Nutrition after appendicitis removal one week. Diagnosis and treatment of gangrenous appendicitis

Removing appendicitis is a routine and not particularly difficult operation. However, this is a surgical intervention, so you should be prepared for the fact that after it, a strict diet will become an obligatory part of life in the next couple of weeks. Special nutrition plays a huge role in the body's recovery process. It is with its help that the patient quickly returns to a normal lifestyle.

Diet in the first days after appendix removal

In the first days after surgery, nutrition should be minimal.

The first day is considered the period when a person recovers from anesthesia. This means that during these 24 hours few people feel hungry. The intestines suffer serious stress and need time to restore full function. Doctors recommend completely abstaining from all food and drink in the first 12 hours after the intervention. The maximum that is allowed is to moisten the patient’s lips with water if necessary. A little later, you can start drinking it in small sips.

If recovery from anesthesia is successful and the patient feels well, it is worth trying to give him clear liquids such as low-fat chicken broth, rice broth, jelly or sweet tea.

The main principle that must be followed is frequent split meals in small portions. Food should be pureed. You should not eat food that is either too cold or too hot.

The following should be excluded from the diet:

• products that increase gas formation (these include legumes and milk);
• foods that increase inflammation of the intestines under the seam (everything fried, spicy, any spices, alcohol).

• yoghurts (preferably natural);
• chicken bouillon;
• puree (ideal base - zucchini, potatoes or pumpkin);
• ground boiled chicken;
• rice on water.

Sometimes doctors allow you to introduce some foods with fiber into your diet - boiled carrots, baked apples, etc.

It is better to cook oatmeal in water Pumpkin porridge is an excellent basis for a postoperative diet After surgery, only natural yogurt is allowed

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Nutrition rules for the first week

Approximately three days after the intervention, all the main concerns about the patient’s condition disappear, which means that you can begin to introduce familiar dishes into his diet in a dosed manner. It is especially important that the patient begins to consume foods containing fiber. After all, it normalizes stool and prevents constipation, which can be a huge problem in the postoperative state.

Products that are currently useful include:

• porridge from usual cereals (basis - water);
• boiled or baked vegetables;
• puree soups and dried fruits.

In addition, it is worth starting to introduce dishes from lean fish and meat, kefir and a small amount of butter into the patient’s diet.

It is extremely important to drink as much water as possible during the period after surgery, of course, if there are no contraindications to this. The minimum amount of liquid per day is 8–10 cups. The main part should be mineral water without gas.

Even after a week has passed after removal of appendicitis, it is necessary to follow the diet established in the first few days. You still need to eat small portions every couple of hours. Now it’s not very critical, but it’s better that the food continues to be pureed - this has a less traumatic effect on the intestines.

Menu for the first week - table

	1 day	Day 2	Day 3	4 day	5 day	Day 6	Day 7
Breakfast	Tea without sugar and biscuits.	Non-dairy unsalted porridge;	Millet or oatmeal porridge (with water); hard-boiled egg; tea and crackers.	Oatmeal (milk not allowed); bread with butter and cheese, tea.	Wheat porridge; tea with cookies.	Bread with butter and cheese;	Repeat the menu from one of the previous days.
Lunch	Juice or mineral water without carbon.	Freshly squeezed juice or tea.	Water or tea with cookies.	Galette cookies and juice.	Juice and cookies.	Galette cookies and juice.
Dinner	Chicken broth; rice or oatmeal porridge with water.	Cream soup with a minimum of meat; boiled chicken (shredded).	Broth with meat (chicken) and vegetables; rice porrige; dried fruits compote.	Vegetable puree soup; buckwheat with steamed meatballs.	Chicken broth soup; porridge with lean fish cutlets; dried fruits compote.	Vegetable puree soup; braised cabbage; bread and tea.
Afternoon snack	Juice, tea.	Kissel.	Kissel or bio-yogurt.	Kissel or natural yogurt.
Dinner	Natural yogurt with minimal fat content; tea with cookies.	Porridge on the water; kefir with 0% fat content.	Porridge with a piece of boiled fish; tea or water.	Stewed cabbage with chicken; low-fat kefir.	Buckwheat porridge; steamed cutlets made from lean meat.	Cheese casserole; tea with cookies.

