet notably common after gastric sleeve & bypass surgery.  Understanding what drives it can open up new solutions.  Potential resolution.

Although, it’s likely a result of multiple contributors.  Learning the 3 patterns of constipation may provide a unique perspective you’ve never explored.

Gut balance!

Root cause resolution is an uncommon approach conventionally.   Yet Functional Medicine’s focus is to uncover the root cause.  Asking questions often never considered.

• Why are you experiencing hard lumpy stools?
• Increasing fiber makes you feel worse. Why?
• My stool is soft, why can’t I go?

The famous quote…

This is the foundation of functional medicine.  This is the foundation of WLS Gut Health!

First, you may want to understand what is considered “normal stools”.  This blog post discusses this very topic of the signs of constipation. Using the Bristol Stool Chart many are unfamiliar with.

So if you’re unsure if you truly have constipation, read this blog first!

In this discussion lets dive into a gut imbalance called dysbiosis.  There are three common dysbiosis patterns that play a role in constipation.  Let’s dig in!

Gut Dysbiosis and Constipation

First, gut dysbiosis is a disruption or imbalance of the gut microbiome that impacts health.  To clarify, it normally involves low beneficial bacteria and high bad bacteria.  Several things impact the level of good and bad gut bacteria.

• pathogens
• medications(antibiotics, PPIs)
• high ultra-processed diet
• digestive & immune dysfunction
• toxins(chemicals, biologicals)

Again, utilizing a combination approach may provide impressive results.  Potentially resolution.

Constipation can be broken down into three patterns.

1. Insufficiency
2. Inflammatory
3. Digestive dysfunction

Insufficiency

Insufficient dysbiosis is when you lack good gut bacteria.  You have low to undetectable levels of Lactobacillus, Bifidobacterium, and Akkermansia bacteria to mention a few.

These bacteria are protective.  Consequently, without adequate levels, you are vulnerable.  Pathogenic bacteria can establish a presence and take over.

It’s not uncommon to experience constipation or diarrhea when you are lacking protective bacteria.

Not to mention insufficient good bacteria increases intestinal permeability.  This is where medication, food, chemicals and toxins pass into the blood stream.  This can lead to autoimmune disease, food sensitivities and allergies.

All together this increases inflammation and digestive issues.

Inflammatory

The inflammatory pattern is all about a potent activator called lipopolysaccharide(LPS).  Certain pathogens produce LPS that activate the inflammatory response.  These pathogens are quite familiar to most, C-diff, E. Coli, and Salmonella.   Inflammation follows wherever they go.

Although the inflammatory pattern may begin with diarrhea, it can quickly shift.  Once resolved, these pathogens can establish imbalance.  Especially if the root cause isn’t discovered.

Digestive Dysfunction

Lastly, digestive dysfunction can really increase constipation for many.  If you cannot digest food.  Break it down into molecules you can fuel off of.  Undigested food ferment in the intestines.  This creates a perfect environment for bacteria to thrive. Constipation can be the result.

At no surprise, digestive dysfunction is quite common after gastric sleeve gastric bypass surgery.  I mean, we are altering your digestive tract permanently!  These digestive dysfunctions include:

• low stomach acid(PPI use, undiagnosed H. Pylori)
• insufficient bile acids
• pancreatic insufficiency
• brush border enzyme deficiency
• altered GI motility
• decreased absorption
  • low elastase(pancreatic enzymes)
  • increased steatocrit(fat malabsorption)
  • positive H. Pylori

To sum it up, resolving the three patterns of constipation can be quite impactful.  Addressing gut dysbiosis can create an environment for full resolution.  Eliminating constipation.

If you want to learn more about dysbiosis check out

If you prefer video, check out our YouTube channel where I discuss this topic in detail!