Human appendicitis is a very common diagnosis of various surgical pathologies. Inflammation of the appendix is most often diagnosed in girls and women aged 19 to 43 years. The incidence in the stronger sex from 18 to 45 years is two times lower. Between the ages of 11 and 23, boys and young people are more likely to get sick. The main method of treatment for the most acute form of the disease is surgical removal of the appendix (appendectomy).
People who undergo such an operation, in particular an operation for appendicitis, before simple preparation or before rehabilitation are faced with such an unusual procedure as an enema or microenema. And almost many people immediately have a question: why is a microenema or enema necessary if a seemingly difficult operation is coming up, and why is this procedure so important?
Symptoms
Delayed bowel movements (inability to go to the toilet) – within 24 hours is the first sign of constipation. In the postoperative period, this time increases to three to five days. This is due to the fact that after the operation the most important thing is the person’s recovery from anesthesia. During this period, vomiting poses a danger, so for 24 hours after the procedure the patient is prohibited from eating, including drinking plenty of fluids. If attacks of vomiting do not recur after a day, the patient is allowed to eat.
If difficulties arise with defecation, the patient feels sharp pain and heaviness in the lower abdomen, and does not leave a feeling of fullness.
The inability to defecate leads to poisoning by toxic elements contained in feces. Intoxication of the body occurs - nausea and vomiting, appetite decreases. Sleep is disturbed, fatigue and a feeling of malaise appear. The accumulation of gases causes belching and an unpleasant taste in the mouth. Feces harden over time and become the cause of mechanical damage - cuts, through which infection easily penetrates. A weakened body suffers complications in the form of an infectious disease.
Diagnosis of appendicitis
The health and life of the patient depends on the knowledge and professionalism of the doctor, as well as on his correct diagnosis. Therefore, it is extremely important to carry out a correct diagnosis of appendicitis, which includes: palpation (palpation) of the abdomen, rectal examination of the rectum (digital), urine and blood examination, ultrasound of the abdominal cavity.
If in doubt, the doctor may prescribe a laparoscopic examination. Doctors need to pay special attention to pregnant women when diagnosing appendicitis. In their case, the signs of the disease are very similar to the symptoms of pregnancy: nausea, vomiting, abdominal pain.
Causes
Removal of appendicitis disrupts the normal functioning of internal organs, which causes difficulty with bowel movements. Constipation after appendicitis removal is caused by the following reasons:
- The effect of anesthesia and other painkillers. Removing appendicitis is a surgical operation that requires the use of narcotics and painkillers. They are the main cause of bowel problems. Anesthesia is administered during the surgical procedure, causing relaxation of all muscles of the body; painkillers reduce tension in the abdominal muscles. Therefore, immediately after the surgical procedure, problems arise in restoring the tone of all muscle tissues; the evacuation function does not occur at once.
- Limited human mobility after appendectomy. Due to bed rest, the patient is inactive, which helps to reduce the tone of all muscles.
- Adhesive processes. Connective tissue compaction can cause obstruction.
- Stressful state of a person. Nervous tension caused by illness and surgery disrupts the normal functioning of the digestive system.
What to do
It is recommended to provide the patient with first aid for appendicitis and call doctors. While waiting for the medical team to arrive, you can take 1 tablet of drotaverine.
Correct position during an attack of appendicitis
What not to do:
- Take painkillers.
- Eat and drink.
- Place hot compresses or a heating pad on your stomach.
- Take antibiotics.
- Lift weights.
- Treat with traditional medicine.
The patient should be placed on his right side with his legs bent. Do not press on the abdomen under any circumstances - the doctor will palpate during the medical examination. Improper actions can worsen the condition and provoke rupture of the appendix, which will lead to purulent contents entering the peritoneum.
For appendicitis in children, no-spa is not excluded to relieve pain, but keep in mind that in a child’s body inflammation occurs faster than in an adult.
Case study: Valentina, 37 years old. As a child, I had a stomach ache near my belly button. I was 9 years old then. My mother gave me painkillers for the night, I went to bed, but woke up in the morning. My stomach was swollen and hurt terribly. An ambulance was called. While we were waiting, I lost consciousness from pain. As a result, a diagnosis of gangrenous appendicitis was made, i.e. it burst. The doctors said that I was lucky - they delayed it, they don’t know what would have happened.
Consequences of stool retention
Accumulated dense feces delay the removal of gases, which causes bloating. Due to bloating, the diaphragm is compressed, cardiac activity and lung function are disrupted. The symptoms of stool retention cannot be ignored; the consequences of the disorder have a bad effect on the patient’s health. This provokes problems with postoperative sutures and injures the intestines. There is a reason for surgeons to perform repeated surgical interventions and prescribe additional medications that will further weaken the body and make it susceptible to other infections. As soon as the operation is completed, prevention begins from the first days.
