Is My Post-Surgery Abdominal Discomfort a Sign of Adhesions?

Could this symptom be intestinal adhesions?

Hello, doctors on the forum: In mid-September of this year, I went to the emergency room due to acute appendicitis.
After examination, the doctor informed me that it was appendicitis (blood tests/CT scans, etc.) and that I could either receive antibiotics or undergo surgery.
The doctor explained that if I chose antibiotics, there was a possibility of recurrence in the future.
After discussing with my family, we decided to proceed with surgery to remove the appendix to prevent future recurrence.
Due to the rushed preparation, I did not research relevant surgical information (such as laparoscopic surgery/anti-adhesion barriers), so I underwent traditional open surgery.
After a follow-up appointment at the end of September, the wound healing was good, and the stitches were removed on the same day.
However, I currently have some questions I would like to ask the doctors on the forum:
1.
In the weeks following the stitch removal, I often feel bloated in my abdomen, have the urge to pass gas, and experience difficulty having bowel movements, requiring effort to go.
Even after using the restroom, I still feel bloated.
Occasionally, I feel a deep, sharp pain in the rectum due to gas in the abdomen.
Is this normal (post-operative recovery period)? Or could this be a symptom of intestinal adhesions?
2.
Currently, the scabbed area of the wound appears somewhat swollen, but it does not hurt when pressed.
Is this normal? Due to these symptoms, I now have a sense of regret about having undergone surgery.
I would appreciate any insights from the doctors on the forum.
Thank you!

Da Mao, 30~39 year old female. Ask Date: 2013/10/10

Dr. Ke Fangxu reply Surgery

1.
After appendectomy, it is common to experience mild abdominal symptoms, which are often related to the degree of inflammation and whether the appendix has ruptured, rather than adhesions.
However, these symptoms typically resolve within 1 to 2 months.
If symptoms persist or if there is a fever, a follow-up appointment for further evaluation or treatment is necessary.
2.
The hardness of the surgical wound is due to the internal sutures.
If there is no pain or swelling, it is not a concern.
Surgical treatment for appendicitis is definitely the preferred option; otherwise, a future episode will be more difficult to manage.
Since the surgery has already been performed, it is best to avoid overthinking and allow the body to recover.

Reply Date: 2013/10/10

More Info

Post-surgery abdominal discomfort can be a common experience, especially after procedures like appendectomy. It's important to understand the potential causes of your symptoms and whether they might indicate complications such as adhesions.

1. Understanding Your Symptoms: After surgery, it is not unusual to experience feelings of bloating, gas, and changes in bowel habits. These symptoms can be attributed to several factors, including the body's natural healing process, the effects of anesthesia, and the manipulation of the intestines during surgery. The sensation of needing to exert effort to have a bowel movement can also be linked to post-operative changes in bowel function, which may take time to normalize.

2. Adhesions: Adhesions are bands of scar tissue that can form between abdominal tissues and organs after surgery. They can cause discomfort and may lead to bowel obstruction in some cases. Symptoms of adhesions can include chronic abdominal pain, changes in bowel habits, and feelings of fullness or bloating. However, it is essential to note that not all post-surgical discomfort is due to adhesions. In your case, the presence of bloating and the need to strain during bowel movements could also be related to temporary changes in gut motility or even constipation, which is common after surgery.

3. Normal Healing Process: The healing process can vary significantly from person to person. It is common for the surgical site to feel tender or slightly swollen as it heals. If the area around the incision is not painful when pressed, this is generally a good sign. However, if you notice increasing pain, redness, or discharge, it would be advisable to consult your physician.

4. When to Seek Medical Attention: If your symptoms persist or worsen, or if you experience severe pain, fever, or vomiting, it is crucial to seek medical attention. Your healthcare provider may recommend imaging studies, such as an ultrasound or CT scan, to evaluate for adhesions or other complications.

5. Psychological Impact: It's also not uncommon to experience feelings of regret or anxiety after surgery, especially if recovery is not going as smoothly as anticipated. It’s important to communicate these feelings with your healthcare provider, as they can offer support and reassurance.

6. Follow-Up Care: Regular follow-up appointments are essential to monitor your recovery. If you have concerns about your symptoms or the healing process, do not hesitate to reach out to your surgeon or primary care physician for advice.

In summary, while some discomfort and changes in bowel habits can be expected after surgery, persistent or severe symptoms warrant further evaluation. Understanding the healing process and being aware of potential complications like adhesions can help you navigate your recovery more effectively. Always prioritize open communication with your healthcare team to ensure the best possible outcomes.

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