Gas Pain After Surgery: Why It Happens and How to Relieve It
If you’ve had surgery before, you may have experienced gas pain as one of the post-operative side effects. Indeed, the number of questions about this topic I get as a board-certified anesthesiologist suggest that many people suffer from—and seek relief from—this type of pain.
There are two common types of gas pain that may occur after surgery. They are quite different from one another, but they are both bothersome. The two types are:
- Intestinal gas pains - Caused by a buildup of gas inside of the intestines.
- Intraperitoneal gas pains - Caused by gas trapped outside of the intestines, but inside the abdominal cavity.
Post-Operative Intestinal Gas Pain
Post-op gas pain can occur after any type of surgery, but is most common after abdominal and pelvic surgery. Open surgery with longer incisions and laparoscopic surgery in the abdominal cavity can leave the bowels (intestines) "stunned." Anesthesia (general, as well as epidural and spinal) can slow down the bowels, preventing the passage of gas and stool.
Pain medications (narcotic) add to and contribute this effect. As a result, I frequently hear patients reporting constipation and gas buildup after surgery.
Tips for Relieving Intestinal Gas Pain
- Walk. The most important thing you can do after surgery to prevent and relieve gas pain is to walk. Walk early and walk often. I know it’s not easy, but I promise you that your doctors and nurses are not being needlessly cruel when they ask you to do it. Walking encourages the peristaltic movement of the bowels, relieving gas and constipation. In addition to preventing gas pain, there are many other benefits to walking after surgery such as preventing blood clots and preventing ileus – intestinal stoppages.
- Leg exercises. Other types of movement like pulling the legs up to the chest and releasing them, rocking back and forth and turning from side to side may also help by stimulating the bowels. Be careful though, because these exercises may be too painful to do, depending on the site of the surgery.
- Heating pads. Heating pads may also provide relief. Remember if you had abdominal surgery, you may have some numbness on your abdominal wall. Do not apply a heating pad to numb skin or burns could result.
- Hot tea. If you are allowed to drink, hot tea is a great remedy to help gastrointestinal motility and relieve painful gas pains.
- Medications. Some prescription such as simethicone, which allow gas bubbles to be eliminated from the body more easily, may be used to help with gas pain relief.
Laparoscopic Surgery and Intraperitoneal Gas Pain
Intraperitoneal Gas Pain Relief
Intraperitoneal gas pain results when gas becomes trapped in the abdominal cavity and is usually the result of laparoscopic surgery. While this kind of gas pain may be unpleasant, laparoscopic surgery is a minimally invasive surgical procedure that typically has a shorter recovery time with less overall pain.
Why Laproscopic Surgery Causes Gas
A laparoscopic surgeon will first make a small incision to pass a long, thin Veress needle into the abdominal cavity, being sure to avoid the organs. Then gas is passed through the needle to inflate the abdomen, causing the abdominal wall to form a dome over the organs. Having the abdominal cavity inflated and the abdominal wall separated from the organs, gives the surgeon room to operate without making large incisions. Other small incisions are made to pass the small instruments to perform the surgery.
At the end of the operation, the abdomen is allowed (and sometimes assisted) to deflate. However, it is not possible to remove all of the gas. The little bit that is left behind can irritate the peritoneum – the lining over the abdominal organs and sometimes the organs themselves. A patient may experience this as sharp or achy pains.
In addition, the CO2 can settle up under the diaphragm, the muscle that helps you breathe. You might experience this as irritation in the lower chest and even all the way up into the shoulder.
This type of pain can be quite uncomfortable and may last several days. It will eventually resolve on its own, but can be aided by walking and moving around. In this case, pain medications may be helpful and will not make this type of gas pain worse.
You can check out how laproscopic surgery works in the video below. Do NOT watch if you are squeamish, however. The first 1.5 minutes of this video demonstrate the insertion of the needle and trocar and insufflation of gas into the abdomen.