Post-Myomectomy Gastrointestinal Discomfort: Causes and Concerns

Occasionally experiencing gastrointestinal discomfort after undergoing surgery for uterine fibroids?

Hello Doctor! I underwent surgery for uterine fibroids on September 28, during which 9 fibroids and a cyst from one of my fallopian tubes were removed.
The surgery lasted nearly 5 hours.
I was doing well for a week post-operation, but on October 8, I suddenly experienced severe abdominal bloating and pain, which required an emergency visit.
Since then, I have felt pain in my abdominal muscles when pressing or stretching, although the pain has gradually decreased over time.
I also have difficulty passing gas and experience bloating.
I had a follow-up appointment on October 15, where all relevant tests were conducted, but we still could not determine the exact cause.
I am very concerned that this might be an issue with intestinal adhesions!

Nana, 30~39 year old female. Ask Date: 2022/10/19

Dr. Huang Yuande reply Obstetrics and Gynecology

After surgery for uterine fibroids, there is indeed a possibility of adhesions forming.
However, it is not easy to confirm this through examinations unless it leads to symptoms such as bowel obstruction.
Therefore, it is still recommended to have a physician evaluate the situation.

Reply Date: 2022/10/19

More Info

Post-myomectomy gastrointestinal discomfort is a common concern among patients who have undergone surgery for uterine fibroids. The symptoms you are experiencing, such as abdominal bloating, pain, and difficulty passing gas, can be attributed to several factors related to the surgical procedure and the body's healing process.

Firstly, it's important to understand that during a myomectomy, the surgeon makes incisions in the abdominal wall and manipulates the organs within the abdominal cavity. This can lead to temporary changes in bowel function due to several reasons:
1. Postoperative Ileus: After any abdominal surgery, including a myomectomy, it is common for the intestines to experience a temporary slowdown in activity, known as postoperative ileus. This condition can cause bloating, discomfort, and difficulty in passing gas or having bowel movements. It usually resolves within a few days to weeks as the intestines regain their normal function.

2. Adhesions: Surgical procedures can lead to the formation of adhesions, which are bands of scar tissue that can develop between abdominal organs. These adhesions can cause discomfort and may lead to bowel obstruction if they restrict the movement of the intestines. While not all patients develop significant adhesions, they are a known complication of abdominal surgery.

3. Inflammation: The surgical trauma can cause localized inflammation in the abdominal cavity, which may contribute to discomfort and bloating. This inflammation typically subsides as the healing process progresses.

4. Gas Accumulation: After surgery, changes in diet, reduced physical activity, and alterations in gut motility can lead to increased gas production and difficulty in expelling gas. This can cause significant discomfort and a feeling of fullness.

Given your symptoms, it is crucial to monitor your condition closely. Here are some recommendations:
- Follow-Up with Your Surgeon: Since you have already had a follow-up appointment, it is essential to keep your surgeon informed about your ongoing symptoms. They may recommend imaging studies, such as an ultrasound or CT scan, to evaluate for any complications like adhesions or obstructions.

- Dietary Adjustments: Consider modifying your diet to include easily digestible foods and avoid gas-producing items such as beans, carbonated beverages, and cruciferous vegetables. Staying hydrated and consuming fiber gradually can also help improve bowel function.

- Physical Activity: Gentle movement and light exercises can promote bowel motility and help alleviate gas and bloating. However, avoid strenuous activities until you receive clearance from your healthcare provider.

- Pain Management: If you are experiencing significant discomfort, discuss pain management options with your doctor. They may recommend medications that can help alleviate pain and discomfort.

- Monitoring Symptoms: Keep a record of your symptoms, including the frequency and severity of pain, bloating, and bowel movements. This information can be helpful for your healthcare provider in determining the next steps.

In conclusion, while your symptoms may be concerning, they are not uncommon following a myomectomy. It is essential to maintain open communication with your healthcare team and follow their recommendations for managing your discomfort. If your symptoms worsen or you experience new symptoms such as fever, vomiting, or severe abdominal pain, seek medical attention promptly, as these could indicate complications that require immediate evaluation.

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