Managing Post-Surgery Pain and Itching: Tips for Recovery After Appendectomy

Since the surgery in January, the wound area has been itchy and painful. I would like to inquire about possible relief methods?

On October 21, 2021, I experienced abdominal pain so severe that I could not stand (the most comfortable position was kneeling or lying down).
I endured the pain and went to a clinic for a consultation and medication, and by that afternoon, I was able to move freely.
On January 8, 2022 (Saturday), I again experienced abdominal pain that left me unable to stand, so I went to the emergency room.
After a CT scan and physical examination, the physician suspected appendicitis, but I was completely pain-free the next day.
Due to the frequent occurrence of abdominal pain and to prevent a situation where I could not stand again, I underwent laparoscopic surgery to remove my appendix on January 10, 2022, to at least rule out future medical issues related to appendicitis.
My recovery has been good, with no drainage, but postoperatively, I have had difficulty passing gas, often experiencing bloating, and I have frequently been questioned about whether I am pregnant again.
I have used a binder (though not daily, as it causes skin itching), which has indeed helped with gas expulsion.
As of September 6, 2022, I still experience occasional tenderness and itching in the area to the right of my navel from the single-port laparoscopic surgery.
The surgeon mentioned that my appendix was located near the right side of my navel.
I would like to ask: 1.
Given that it has been so long, is the lingering pain and itching possibly due to adhesions? 2.
Should I frequently massage the area around my navel? 3.
What other actions can I take to alleviate the itching and pain? Thank you for your willingness to provide online consultation!

KIKI, 30~39 year old female. Ask Date: 2022/09/06

Dr. Chen Ronghong reply Surgery

Hello KIKI,
1.
Laparoscopy typically does not cause severe adhesions; itching is more likely related to the wound.
Many patients experience itching at the wound site for several months after healing, but it usually improves gradually.
For pain, it is important to differentiate whether it is superficial or deep.
If it is superficial, such as pain with light pressure, it is more related to the wound.
If it is a deep, dull pain, we cannot rule out the possibility of an internal issue.
In addition to abdominal ultrasound, women can also undergo gynecological ultrasound to rule out ovarian or uterine problems.

2.
If massage helps alleviate your discomfort, then it can be done, but theoretically, it should not have a significant effect on relieving itching or pain.

3.
Please observe the condition of the scar.
If there is keloid formation or hypertrophic scarring, you should consult a dermatologist or plastic surgeon.
If the scar is flat but itching and pain are bothersome, you may consider supplementing with B vitamins or consulting a physician for medications to treat neuropathic pain.

Reply Date: 2022/09/06

More Info

After undergoing an appendectomy, it is not uncommon to experience lingering pain and itching at the surgical site, even several months post-operation. Let's address your questions and provide some insights into managing these symptoms effectively.

1. Lingering Pain and Itching: It is possible that the discomfort you are experiencing is related to adhesions, which are bands of scar tissue that can form after surgery. These adhesions can cause pain and discomfort as they may pull on surrounding tissues. However, it is also important to consider that some degree of pain and itching can be a normal part of the healing process. The body goes through various stages of recovery, and nerve endings in the area may still be sensitive. If the pain is mild and manageable, it may not be a cause for concern. However, if the pain worsens or is accompanied by other symptoms such as fever or significant swelling, it is advisable to consult your healthcare provider.

2. Massage: Gentle massage around the surgical site can sometimes help alleviate discomfort and promote blood flow, which may aid in healing. However, it is crucial to approach this with caution. You should avoid applying too much pressure directly on the incision site, especially if it is still tender. Instead, you can gently massage the surrounding areas to help reduce tension. Always consult with your surgeon or a physical therapist before starting any massage therapy to ensure it is safe for your specific situation.

3. Managing Itching and Pain: There are several strategies you can employ to help manage itching and pain post-surgery:
- Topical Treatments: Over-the-counter hydrocortisone cream can help reduce itching. Be sure to apply it only to the areas that are not open or irritated. If the itching persists, consult your doctor for alternative treatments.

- Warm Compresses: Applying a warm compress to the area can help soothe discomfort and reduce itching. Ensure that the compress is not too hot to avoid burns.

- Pain Management: If you experience pain, over-the-counter pain relievers such as acetaminophen or ibuprofen can be effective. Always follow the dosage instructions and consult your doctor if you have any concerns about medication interactions or side effects.

- Gentle Movement: Engaging in light physical activity can help improve circulation and reduce stiffness. Activities such as walking or gentle stretching can be beneficial. However, avoid any movements that cause significant pain.

- Hydration and Diet: Staying well-hydrated and maintaining a balanced diet can support your overall recovery. Foods rich in fiber can help prevent constipation, which can sometimes exacerbate abdominal discomfort.

In conclusion, while some discomfort and itching after an appendectomy can be normal, it is essential to monitor your symptoms closely. If you notice any significant changes or if the pain and itching become unbearable, do not hesitate to reach out to your healthcare provider for further evaluation. They may recommend imaging studies or other interventions to rule out complications such as adhesions or infections. Your recovery is important, and addressing these concerns with your doctor will help ensure a smooth healing process.

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