Post-Appendectomy Complications: Adhesive Bowel Obstruction

Q: Post-Appendectomy Complications: Adhesive Bowel Obstruction

Hello： Postoperative intestinal motility may be altered, requiring time for recovery and adaptation. <br>Ideally, having a bowel movement daily is best; however, if your food intake is lower, having a bowel movement every two days is acceptable as long as the stool does not becom

Postoperative adhesive intestinal obstruction following appendectomy?

Hello Doctor, my child is a freshman in college.
On December 3rd, he underwent surgery for acute appendicitis that led to peritonitis.
The procedure was performed using traditional open surgery, resulting in an incision of about 20 centimeters with 15 stitches.
He was discharged on December 9th.
However, on the 17th, he experienced abdominal distension, pain, and vomiting, leading to another emergency visit and hospitalization.
The doctor diagnosed him with adhesive intestinal obstruction, and he was treated at Linkou Chang Gung Memorial Hospital, being discharged on the 28th.

Since returning home, he has had normal bowel movements and gas, but today, the 29th, he has only passed gas and has not had a bowel movement.
I would like to ask: is it necessary to have a bowel movement every day? His diet has been light, but he is still eating vegetables (leafy greens) and white rice, and he is also walking and exercising.
I am really worried, so I would like to know what is considered a normal frequency of bowel movements after surgery.
Thank you! I hope you can find time to respond amidst your busy schedule.
I appreciate it!
Additionally, since he has final exams coming up, I need to take him to Kaohsiung on January 3rd, and we live in the northern part of Taiwan.
Would you recommend that he return to Kaohsiung for classes and exams during this time?

Xinji Ruwen de Mama, 40~49 year old female. Ask Date: 2016/12/30

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: Postoperative intestinal motility may be altered, requiring time for recovery and adaptation.
Ideally, having a bowel movement daily is best; however, if your food intake is lower, having a bowel movement every two days is acceptable as long as the stool does not become too hard.
It is important to pay attention to hydration and electrolyte replenishment, and to avoid high-fat foods or those that may cause gas.
Additionally, plant fibers should not be excessive; they should be finely chopped or crushed and consumed in moderation.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2016/12/30

More Info

After an appendectomy, particularly one performed via traditional open surgery, there are several potential complications that can arise, one of the most common being adhesive bowel obstruction. This condition occurs when scar tissue (adhesions) forms after surgery and can lead to the intestines sticking together or to other abdominal structures, which can obstruct the normal passage of food and waste.

In your child's case, the symptoms of abdominal distension, pain, and vomiting following the surgery are indicative of this condition. It’s not uncommon for patients to experience adhesive bowel obstruction after abdominal surgeries, especially those involving the intestines. The risk of developing adhesions can be influenced by various factors, including the extent of the surgery, the technique used, and individual healing responses.

Regarding your specific concerns about bowel movements post-surgery, it’s important to understand that the frequency of bowel movements can vary significantly among individuals. While many people may have a daily bowel movement, it is not unusual for some to have less frequent bowel movements, especially after surgery. Factors such as diet, hydration, physical activity, and the presence of any complications like bowel obstruction can all influence bowel habits.

In general, a normal range for bowel movements can be anywhere from three times a week to three times a day. If your child is experiencing gas but no bowel movement, it could be a sign that the intestines are still recovering from the surgery and may be temporarily sluggish. However, if there are significant changes in bowel habits, such as prolonged constipation or inability to pass stool, it is crucial to consult a healthcare provider.

To promote healthy bowel function, it is advisable to maintain a diet rich in fiber, stay well-hydrated, and engage in regular physical activity, which your child seems to be doing. If constipation persists, over-the-counter remedies such as stool softeners or mild laxatives may be considered, but it’s best to discuss these options with a healthcare provider first.

As for your concern about traveling to Kaohsiung for classes and exams, it’s essential to consider your child's overall health and recovery status. If your child is stable, able to eat normally, and has resumed regular bowel movements, traveling may be feasible. However, if there are ongoing symptoms or concerns about bowel function, it might be wise to delay travel until a healthcare professional has evaluated your child’s condition.
In summary, while daily bowel movements are ideal, variations are normal, especially post-surgery. Monitoring your child's symptoms and maintaining open communication with healthcare providers will be key in ensuring a smooth recovery. If any alarming symptoms arise, such as severe pain, persistent vomiting, or inability to pass stool, seeking immediate medical attention is crucial.

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