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Diet in the first month after surgery

It would seem that more than a week has passed since a routine and not particularly complicated surgical intervention, and I want to completely return to my previous routine of life and nutrition. Unfortunately, this cannot be done fully yet. The first month after appendicitis removal you will have to adhere to a special diet.

Food should either be steamed or boiled, and consumed only in grated or liquid form. You will still have to eat small portions 5-6 times a day, accompanying each meal with plenty of water.

For the first 30 days after surgery, the following is removed from the diet:

• salty, spicy, smoked, fried foods;
• fatty fish and meat;
• fish soup, borscht and okroshka;
• cheese, cottage cheese and milk with a high percentage of fat;
• fresh confectionery and baked goods;
• carbonated drinks.

Prohibited products - photo gallery

Fatty food

Many people are interested in the question of whether there are significant differences in the diet after appendicitis in an adult and a child. There isn't much difference. Children need to limit their consumption of sweets as much as possible, as they greatly irritate the intestines. In addition, it is necessary to exclude flour, spicy and salty foods. The basis of the diet is light and healthy soups, as well as vegetables and fruits.

In the first month, the patient is allowed a fairly large number of foods and dishes:

1. Broths and soups prepared with water or light vegetable broth. You can add any vegetables to first courses that do not cause increased gas formation (carrots, potatoes, beets, onions). It is better to prepare puree soups - they are easier to digest by the intestines.
2. Second courses:
   • stewed or boiled vegetables;
   • casseroles;
   • omelette with mushrooms and vegetables;
   • mashed potatoes. It is worth noting that doctors advise dosing the consumption of potatoes, since they contain a lot of starch;
   • fish and meat - lean;
   • porridge - with water or milk diluted 1:1.
3. Dairy products should be chosen low-fat.
4. Fruits and berries are limited to those that do not contain a lot of sugar.
5. Beverages:
   • rosehip decoction;
   • jelly;
   • green tea.

After a month has passed from the date of surgery, you should gradually return familiar foods to your diet.

Sample menu - table

Appendicitis with complications: diet features

If peritonitis is added to appendicitis, the operation to remove it becomes much more difficult. Of course, after such a serious intervention, recovery will be longer and more difficult. The diet for appendicitis complicated by peritonitis should be as gentle and light as possible.

The basic principles of the diet will be exactly the same as for ordinary appendectomy, but with some differences:

1. Nutrition for peritonitis should be made as rich in vitamins as possible.
2. Sour vegetables and potatoes are prohibited.
3. Citrus fruits and sour berries are an essential component of a therapeutic diet.
4. Preference should be given to fruits such as pears, bananas and apples. They contain a large amount of sugar and are prohibited for ordinary appendicitis.

The patient’s therapeutic diet after phlegmonous appendicitis is compiled exclusively by the doctor based on the patient’s condition and some of his eating preferences. The menu in this situation, as with ordinary appendicitis, should consist of liquid porridges, soups, stewed vegetables and cottage cheese - those products that are enriched with useful substances.

An obligatory component of the diet after phlegmonous appendicitis is fruit purees. They are as easily absorbed even by a weakened body.

Answers to frequently asked questions

Chocolate consumption will have to be limited

1. When can you start drinking alcohol? It is worth immediately noting that after surgery, alcohol abuse is strictly contraindicated. And this rule does not depend on the time that has passed since the intervention. The minimum period when you can start drinking both low-alcohol drinks and strong alcohol is 3–4 weeks after surgery.
2. Is it okay to eat chocolate after appendicitis? Sweet lovers are often interested in this question. But the doctors’ answer is unlikely to please them, since any sweet confectionery and chocolate should be excluded from the diet. However, any solid products must be removed. Chocolate can be gradually introduced into the diet in very small portions 3–4 weeks after surgery.
3. What fruits can you eat? Many doctors believe that in the first 30 days after surgery it is worth limiting the consumption of any fresh fruit. This is especially true for those products that stimulate increased gas formation. In addition, during the period after surgery, it is advisable to exclude all sweet fruits and berries from the diet: bananas, grapes, pears, and nectarines. You can eat peaches, strawberries, tangerines and oranges.
4. Can I drink juices and coffee? There are no restrictions on juices. But it is worth reducing your consumption:
   • grape juice, as it increases gas formation;
   • pomegranate - it strengthens;
   • plum - weakens.

