Post-Appendectomy Complications: Symptoms and When to Seek Help

Post-appendectomy

Hello Doctor, my mother underwent an appendectomy on the early morning of October 11.
During the surgery, there was some adhesion to the small intestine, and she has been experiencing persistent sharp pain since then, which sometimes still occurs.
The doctor during her follow-up visit mentioned that this is normal.
From November 20 to November 23, she had diarrhea, and on November 23, she returned for a follow-up and received medication.
However, starting from November 28, she has not had a bowel movement.
On that day, she vomited everything she ate.
On November 29 and 30, she also did not have a bowel movement, but there was no vomiting, just a feeling of nausea.
Despite this, she has been passing gas during these three days (she needed enzymes to have bowel movements even before the surgery).
Currently, she is unable to eat much, having about one meal a day, because if she eats more, her stomach starts to hurt, and she has little appetite.
I would like to ask the doctor a few questions: 1.
Could this be a bowel obstruction? What other symptoms should we be aware of regarding bowel obstruction? 2.
Can she start taking probiotics now? 3.
What symptoms would require immediate hospitalization? Thank you for your response, Doctor.

W, 20~29 year old female. Ask Date: 2021/12/01

Dr. Chen Jiaming reply Surgery

Due to diarrhea from November 20 to 23, I sought medical attention and received medication.
I am unsure if the medication used at that time had any effect on inhibiting intestinal motility.
Prolonged use may have led to more difficulty in bowel movements, which does not necessarily indicate intestinal obstruction.
It is indeed worth trying probiotics, especially since he has a history of using them.
If symptoms such as persistent abdominal pain, severe bloating, or vomiting occur, immediate medical attention is required.

Reply Date: 2021/12/01

More Info

Post-appendectomy complications can be concerning, especially when symptoms persist or worsen after surgery. Your mother's situation, involving ongoing pain, changes in bowel habits, and nausea, warrants careful consideration. Let's address your questions one by one.

1. Is this intestinal obstruction? What symptoms should be monitored?
Intestinal obstruction can occur after abdominal surgery, including appendectomy, particularly if there are adhesions (scar tissue) that can block the intestines. Symptoms of intestinal obstruction typically include:
- Severe abdominal pain or cramping
- Inability to pass gas or have a bowel movement
- Nausea and vomiting
- Abdominal swelling or distension
- Changes in bowel sounds (either increased or decreased)

Given that your mother has not had a bowel movement for several days and is experiencing nausea, these could be signs of a potential obstruction. While passing gas is a positive sign, the absence of bowel movements combined with pain and nausea should be closely monitored. If she experiences worsening pain, persistent vomiting, or abdominal swelling, it would be prudent to seek medical attention immediately.

2. Can she start taking probiotics?
Probiotics can be beneficial for gut health, especially after antibiotic use or surgery, as they help restore the natural balance of gut bacteria. However, given your mother's current symptoms, it would be wise to consult her healthcare provider before starting probiotics. They can assess her condition and determine if probiotics are appropriate at this time, especially considering her ongoing gastrointestinal issues.

3. What symptoms require immediate hospital visit?
There are several red flags that should prompt an immediate visit to the hospital:
- Severe or worsening abdominal pain that is not relieved by over-the-counter pain medications
- Persistent vomiting, especially if it is bilious (greenish) or contains blood
- Inability to pass gas or have a bowel movement for more than 48 hours, especially if accompanied by abdominal distension
- Signs of dehydration, such as dry mouth, decreased urination, or dizziness
- Fever or chills, which could indicate an infection
- Any new or unusual symptoms that cause concern
In summary, while some post-operative discomfort can be normal, the combination of ongoing pain, changes in bowel habits, and nausea should be taken seriously. It is essential to maintain open communication with her healthcare provider, who can provide tailored advice based on her specific situation. If her symptoms worsen or if she experiences any of the concerning signs mentioned above, seeking immediate medical attention is crucial. Early intervention can often prevent more serious complications and facilitate a smoother recovery.

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