Some interesting cases from medical practice
1 case from medical practice
A young 28-year-old guy came to see a doctor with pain in his right side. When asked how long ago the pain began, the answer was about 8 hours ago. His side began to hurt completely unexpectedly, for no apparent reason, and his temperature rose slightly to 37.8°.
During the examination, the doctor determined that the pain was spreading from the left side to the area just below the navel. At first glance, the symptoms indicated peritonitis.
The patient was diagnosed with acute appendicitis. The young man was immediately taken to the surgical department to the operating room for a laparotomy. During the operation, it turns out that the process of the cecum is not at all changed despite the presence of serous effusion in the peritoneum. It was decided to examine the small and large intestine more carefully. As a result, an inflamed diverticulum (embryonic bile duct) was found at their junction. It was removed because... It was he who caused symptoms similar to appendicitis. Most often, inflammation of the diverticulum occurs without any symptoms, and in only 5% of people it is detected during laparoscopy or some other operation.
2 case from medical practice
A 65-year-old man with suspected acute appendicitis was taken by ambulance to the hospital emergency room. The necessary tests were taken and additional examinations were carried out. It was decided to operate because other methods could not eliminate the pain. The patient agreed to undergo the operation.
During the operation, the surgeon discovered an inflamed appendix with a dense consistency. Its length was 3.5-4 cm, there was a fibrin coating and obvious signs of the inflammatory process. The appendix was removed. After the operation, the wounds began to fester a little, despite this the patient was discharged home.
After 21 days, a conclusion was received after an examination of the appendage. Result: appendicitis cancer. The necessary data was transferred to the clinic at the patient’s place of observation. He was called to an appointment for consultation with an oncologist. The man chose to refuse further treatment. He died 6 months later.
Features of treatment
After studying the patient’s complaints and personal examination, the doctor recommends treatment. The main directions are drug treatment, gymnastics, diet.
Drug treatment
The patient is prescribed laxatives and glycerin suppositories. Enemas and microenemas are used - oil or based on herbal decoctions. The purpose of these drugs is cleansing; they help perform the evacuation function, but do not improve intestinal motility.
Their constant use will allow a person to get used to the auxiliary substances; without their use, defecation disorders become chronic. As you get used to it, a constant increase in the dose of the laxative is required, and the drug soon becomes useless. Therefore, a laxative is not a panacea for this problem, but only an element in the fight against it. If problems with stool are caused by a stressful condition, sedatives are prescribed - tincture of motherwort or valerian. Tinctures of chamomile, mint, caraway fruits and dill seeds enhance the muscle activity of the intestines. Oil preparations in combination with herbal ones have a healing effect.
Physiotherapy
To restore intestinal functionality, a course of therapeutic exercises is prescribed, aimed at strengthening the pelvic floor muscles. The main condition for the appearance of a positive shift is the regularity of the exercises. Walking and light jogging are helpful if your doctor allows it. Physical activity is allowed only on the recommendations of a specialist.
Diet
Principles of normalizing the functioning of the gastrointestinal tract:
- Food is taken in portions five or six times a day.
- Food is heated to a comfortable temperature, hot and cold are excluded.
- Maintaining water balance.
- Products that cause gas formation are excluded.
Immediately after appendectomy, the diet includes jelly, juice, weak tea and low-fat chicken broth. After a few days, mashed potatoes, zucchini and pumpkin are added. Then the menu includes light vegetable soups and steamed chicken cutlets, fruits and low-fat yogurt. It is forbidden to eat fixative foods: semolina or rice porridge, astringent fruits, fatty broths from fish and meat.
Beetroot, dried apricots and prunes provide a relaxing effect. Products containing fiber, oatmeal, honey, and natural juices have a beneficial effect. Smoked meats, spices, chocolate and pickles are prohibited. Solid food, fast food, coffee, soda, alcohol and cigarettes are prohibited.
Therapeutic measures for constipation
Strong laxatives for constipation should not be used frequently, as the body quickly gets used to the excipients, and under the influence of medications the intestines cope with their functions worse. It should be remembered that the purpose of a laxative is to alleviate the patient’s suffering by making bowel movements possible. Laxatives do not treat the cause of constipation, but help cleanse the body and restore natural microflora.
Irritant laxative
Fast-acting drugs have the greatest effect for constipation caused by sluggish peristalsis. Not intended for long-term use. The drug is taken in the evening so that stool appears in the morning. Thinning medications are contraindicated for anal fissures, uterine bleeding, and hemorrhoids during exacerbation. Drugs in this group include:
The drugs are available in the form of tablets, syrups, suppositories, and drops.
Prebiotics
Prebiotics are delayed-acting drugs. The main task of prebiotics is to restore normal intestinal microflora. Drugs in this group are safe for nursing mothers and children. A mild laxative does not act instantly, but, unlike irritating drugs, prebiotics can be used for a long time. The main thing is to follow the instructions. Prebiotics include Duphalac, Goodluck, and Exportal.
