Post-Appendectomy Nausea: Causes, Concerns, and Dietary Tips

Vomiting after appendectomy?

Hello, Doctor.
I underwent a laparoscopic appendectomy on October 29.
I started eating the meals provided by the hospital from lunch on October 30, but I began to feel nauseous after dinner that day.
Starting October 31, I stopped eating regular meals and only consumed small amounts of yogurt and half a banana, yet I still felt unwell.
After attempting to induce vomiting, I only expelled a small amount of saliva.
On the morning of November 1, I ate less than half a banana, a small amount of water, and a sports drink, which resulted in the most severe vomiting episode.
After being discharged home on the afternoon of November 1, I had a simple egg and seaweed soup, but after resting briefly, I still vomited due to discomfort.
What could be the cause of this situation? Additionally, since early October, I have experienced hiccups even with minimal food intake (sometimes a light sound or prolonged gas), and this continues to this day.
I wonder if this is related.
*Postoperatively, I have been able to urinate and pass gas without issues.* I also experienced mild diarrhea twice during the early hours of November 1, coinciding with my menstrual period.
*Lastly, I would like to ask if I can continue to take probiotics post-surgery to help with my severe constipation.
Thank you, Doctor!*

Ms. Chen, 20~29 year old female. Ask Date: 2021/11/01

Dr. Chen Jiaming reply Surgery

It is advisable to directly consult the surgeon regarding the clinical status after appendectomy, as most conditions are related to the clinical situation and the medications used.
The patient's preoperative physical condition can also influence the outcome, such as the baseline gastrointestinal motility and the tendency for gas and nausea.
The use of probiotics is recommended to be postponed until the clinical condition related to appendicitis stabilizes (and it should also be confirmed that antibiotics have been discontinued).

Reply Date: 2021/11/01

More Info

Post-appendectomy nausea is a common concern that can arise due to several factors related to the surgical procedure and the body's response to it. After undergoing laparoscopic appendectomy, it is not unusual to experience nausea and vomiting, especially in the first few days post-surgery. This can be attributed to a variety of causes, including the effects of anesthesia, pain medications, and the body's natural response to surgical trauma.

Causes of Nausea Post-Appendectomy
1. Anesthesia Effects: General anesthesia can lead to nausea and vomiting as a side effect. Some individuals are more sensitive to these effects, which can persist for several days after surgery.

2. Pain Medications: Opioids, commonly prescribed for post-operative pain management, can cause gastrointestinal upset, leading to nausea and constipation. If you were prescribed such medications, they might be contributing to your symptoms.

3. Dietary Changes: After surgery, your digestive system may be sensitive. Introducing solid foods too quickly or consuming foods that are difficult to digest can trigger nausea. It's essential to start with clear liquids and gradually progress to bland, easy-to-digest foods.

4. Gastrointestinal Motility: Surgery can temporarily disrupt normal gastrointestinal motility. This can lead to symptoms like nausea, bloating, and changes in bowel habits, including constipation or diarrhea.

5. Hydration Status: Dehydration can exacerbate feelings of nausea. Ensure you are drinking enough fluids, especially if you are experiencing vomiting.

Concerns
Given your symptoms of persistent nausea and vomiting, it is crucial to monitor for signs of complications, such as:
- Infection: Look for fever, increased pain, or discharge from the surgical site.

- Bowel Obstruction: Symptoms may include severe abdominal pain, inability to pass gas or stool, and significant bloating.

- Dehydration: If vomiting persists and you cannot keep fluids down, you may become dehydrated, which can lead to further complications.

Dietary Tips
1. Start Slow: Begin with clear liquids (water, broth, electrolyte drinks) and gradually introduce bland foods like toast, rice, or applesauce as tolerated.

2. Small Portions: Eat small, frequent meals instead of large ones to avoid overwhelming your stomach.

3. Avoid Irritants: Steer clear of spicy, fatty, or fried foods, as well as caffeine and alcohol, which can irritate the stomach.

4. Ginger or Peppermint: These natural remedies can help alleviate nausea. Ginger tea or peppermint tea may be soothing.

5. Probiotics: Since you mentioned a history of constipation, continuing probiotics post-surgery can be beneficial for gut health. They may help restore the balance of gut flora and improve digestion, but consult your healthcare provider before starting any new supplements.

Conclusion
Your ongoing symptoms of nausea and vomiting after your appendectomy warrant attention. It is advisable to consult your surgeon or healthcare provider to discuss your symptoms, especially since they have persisted despite dietary modifications. They may recommend adjusting your pain management regimen or further evaluating your gastrointestinal function. Additionally, if you are experiencing diarrhea, it could be related to dietary changes or stress on your digestive system, particularly if you are also managing menstrual symptoms.
In summary, while post-operative nausea is common, persistent symptoms should be evaluated to rule out complications. Adjusting your diet, staying hydrated, and possibly incorporating probiotics can aid in recovery. Always keep your healthcare provider informed of your symptoms for the best guidance tailored to your situation.

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