There are no strict restrictions regarding coffee. But, of course, you should ask your doctor for permission to use it. The problem is that coffee speeds up the heart rate and increases blood pressure - this can lead to unnecessary complications in the postoperative period.

The diet after appendectomy may differ slightly from patient to patient. But no matter what diet is compiled, it must meet one rule - the food must contain a maximum of useful microelements and vitamins. Only such nutrition will help the body recover as soon as possible.

Appendicitis is an inflammation of the appendix, a rudimentary extension of the cecum. Its dimensions are relatively small: length 2-13 centimeters, diameter only 3-4 centimeters. The disease can be either acute or chronic.

The acute form is the most common, and in many cases provokes the development of inflammation of the peritoneum. According to statistics, within a year, 4 or even 5 people out of 1,000 are diagnosed with this disease. Mostly children over 10 years of age and young people under 30 are affected.

Classification

• simple or catarrhal;
• destructive (gangrenous, phlegmonous, perforative);
• complicated.

The simple form is characterized by the fact that inflammation affects the mucous membrane of the organ with the prospect of migration to all its tissues, or may undergo extinction.

The phlegmonous form is different in that with it the inflammation progresses and pus accumulates inside the organ.

If the amount of pus is critical, swelling increases, resulting in inflammation of the blood vessels and the formation of blood clots, which leads to the death of the appendix wall - gangrene develops.

In the perforated form, destruction of the epithelial tissue of the appendix occurs due to the development of phlegmon or gangrene. This leads to the pus accumulated inside the organ pouring into the peritoneum, causing complications.

Causes

The main culprit behind inflammation of the appendix is ​​its blockage. This occurs due to the accumulation of fecal stones and foreign bodies in the appendix (this is how appendicitis usually occurs in children). The bending of the organ under the influence of various factors, such as scars and adhesions, also plays a role. In rare cases, the provocateur is a helminth or a neoplasm on the tissues of the appendix.

There is a theory that the disease is caused by an insufficient amount of plant fiber entering the body with food.

It is possible that the syndrome occurs due to suppression of the body's immune function. The walls of the appendix are permeated with lymph cells, which are part of the immune system. The appendix tissue and lymph cells act as a shield. Disruption of the functions of this shield and the presence of infection provoke inflammation.

Symptoms

• acute pain in the lower abdomen on the right;
• nausea, which is accompanied by vomiting;
• a sharp jump in temperature (37.5-38 degrees);
• pulse 90-100 contractions per minute;
• rigidity of the abdominal muscles.

The course of the acute form of the disease is influenced by such conditions

• position of the diseased organ;
• phase of the pathological process;
• changes in the tissue structure of the appendix;
• the ability of the circulatory and immune systems to respond quickly and adequately;
• painful conditions and complications present in the body.

Pain appears unexpectedly and increases quickly, worsening with movement or coughing.

The location of the appendix influences where exactly a person feels pain. When the first signs of appendicitis appear, it is impossible to clearly determine the location of the pain. It is felt throughout the abdomen and only after a while it descends into the iliac region.

In cases of an uncharacteristic position of the diseased organ, the pain may have a different nature and be located in some other place. If the cecum is located low enough, the onset of the attack is characterized by aching or stabbing pain over the pubic area.

When the appendix is ​​located behind the cecum, pain is felt in the lower back, iliac region and lower abdomen on the right.

When the appendix is ​​located behind the peritoneum, the pain is localized in the lower back, but it can be felt in the genital area and in the thigh. In this case, the upper part of the appendix may be quite close to the bladder, right kidney or appendages in women. Because of this, inflammation of the celiac appendix can be mistaken for problems with the kidneys or disease of the uterine appendages.

Another sign of the acute form of this disease is vomiting. It is observed in 30% of those who are diagnosed with inflammation of the appendix. Some time after the onset of pain, loss of appetite and nausea with vomiting are noted, attacks of which are sometimes repeated. If this happens after a relatively long period of time, it is a clear symptom of peritonitis.

