Eight months out and going to the loo once a week at best since they upped my iron. Is this just how it is now?

Warning, this is a bowel thread, scroll on if you're eating.

Some of you will remember the freezing thread and my bloods coming back with iron on the low side. Team adjusted what I take in July, which I was pleased about, and I've felt a bit less like a corpse since. BUT. Since then I am going to the loo once a week. Sometimes once in nine days. And when it happens it is, how to put this, an event. Hard, painful, and I've started dreading it, which I'm aware is a ridiculous thing for a grown woman to type.

Before the iron change I wasn't exactly regular, every 2 or 3 days, but it was fine. I'm eating properly now, meat, veg, the works in tiny portions, drinking what I THINK is enough, walking most days. So I can't work out if this is the iron, or the sleeve, or both, or whether this is just my life now and I need to make peace with it. Do I ring the team about something this unglamorous or is it a "just take something from the chemist" situation? Slightly scared of laxatives with a sleeve, don't know why.

Ring them, it's not unglamorous to them, it's Wednesday. Also it's almost certainly the iron plus the sleeve, not one or the other, and that combination is the story of my first year.

Two and a half years on I still have a fibre supplement in the cupboard on my team's say-so. I'd stopped thinking of it as a problem and started thinking of it as part of the kit, like the vitamins.

"What I THINK is enough" was my downfall. I logged my fluids for a week out of spite when the dietitian asked and I was nowhere near what I'd have sworn I was drinking. Warehouse job, sweating, sipping rules, it adds up to less than you think. Sorted about half of it for me on its own.

Following with interest from the early end of this. Nobody put a word about this on my discharge sheet either, and the codeine plus iron plus shakes fortnight was a very quiet week in that department, put it that way. My team's sheet had a softener listed as "if needed", so it must be common enough that they print it.

Tracey, direct answer: this is common, it is very likely the iron and the sleeve together, and it is absolutely a ring-your-team thing rather than a make-peace-with-it thing, mostly because the fix is easy and the version you're describing, once a week and painful, is past the point where fluid and walking alone tend to sort it.

The mechanics, briefly, because they explain why it's hit you now rather than in the first weeks. A sleeve-sized diet produces very little bulk, so going every 2 or 3 days without straining was never constipation, it was just a small intake doing what small intakes do. Oral iron then firms up whatever is there and slows it down, calcium can add to that, and if fluids are even slightly short, which Alan has confessed to on all our behalves, the bowel takes more water out of what's passing through and you get exactly the hard, painful, once-a-week pattern you've got. I had the identical thing when my own iron went up in the first year, and it took me a stupid amount of time to connect a change in a tablet with a change in the bathroom. I wrote up the whole picture in constipation after a gastric sleeve, including the bit about what's normal and what isn't.

What your team can actually do, which the chemist can't: look at the form and timing of the iron, since not every version is equally constipating and some people do far better with it taken differently; decide whether a softener or a gentle osmotic laxative alongside it makes sense for you, chosen for a sleeve rather than grabbed off a shelf, because some products are fizzy or sugary or need more fluid than you're managing; and check that the iron adjustment is still the right one on your next bloods. What they will not do is take you off the iron for the sake of your bowels, and please don't do that yourself either, since the whole reason the vitamins and monitoring routine exists is that deficiency is the bigger risk by a distance.

In the meantime, the three things that shift most cases: actually measure the fluid for a few days and aim for the 1.5 to 2 litre range sipped between meals, get some soft fibre in behind the protein (oats, stewed fruit, pulses, veg with skins where they agree with you) but only with the fluid, never without, and keep walking. And the fear of laxatives with a sleeve: it's the fizz, the sugar, and the big tablets that don't suit a sleeve, not the idea of them. Your team will name one. The things I'd ring about today rather than this week are different: severe or worsening belly pain, vomiting, a tight swollen belly, no wind at all, or blood. Those aren't constipation and they don't wait.

Claire Maddox said:

it took me a stupid amount of time to connect a change in a tablet with a change in the bathroom

This is exactly what happened and I feel seen and slightly foolish. Rang them at lunchtime. The nurse didn't even pause, said it's one of the commonest calls they get after an iron change, and I've got a dietitian call on Monday. Also measured my fluids yesterday out of Alan-style spite and I'm at about 1.2 litres, which explains a lot.

Update for whoever searches this at 11pm in a cold sweat. Dietitian moved my iron to a different time of day and swapped the form, added a softener to take alongside it for now, and gave me a fluids target with actual numbers on it. Nearly two weeks on: every 2 to 3 days, no drama, no dreading it. Iron stays. The thing I'd pass on is that once a week and painful is NOT the "new normal" I'd decided it was, and it took one phone call to prove it.