Ruptured Appendix & Bowel Resection

[raisungirl29]

Hello.  I'm hoping someone has had a similar experience and can help me understand what the longterm prognosis and implications might be in this scenario.

My brother had emergency surgery this week for a ruptured appendix.  The surgeon estimated that the appendix had actually ruptured almost a full week before he went to the ER and she operated.  She basically said that if it weren't for his young age (he's in his early 20s), he would not as made it as far as he did.  During the surgery, she removed almost 1/2 of his colon, including his ileocecal valve (valve that connects the small intestine to the large intestine).

Obviously, we are so thankful that he is still alive after the close call we now realize that he had.  Our main concern right now, as he is only a few days into recovery, is that he heals well and there is no further spread of infection (they left his incision site open after the surgery to drain).  Once he gets past this initial recovery hurdle though, I'm curious about the longterm implications for him of the bowel resection.  Does anyone have experience with having this much of the colon removed.  All the surgeon has really said so far is that he will likely have more frequent and looser stools as a result of losing that portion of his colon.

Thanks in advance for your experiences-

[barbaraJannise]

I hope someone can provide potential solutions.  I am 59 female. July 2015 I had ruptured appendix, which I believe occurred almost two weeks before the surgery causing the doctor to cut about 4" of my colon and 12" of my small intestine and sewed them together. Now at 7-months later, I am still having problems with diarrhea, bloating, gas, etc.  The doc provided prescription cholestyramine for oral, back in August daily.  Then doc cut to a package every other day.  Then I cut to 1/2 pack every other day.  I take with either apple or craneberry juice.  The water like diarrhea, leaking, bloating still occurs. Also I go to the bathroom near 4-times daily and then about 2 more times at night.  Any suggestions will be appreciated.  Thank you, **

[boozer303]

I waited too long (about 12 days) after the pain to have my appendix out and because of that I had to have half of my colon taken out and 3 inches of my small intestine. Since then I have developed hemorrhoids and I smell nearly all  of the time. It's awful. I will get out of the shower and 10 minutes later I smell. I don't know why but it didn't start until after the surgery. It has been 2 years now.

[anne364]

My son's appendix has burst and is contained within his colon.  He is to have surgery as soon as possible.  All they've mentioned is that; is he going to have to have part of his colon removed?  Is this the usual scenario?  My son is 54 and in otherwise good health.

We might not have known of the rupture so early if he had not had to have a CT scan because of his sister's recent death.  She died from an aortic dissection which is a congenital problem so he had to go for a CT scan and they found the appendix.  Can someone tell me a little more about this, please?

[sorestomach]

I just had my appendix rupture and removed two weeks ago. I am thinking it had ruptured three to four days prior to surgery it had already started forming an abcess around the toxins. I was feeling better first week home besides the normal pain from the surgery.  But this week it seems if my body is having a hard time digesting the food. I have lots of pain and cramping. Low grade temp. Do you think any of this is somethng to worry about. I go back to doctor in two days for first follow up so trying to hold out for that but do you think it could be something serious and should go to ER?

[Jaybay]

As long as you aren't running a high fever - like 101 or more - you don't need to worry.  A low grade fever is a normal part of the healing process.  Resection surgery is a major operation and your body burns a whole lot of calories as it heals.  That's why it's so important that you rest for the first few weeks.

Intestines are very picky organs.  They don't like to be bothered and tend to go "on strike" for a while after surgery.  Normal peristalsis takes a while to resume, so take it easy on eating.  You'll do better with eating tiny, easily digested meals several times a day rather than immediately resuming a 3-squares a day diet. Yogurt or yogurt-based smoothies worked well for me in the early post-op days.  Avoid fats for the first couple of weeks and add them back to your diet slowly.  

It's also normal to feel bloated and crampy for a while after surgery.  It WILL get better.  If you experience extreme pain or a very high fever, then it's time to call your doctor.  As patients we aren't always well-informed as to what to expect after a surgery.  When the surgeon gives us a recovery time of say, three weeks, we expect to be 100% by that time.  Not true.  Those recovery times (in my experience anyway) simply mean you'll be feeling fairly human by then.  Best of luck to you, and try to be patient and rest.  :-)

[ISTMOM]

Ruptured appendix and perforated colon and small intestines...This just happened to me...I'm 48...so never thought of an appendix problem...it ruptured they took part of the colon and small intestines including the valve....  my belly is still puffy and very sore... they all say this is major surgery and I should rest....I worry too much when I rest..I need to keep busy..any suggestions.....and don't suggest the internet....that's only making me worry more!! How much do I have to worry about the possibility of infection...peritonitis?

[tummytime333]

I didn't have any problems with them connecting, or with scar tissue. I did have a follow-up colonoscopy almost a year after my emergency appendectomy, and everything was fine. Swollen belly and pain are probably totally normal. I was back to work about three weeks later.

I hope that helps! Good luck to her.