At the initial stage of the acute form of the disease, body temperature does not exceed the normal limit or reaches 38 degrees, but if the disease actively worsens, it increases. For those cases of inflammation when destruction of organ tissue is observed, low temperature and rapid pulse are characteristic, which is not the norm. In addition, increasing intoxication borders on inappropriately low blood pressure.

Body temperature rarely rises during acute inflammation of the appendix. Usually it reaches 39 degrees and higher when the process is perforated.

The chronic form follows from the acute one, when the attack subsides without medical intervention.

Types of chronic appendicitis

• recurrent;
• residual.

A recurrent inflammatory process is a kind of return of an acute one, only with weaker manifestations.

Residual inflammation manifests itself as damage to the cecum or adhesions.

Complications

• appendicular infiltrate;
• (inflammation of the peritoneum).

The formation of infiltrate occurs on the third, sometimes on the fifth day from the moment when acute appendicitis occurred. Organs adjacent to the appendix participate in the inflammatory process. When the course of the disease becomes unfavorable, an abscess develops.

An abscess can occur in various areas of the abdominal cavity.

Depending on this, the following types of abscess are distinguished:

• periappendicular;
• localized between the intestines;
• developing under the diaphragm;
• pelvic.

Diffuse peritonitis is the most dangerous complication.

Can provoke diffuse peritonitis

• migrating inflammation;
• rupture of the appendix wall;
• penetration of the abscess into the abdominal organs.

Appendicitis in men

Diagnosis of appendicitis in men

To make an accurate diagnosis, the doctor will prescribe a series of examinations. In particular, these are blood and urine tests. A blood test is a fairly informative diagnostic method, which mainly monitors the presence of leukocytes and their level, as well as the erythrocyte sedimentation rate. A urine test can detect the presence of protein (which should normally be absent).

X-ray is an outdated diagnostic method, since all it can reveal is the presence of fecal stones. Therefore, the patient will be referred for an ultrasound examination, which is the most optimal diagnostic method today. Using ultrasound, you can most accurately identify signs of appendicitis in men, in particular, an increase in the appendix up to 5 mm. However, in approximately 50% of patients, ultrasound will not detect appendicitis due to an unnatural position or obesity.

Therefore, the most productive research method can be prescribed - computed tomography. It makes it possible not only to see the inflamed appendix, but also the inflamed tissue itself near the appendix. True, the cost of diagnostics is quite high, and only modern or very large clinics have such equipment.

Laparoscopy is the most objective diagnostic method. However, they resort to it in very complex and controversial cases, when standard methods do not give the whole picture of the problem. A probe with a camera is inserted into the patient under anesthesia through a small incision, with the help of which the doctor will accurately see the source of inflammation and provide adequate treatment.

Symptoms of appendicitis in men can be similar to those of other diseases. Even an experienced doctor may not make an accurate diagnosis the first time (which is why an examination is prescribed). In general, along with appendicitis, the patient may be suspected of having urolithiasis or renal colic (a urine test will verify the accuracy of the version). A perforated gastric ulcer may also be suspected (to rule out this possibility, laparoscopy is performed). Another “similar” disease is right-sided pneumonia, which can be excluded or confirmed with x-rays.

Type of appendicitis in men

Signs of appendicitis in men may depend on the type of inflammation. The first stage of the disease is acute catarrhal appendicitis - at this stage the symptoms are quite weak (or do not appear at all). But if the disease is detected at this stage, treatment will be very easy, and recovery after removal of the appendix will be quick.

Destructive appendicitis is an inflammation with pronounced symptoms and unpredictable signs. During the course of the disease, symptoms may change - in particular, sharp fluctuations in body temperature are possible. In any case, discomfort, pain, nausea and other signs should be a signal to consult a doctor. It’s better not to delay - and then the help will be more effective, and you will be able to return to your usual way of life faster.

Appendicitis in women

The main signs of appendicitis in women:

• nausea;
• vomit;
• acute abdominal pain;
• muscle tension;
• Shchetkin-Blumberg syndrome;
• heat.

