Postoperative issues
Hello, I had laparoscopic surgery for appendicitis eight years ago, and my recovery was normal.
However, starting from October 5, 2017, I have been experiencing irregular bowel movements, finding it difficult to pass stool.
The shape resembles diarrhea but is not as watery.
I have also been experiencing pain at the site of the previous surgery, which I initially attributed to postoperative neuropathic pain.
I have been using a warm towel for relief.
On October 9, the bloating became so severe that I completely lost my appetite, and I constantly felt the urge to pass gas but couldn't.
Due to school and work commitments, I had to eat to maintain my energy, so I took some gastrointestinal relief medication.
However, aside from a slight burp after eating, the bloating has worsened, and nothing seems to work as effectively as before.
Additionally, I have been experiencing increasing sharp and aching pain in my lower abdomen whether I am biking, walking, or even urinating.
On October 11 (yesterday), even though I was hungry, I could only eat a bite or two before feeling nauseous.
The sharp pain intensified when lying flat at night, and I could only manage to rest while sitting.
This pain has started to affect my daily life, but after taking medication prescribed by a clinic for three days without improvement, my family suggested I go to a larger hospital for further examination.
However, I am concerned about the time and cost involved, so I would like to ask for the doctor's opinion (the clinic doctor was too busy to listen to my detailed concerns).
1.
Could this be due to intestinal adhesions? I read online that typical symptoms include significant vomiting (I only feel nauseous, but have not vomited) and fever (I do not have a fever).
2.
Should I only go to a larger hospital if I develop fever and vomiting? What department should I consult with?
Cai7, 20~29 year old female. Ask Date: 2017/10/12
Dr. Cai Anshun reply Gastroenterology and Hepatology
Hello: Intestinal adhesions can vary in severity; in severe cases, they may cause complete bowel obstruction, while mild cases may only result in bloating and discomfort.
Your symptoms should also consider diverticulitis, ureteral stones, or ovarian issues.
It is recommended to first consult a gastroenterologist and then determine if further evaluation by a urologist or gynecologist is necessary.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.
Reply Date: 2017/10/12
More Info
Post-surgery complications, particularly gastrointestinal issues following an appendectomy, can be quite concerning and may significantly affect your quality of life. Based on your description, it seems you are experiencing a range of symptoms, including difficulty with bowel movements, abdominal pain, bloating, and nausea. These symptoms can indeed be related to complications such as adhesions, which are bands of scar tissue that can form after surgery and may lead to intestinal obstruction or other gastrointestinal disturbances.
1. Adhesions and Bowel Obstruction: After any abdominal surgery, including an appendectomy, there is a risk of developing adhesions. These can cause the intestines to stick together or to the abdominal wall, leading to pain and changes in bowel habits. While not everyone develops adhesions, they can cause significant discomfort and may result in symptoms like bloating, pain, and altered bowel movements. The fact that you are experiencing pain at the surgical site and changes in your bowel habits could suggest that adhesions might be a contributing factor. However, not all cases of abdominal pain and altered bowel habits are due to adhesions, and other conditions must also be considered.
2. Symptoms to Monitor: You mentioned that you have not experienced fever or vomiting, which are often associated with more severe complications like bowel obstruction. However, the presence of significant abdominal pain, especially if it is worsening, and the inability to pass gas or have a bowel movement can be concerning. While the absence of fever is a positive sign, it does not rule out the possibility of an underlying issue that may require medical attention.
3. When to Seek Further Medical Attention: Given that your symptoms are affecting your daily life and have not improved with over-the-counter medications, it is advisable to seek further evaluation. If your symptoms worsen, especially if you develop fever, persistent vomiting, or severe abdominal pain, you should seek immediate medical attention. In your case, it would be appropriate to consult a gastroenterologist, as they specialize in digestive system disorders and can perform necessary diagnostic tests, such as imaging studies or endoscopy, to determine the cause of your symptoms.
4. Potential Diagnostic Tests: A gastroenterologist may recommend imaging studies, such as an abdominal ultrasound or CT scan, to assess for any signs of obstruction or other abnormalities. Additionally, they may perform a physical examination to evaluate your abdominal pain and tenderness.
5. Management and Treatment: Treatment will depend on the underlying cause of your symptoms. If adhesions are confirmed, options may include conservative management with dietary modifications, medications to relieve symptoms, or, in some cases, surgical intervention to release the adhesions. If there is a significant obstruction, more urgent surgical intervention may be necessary.
In summary, while your symptoms may be related to adhesions or other gastrointestinal issues following your appendectomy, it is essential to seek further evaluation from a healthcare professional. Monitoring your symptoms closely and seeking timely medical advice can help prevent complications and improve your overall well-being.
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