[badchi]

Hi All,

My daughter (nearly 16) had her appendix removed 2 weeks ago (we think it has been ruptured for about 4 days before it was removed). She went home but was still complaining of pain and yesterday went back to ER and she had bowel resection - the surgen said about 20 cm was removed and also the section that connects small intestine to the large intestine. We are so worried as surgen told us to be prepared as sometime the intestines don't connect well, may leak, or later on have problems with scar tissue and also wound infections. I am so worried as its been a day since she has had surgery but she has a swollen belly, tube up her nose draining the fluid, and about 4 other drainages coming out of her. She is still in pain. How long does it take before she is comfortable and what do you think about all the risks that the surgen said?

I am so worried.

[tummytime333]

Hi there,

I had a very similar experience to your brother's. My appendix perforated about two weeks before I figured out that it was something more than the stomach flu or food poisoning (pain and vomiting stopped the day after it ruptured and I felt better). They removed about a third of my large intestine, and a bit of my small, as it had gotten infected in those two weeks. All the side effects above are very familiar, but I should also add, if you haven't found this out already, that the specific parts of the small intestine absorb certain nutrients, so removal of those parts can have an effect on you. For me, the part removed was supposed to absorb vitamin B12, so I often feel tired and dizzy. Vitamin supplements don't work because they still have to be absorbed through your stomach, so injections or a nasal spray can be used to treat it.

Probiotics, either through Kefir yogurt smoothies, Good Belly juice or capsules also seems to help.

Good luck!

[thegrinningcat]

Morecambe and the others, this was very helpful. I would like to add blueberry juice as a remedy which made me constipated and my mom, who is the one with the short colon, "normal". You have to experiment h the amount, as it also made her constipated finally, and don't eat the plain berries as they cause soft stool. They also blacken the stool so I thought I was in for colon cancer due to the stress, until my D ad told me  the bulk of blue berries he had picked and we had been turning into shakes were the reason. I crushed them with a blender alongside some strawberries and mixed them with soy milk and some grape juice for sweetening which is delicious and despite the creamy consistency,  it still worked despite my knowledge of the effect. Later I found this in a book as an anti-diarrhea measure when you have a surgically shortened colon. And yes, do invest in those baby wipes, we didn't think of them, and nobody ever looks at that part until I did and it looked horrible, sore and already blistered after all those harsh frequent toilet paper wipes.

After the first colon sugery, the diarheea gradually subsided after ca. 3 months, now we have been at it for over 4 months.

To save money, you could also keep some baby cream handy and dipp the the tp sheets into the cream before each wipe.

Don't forget to take it all with a sense of humor...

[Morecambe]

Hi - as you may have seen from my other postings, I underwent a total colectomy four years ago for torrential diverticular bleeding.  Indeed after the operation there were significant changes in my bowel habits.  These were:-

- increased frequency (6-8 times per day and 2-4 times per night).  However, after some months these declined to ~4 times per day and 0-1 times per night.


- the stools composition was semi-liquid/watery.  To avoid anal soreness from the more corrosive nature of one's stools, I suggest that after wiping with toilet paper, another (i.e. the last) wipe is made with soapy toilet paper.  If you are away from home, take very mild baby wipes with you for this last "wipe".  Then there are steps that you can take to cause your stools to become more "muddy/sludgy" rather than watery.  Eat plenty of fibre in the form of pulverised fruit and vegetables.  I found that home made muesli (made with organic oats, plenty of organic bran, grated apple, grated lemon/lemon juice, nuts etc all soaked in milk so that the mixture looks like "wet cement") causes your motions to "bulk up".  In other words the effect is a bit like cleaning up a liquid spillage on the kitchen floor by sprinkling sawdust on it.  Organic bran can also be added to yoghurt to enhance the absorbative effect.

A total colectomy/partial colectomy is a "big" operation and it may well take a few months before your brother feels 100% again.  I am now 62 and it took 4-6 months before I felt able to go back on the tennis court.  However, after the first few weeks you can live semi-normally (ie.e. a quietish life at home but going for short walks rather than being bed-bound).

In the immediate aftermath of the operation, do watch out for abdominal pain associated with an increased temperature.  After any intestinal operation there is always a slight risk of leakage from the point of the join (anastomosis) which can cause peritonitis.

Good luck to your brother and I'll watch out for any further questions you may have on this thread.

Morecambe

[boron]

Surgeon was right. Lose stools is pretty much all, what he can expect. Colon is more or less only a storage place for the stool, for gut flora (normal intestinal bacteria), and is the site where a part of water is absorbed. Most of water is absorbed in small intestine anyway. Now the rest of the colon can adopt the absorptive power of the resected part, and from this lose stools depend.

Due to removed ileocecal valve, he might build a small intestinal bacterial overgrowth (SIBO) - colonic bacteria move upwards in small int. This would be experienced like bloating, and possibly diarrhea. Bear that in mind, since many doctors don't. It can happens anytime. This can be diagnosed with a breath test, and treated with antibiotics.