It is important to identify appendicitis in women in time in order to put her health at risk as little as possible. One of the most important signs is pain. At the very beginning of inflammation, the pain is pulling and pressing. They occur not only on the right side; it is quite normal for the pain to radiate to the left side or concentrate around the navel. In pregnant women, pain often occurs in the upper abdomen. After some time, the pain can spread throughout the abdomen, and then concentrate in the appendix area. At this time, they can be either constant or attacks similar to contractions. Another feature of pain with appendicitis is that it intensifies when coughing or even laughing.

Another sign by which you can understand how to determine appendicitis in women is vomiting and nausea. This is a completely typical manifestation of appendicitis. Vomiting occurs once or twice during the course of the disease. In addition to nausea, pregnant women also experience severe shortness of breath.

Appendicitis provokes an increase in body temperature. The normal temperature for this disease is 38 degrees. Quite often, the inflammatory process in the abdominal cavity provokes tension in the abdominal walls, as a result it becomes hard. In pregnant women, such a belly is a sign of uterine tone, so confusion often arises.

Another sign of how appendicitis manifests itself in women is lack of appetite. In addition, there is general weakness and poor health. The first signs of acute appendicitis in women most often appear in the late afternoon or even at night.

Signs of chronic appendicitis in women

The main symptoms of chronic appendicitis in women are pain in the right iliac region. The nature of pain varies. Attacks occur both at night and early in the morning. Moving with chronic appendicitis is extremely difficult. In addition, the woman simply cannot lie on her left side, as very severe pain occurs.

In addition to pain with chronic appendicitis, women experience constipation or intestinal upset. Frequent urination also appears, which is also accompanied by quite painful sensations. When examined by a gynecologist, intense pain occurs. On palpation, the compacted and painful process can be clearly felt.

Features of the course of appendicitis in women

Acute appendicitis in women is characterized by severe pain in the right hypochondrium and a tense abdomen. The disease in women is difficult to identify due to the characteristics of the female body. Diagnosing a disease during pregnancy is a rather difficult task, because all organs are displaced from their usual places, which means it is problematic to determine the localization of pain. It is worth noting that abdominal pain during pregnancy is quite common. After all, they are provoked by: fetal tremors, tissue stretching. And nausea and vomiting are quite traditional companions of pregnant women.

In order to identify appendicitis in women, you should not focus specifically on pain. But the presence of painful nausea and vomiting are some of the signs of appendicitis in women. In most female diseases, despite abdominal pain, these signs are absent.

Do not forget that any female inflammation and appendicitis can provoke peritonitis, as well as other serious consequences. This means that if you have any acute abdominal pain, you should immediately consult a doctor.

Diagnosis of appendicitis in women

The examination of the patient usually begins with a general examination. The presence of inflammation of the appendix can indicate:

• palpation of the abdomen, which causes the patient pain in the area of ​​the right ilium;
• the occurrence of painful sensations when palpating the area of ​​the cecum when the patient lies on his left side;
• increased pain when simultaneously pressing on the stomach and lifting the straight right leg;
• increased pain after pressing and abruptly releasing the painful area.

Of course, the most informative are modern methods for diagnosing appendicitis: ultrasound, computed tomography, endoscopy. Laboratory tests are also needed that can confirm the picture of the inflammatory process in the body.

Quite often, even doctors can confuse acute appendicitis in women with right-sided pyelonephritis, rupture of an ovarian cyst, intestinal obstruction, etc. To make a final diagnosis, laparoscopy is performed - instruments and video cameras are inserted into the abdominal cavity through microcuts, with the help of which the cecum is examined and neighboring organs. If a hypertrophied appendix is ​​detected, it is immediately removed.

Causes and risk factors for appendicitis in children

Closing the lumen of the appendix leads to a deterioration in the blood supply in it, stagnation of venous blood, and proliferation of microbial contents. 12 hours is enough for inflammation to develop. If surgery is not performed within 1-3 days, the appendix will rupture and pus and fecal matter will enter the abdominal cavity.

Acute appendicitis is very rare in children under 2 years of age. This is due to the feeding habits and anatomical characteristics of the appendage (it is shorter and wider).

Risk factors for developing inflammation of the appendix in children:

• binge eating;
• lack of fiber in the diet;
• increased sugar consumption;
• frequent constipation;
• diseases of the gastrointestinal tract;
• dysbacteriosis;
• ascariasis.

