Probiotics after RALP

I would like to share a thought about post robotic care. I had very little pure surgical pain post surgery, but some rather astonishing gas pains from my bowel, took several days to subside, even with a liquid diet. Once home, my bowel movements were glacial with some subsisting gas pain. I had a very good conversation with a close friend who has had GI issues for some time as well as experience with surgery (not prostate). He suggested that I immediately procure some probiotic pills and take them as indicated on bottle. These pills are the "good" bacteria naturally occuring in our GI tract. The results were dramatic, I was regular within a day with no gas pains. The issue post surgery is twofold: (1) Antibiotics serve as sort of a neutron bomb in your GI tract, leaving your tract intact but killing off much of the good bacteria so necessary for digestion and (2) Narcotics can cause your GI tract to shut down. The combo can result in a rather uncomfortable situation. I am curious why more docs do not suggest probiotics or activia after surgery? My friend gets on these immediately in the recovery room and reports that the probiotic regimen is most helpful. I am not prescribing this treatment for everyone, but reporting on a situation in which the probiotics helped me, and probably would have saved much discomfort if taken sooner. Any thoughts?

Laxacharlie, the pains also come from the fact that a fair amount of air (I believe it's carbon dioxide) is pumped into the abdominal area for a prostatectomy or any abdominal surgery. My sister had horrible gas pains after her hysterectomy but my husband had no pain at all after his prostatectomy. Another issue with constipation after surgery is the narcotics used for pain management - any narcotic will do a number on your intestinal tract. We were cautioned by the surgeon to only use the oxycodene he sent John home with if necessary since any narcotic pain med will do a number on the intestinal tract.

What your friend said about the antibiotics makes great sense - all bacteria (good and bad) are attacked which upsets the natural balance.

Glad you found quick relief from your pain.

 

   After DaVinci surgery I had agonizing sporadic pain that they couldn't control with anything. Just be sitting there feeling fine then it was like someone stuck a knife in my gut. I spent most of my time in the fetal position trying not to move. After the third day a new nurse came in and asked if I'd been walking around, I obviously had gas pain. Because the nursing staff was shorthanded nobody had offered to walk with me or inform me I might have gas pain, (they wouldn't let me walk by myself because I was in such pain, duhh--). My kids came in and started hauling  me up and down the corridors, and within a couple hours I was feeling 100% better. On the fourth day right before discharge, one of the attending doctors told me they had to apply a higher CO2 pressure during the surgery because of an existing hernia patch and my musculature, and that was the source of my "discomfort". Gee, thanks for the info Doc!

     I got an added "gift" from the hospital, a c-difficle infection that it took my doctors two weeks to diagnose. When I asked, after a week at home, if it was normal to be having a bowel movement every 45 minutes, I was told that temporary irregularity is sometimes a side effect. After two and a half weeks I had the catheter removed, the infection was controlled and I felt like I was walking out of a Turkish prison when I left the doctor's office. And, yes the probiotics are a necessity to get things back in balance.

   I've had several extended hospital stays in my life (all orthoapedic except for the PCA surgery). I could write a book about some of the crazy (and funny looking back at it now) things that have happened all because I was ignorant, or trusted hospitals, doctors and nurses, to do the right thing at the right time. You HAVE to do everything you can to educate yourself BEFORE surgery. Take some responsibility for your care if you don't think things are going right. If I had discovered this website before my surgery I am convinced my recovery experienc would have been totally different.

   Thanks for letting me rant, I feel so much better now.

Charle,

I don't disagree. At Cleveland Clinic, you can't go home home until you pass gas, and a BM, and you saty on clear liquids. Some places seem to kick you out as soon as possible regardless of your bowel status.

Tim-from-Maine
Excellent question, perhaps a good idea to ask doc., although many do not have expertise outside of their specialty. I am astounded that more docs and hospitals do not recommend probiotics. Am curious -did taking probiotics help you. Again, my results were very noticeable.

I remember I had gas passing for 4 days before "Lunch' finally arrived.

But, now it occurs to me that when the Doc OK'd me for a meal on the day after surgery at the hospital I had wolfed down mashed potatoes, chicken, rolls, jello and beans!! Probably not such a great idea (after I got home I was doing mostly liquids and fruit). No doubt the damage had been done and that logjam just slowly wound its way thru the intestines.

So, if the Doc says OK to eat .. pick something soft and soupy and mushy!

Laxacharlie
Great idea! Between the enemas, colon flush, antibiotics and yes, the complete shutdown of systolic action of the bowels during surgery is a nuclear meltdown for the whole system. I think the reason docs don't do the probiotic thing is that they simply don't think of it, and there probably has not been a study in the NEJM about it!
Thanks for pointing out that the CO2 in the abdomen is totally and completely separate from the gas pains in the intestines. A lot of people confuse the two. The passing gas thing is the first sign that indeed, your bowels are beginning to function. That alone causes pain. The CO2 in the abdomen can also cause pain, but it just has to be absorbed into the blood system.
Good idea, good thread.
Paul