I had my appendix removed about five years ago, yet today I still experience pain on my post-surgical scar. Is this something that is expected to happen or is it abnormal? 

Anita

Dear Anita,

Abdominal pain after surgery is common, but usually goes after days to weeks as the wound heals, and due to pain killers given as part of post operative management. But persistent pain after five years is abnormal and needs to be investigated.

After the operation, bowels invariably go into spasm which is felt as colicky pain. Rarely this may persist for a long time after surgery. There may be herniation of the bowels through an opening in the surgical scar. This can cause swelling while coughing or with strain and pain. Rarely the bowels may get strangulated during herniation, causing severe pain and vomiting.

Adhesions can form at the site of surgery, which manifest as chronic post operative pain. One may develop constipation after surgery, which can cause abdominal pain as well as pain at site of surgery due to strain on abdominal muscles. Pain killers of the opium group used after surgery can contribute to development of chronic constipation.

If one has chronic abdominal pain before surgery due to dyspepsia, that can be aggravated after surgery. There may be other underlying reasons for the pain, unrelated to surgery like intestinal infections.

You can consult your surgeon and undergo ultrasound examination and stool test. Treatment will depend on the underlying cause.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital