Post-Surgery Complications: Abdominal Pain and Recovery

Postoperative issues?

On June 20, I underwent surgery for a ruptured appendix that led to peritonitis (laparoscopic surgery).
Since I have been feeling unwell, I had an upper gastrointestinal endoscopy on July 18, which revealed gastritis/esophagitis.
I returned to work in August, but I frequently experienced stomach pain, discomfort, nausea, and pain during breathing.
The pain would suddenly occur approximately every two weeks.
On September 17, I visited an internist again, and after the consultation, the pain frequency decreased to about once a week.
Whenever I experienced pain, I took the medication prescribed by the doctor, but I forgot to ask about the cause of the pain.
By the end of September, I was experiencing pain every 1-2 days.
On October 8, I experienced pain again, and despite taking medication for a long time, the pain persisted to the point where I couldn't sleep.
Eventually, I noticed that the pain gradually subsided after eating, so I tried to eat until I was very full (including an extra serving of fruit).
By around October 22, I had not experienced any more pain.
Why is that?
On October 25, after eating fruit that had been taken out of the refrigerator for about five minutes, I suddenly experienced stomach pain again.
Why did this happen?
Some areas around my scars feel hard; why is that?
Additionally, some areas around my scars are painful to the touch; what could be the reason for this?

Ms. Zhang, 20~29 year old female. Ask Date: 2018/10/25

Dr. Chen Jianyu reply Internal Medicine

1.2.
It cannot be ruled out that the symptoms are complications from surgery or other internal medical issues; a follow-up visit to a gastroenterologist is necessary to address this dilemma.
3.4.
Since no scars are visible, it is suspected that there may be a keloid formation from the surgical wound; a detailed assessment still relies on visual inspection and palpation for diagnosis!

Reply Date: 2018/10/25

More Info

Post-surgery complications, particularly after abdominal surgeries such as appendectomy or laparoscopic procedures, can lead to a variety of symptoms and discomforts. Your experience of abdominal pain, nausea, and discomfort after eating is not uncommon, especially following significant surgical interventions like the one you underwent for a ruptured appendix and subsequent peritonitis. Let’s break down your concerns and provide some insights based on medical knowledge.

1. Understanding Your Pain: The pain you experience, particularly after eating, could be attributed to several factors. After surgery, the body undergoes a healing process that can involve inflammation and irritation of the abdominal organs. This can lead to symptoms such as pain, discomfort, and even nausea. The fact that your pain seems to correlate with eating suggests that it may be related to how your digestive system is functioning post-surgery. It’s possible that your stomach and intestines are still adjusting after the trauma of surgery, which can lead to spasms or increased sensitivity.

2. Food and Pain Connection: The observation that eating alleviates your pain could be due to a few reasons. Eating can stimulate digestive processes and may temporarily relieve discomfort caused by gas or spasms in the digestive tract. However, it’s also important to note that certain foods, especially those that are cold or hard, can sometimes trigger discomfort if your digestive system is still sensitive. The sudden onset of pain after consuming cold fruit may indicate that your stomach is reacting to temperature changes or the type of food, which can be common after surgery.

3. Hardness Around Scars: The hard areas around your surgical scars are likely due to scar tissue formation. After surgery, the body produces collagen to heal the incision, which can lead to the formation of fibrous tissue. This tissue can feel firm or hard to the touch and may take several months to soften. In some cases, this scar tissue can also cause discomfort or sensitivity in the surrounding area, especially if it adheres to underlying tissues or organs.

4. Pain and Sensitivity: The pain you feel when pressing on certain areas around your scars can be attributed to nerve endings that may have been affected during surgery. Surgical procedures can sometimes damage or irritate nearby nerves, leading to sensations of pain or discomfort in the area. Additionally, if there is any inflammation or residual healing occurring, this can also contribute to sensitivity.

Given your ongoing symptoms, it is advisable to follow up with your healthcare provider. They can perform a thorough evaluation to rule out any complications such as adhesions, which are bands of scar tissue that can form after surgery and may cause pain or gastrointestinal issues. They may also recommend imaging studies, such as an ultrasound or CT scan, to assess your abdominal organs and ensure everything is healing properly.

In the meantime, consider keeping a food diary to track what you eat and any symptoms that arise afterward. This can help identify any specific triggers that may exacerbate your pain. Additionally, maintaining a balanced diet and staying hydrated can support your recovery.

In summary, while some discomfort and pain post-surgery are normal, persistent or severe symptoms warrant further investigation. Your healthcare provider can help determine the best course of action to alleviate your symptoms and ensure a smooth recovery.

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