Everything about the surgical encounter from pain medications, decreased mobility, alterations in eating, and even the sheer impact of having an incision all cause constipation. Because of this, you must manage your bowels aggressively from the beginning. I encourage a dose or two of a mild laxative preoperatively to start moving things along. Please do not come to surgery constipated as it will only worsen. After surgery, immediately take over-the-counter suppositories or laxatives to keep your bowels stimulated to have bowel movements at least as often as your normal baseline before surgery. Walking and mild stimulants such as coffee can also be helpful. A bloated abdomen will add to your pain and can even create other complications.