Post-Appendectomy Abdominal Distension and Bowel Changes Explained

Post-appendectomy abdominal distension issue?

Hello Doctor, thank you for your previous response! I had an appendectomy on November 3rd due to appendicitis (partially purulent but not ruptured, and no peritonitis).
I was discharged on November 6th and had my stitches removed on November 11th.
Currently, aside from the drainage site which still has discharge and has not healed (it still hurts when applying medication), the wound from the left side where gas was injected has not healed on the skin surface since the stitches were removed.
I continue to apply medication for that, but the rest has improved.
However, I have two questions:
1.
I understand that carbon dioxide is introduced into the body during the surgery, which causes the abdomen to swell; I also know that the abdomen naturally expands after eating.
However, since the surgery on November 3rd, for three weeks now, my lower abdomen (below the navel) swells significantly after every meal (it feels like a balloon or pregnancy, to the extent that I cannot see my pubic bone when I look down).
This abdominal swelling lasts all day, but I do not experience any bloating or abdominal pain.
I have tried eating less and walking after meals to aid digestion, but my abdomen remains the same size (my height and weight are 174 cm and 53 kg, with no change before and after surgery).
I would like to know why this lower abdominal swelling occurs.
Is this normal? How can it be improved, and when?
2.
Recently, my bowel movements have gradually become more solid (previously, I was experiencing diarrhea), but compared to before the surgery, the shape of my stool has become thinner (it used to be about the thickness of two thumbs, and now it is about the thickness of one thumb), but there is no blood in the stool or pain during bowel movements.
I would like to ask if the thinning of the stool is a normal phenomenon after surgery.
Will it return to the pre-surgery state/shape?
Thank you for addressing these two questions!

Sherry, 20~29 year old female. Ask Date: 2021/11/25

Dr. Chen Jiaming reply Surgery

The treatment of intra-abdominal infections often involves the use of broad-spectrum antibiotics, which can alter the gut microbiota after surgery.
This frequently leads to symptoms such as bloating (due to an increase in gas-producing bacteria), and bowel habits may also change.
Some individuals gradually return to normal, while others may experience prolonged issues.
You might consider using commercially available probiotic yogurt or probiotics, which can help modify or restore the gut microbiota.

Reply Date: 2021/11/25

More Info

After an appendectomy, it is not uncommon to experience abdominal distension and changes in bowel habits. These symptoms can be attributed to several factors related to the surgical procedure and the body's healing process.

1. Abdominal Distension: Following surgery, especially laparoscopic procedures where carbon dioxide is used to inflate the abdomen, patients often experience a sensation of fullness or distension. This is due to the residual gas that may take time to be absorbed by the body. In your case, the persistent abdominal distension three weeks post-surgery, particularly after eating, could also be influenced by factors such as dietary choices, the healing of the intestines, and changes in gut motility. It is important to note that the intestines may be temporarily sluggish after surgery, leading to a sensation of fullness.
Additionally, if you are experiencing significant distension without accompanying pain, it may indicate that your intestines are still adjusting post-surgery. It is advisable to monitor your diet, focusing on easily digestible foods and staying hydrated. Gentle physical activity, such as walking, can also help stimulate bowel function and reduce feelings of fullness. If the distension persists or worsens, it would be prudent to consult your healthcare provider for further evaluation, as they may want to rule out any complications such as bowel obstruction or infection.

2. Changes in Bowel Movements: The changes in your bowel habits, including the transition from diarrhea to more solid stools and the narrowing of stool diameter, can also be a normal part of the recovery process. After surgery, especially in the abdominal area, the intestines may experience temporary changes in motility and function. The narrowing of stool could be influenced by several factors, including diet, hydration levels, and the healing process of the intestines.
It is not uncommon for stool consistency and shape to change after abdominal surgery. The intestines may take time to return to their normal function, and it is possible that your bowel habits will gradually normalize as your body heals. However, if you notice persistent changes in stool shape, such as significant narrowing or any other concerning symptoms (like blood in the stool or severe pain), it is essential to seek medical advice. Regular follow-ups with your healthcare provider can help monitor your recovery and address any ongoing concerns.

In summary, while some degree of abdominal distension and changes in bowel habits can be expected after an appendectomy, it is crucial to remain vigilant about your symptoms. If you have any concerns about your recovery or if symptoms persist, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. Regular follow-ups and open communication with your medical team are key to ensuring a smooth recovery process.

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