Types of appendicitis in children

Inflammation of the appendix in children is usually classified according to the characteristics of the destructive processes, as well as the degree of severity:

• simple (catarrhal) - appendicitis without complications, manifested in the form of slight thickening of the walls with a mild inflammatory process;
• destructive - can be phlegmonous (increase in the size of the appendix, vascular thrombosis) and gangrenous (tissue necrosis);
• empyema is an acute purulent inflammation of the appendix.

In the second and third cases, perforation of the appendix (rupture) is possible, but this does not happen all the time - the integrity of the rudimentary organ may well be preserved. Occasionally, cases of spontaneous recovery are recorded. There is also a risk of inflammation becoming chronic, with relapses occurring periodically.

When diagnosing appendicitis in children, one should take into account a characteristic feature - a large selection of options for localizing the appendix. It can be located in various places in the abdominal cavity: in the right or left hypochondrium, in the pelvic space, under the liver, etc. This makes diagnosing appendicitis in children very difficult.

Main symptoms and diagnosis of appendicitis in children

Acute appendicitis in children is a disease with frequent cases of misdiagnosis. On the one hand, vague symptoms do not give the doctor the opportunity to immediately suspect appendicitis (plus, not all children can accurately describe complaints). As long as the doctor doubts and makes other diagnoses, appendicitis will progress until it reaches dangerous stages.

However, on the other hand, the symptoms of appendicitis in children are similar to the symptoms of other diseases, so a child with a preliminary diagnosis of appendicitis may develop a completely different disease. Modern methods of ultrasound diagnostics greatly facilitate the solution of these problems.

Classic symptoms of appendicitis in children, characterized by their ability to progress:

• Pain around the navel or in the pit of the stomach, which is then localized on the right side in the iliac region (the standard location of the appendix). The child tries to change the position so that the pain is felt less (most often on the right side or back). In young children who cannot indicate the location of pain, the first signs should be discomfort, crying, lack of appetite, and sleep disturbances.
• Vomiting, after which there is no feeling of relief. Vomiting can be repeated (typical of small children) or single (most often in older children).
• The inflammatory process in young children is most often characterized by elevated temperature. The temperature also rises in older people if appendicitis is complicated. In its simplest form, the temperature can fluctuate in the sub-range.
• One of the indicators of inflammation is the condition of the tongue. Most often, the disease can be recognized by an abundant white coating. The more severe the inflammation, the larger the area of ​​the tongue turns white. With gangrenous appendicitis, not only whitening is diagnosed, but also dryness of the tongue.
• Abnormal bowel movements: diarrhea in small children and constipation in older children. If the appendix is ​​located close to the urinary organs, there may be problems with urination.

Symptoms of appendicitis in children of different ages

Even a professional doctor will practically not be able to detect signs of appendicitis in newborns or infants. True, at this age appendicitis develops only in exceptional cases. Characteristic symptoms are expressed only as signs of general malaise. These are: monotonous sharp crying, short and restless sleep, sluggish sucking or complete refusal to eat, frequent belching, rapid movements of the legs or pulling them towards the stomach (a symptom of abdominal pain). Most often, the diagnosis is confirmed only during surgery. The appendix erodes quickly enough and there is a risk of peritonitis.

Signs of appendicitis in children 3 years old manifest themselves in the form of changes in general condition. The presence of pain itself is very difficult to establish. Symptoms of appendicitis in children 5 years old are also expressed in a deterioration in the general condition, and the child cannot describe the pain. Given the similarity of symptoms with a large number of other diseases, appendicitis is difficult to diagnose not only for parents, but sometimes also for doctors. To begin to suspect appendicitis in a child, you should look for the following signs:

• peculiarities of behavior (whims, causeless crying);
• constant change of position in order to reduce pain, restlessness;
• refusal to eat (even your favorite dishes);
• single or repeated vomiting;
• diarrhea (however, this occurs rarely);
• sleep disorders - the child cannot fall asleep because pain interferes;
• an increase in body temperature to 37°C in the absence of a runny nose and cough.

Symptoms of appendicitis in children 8 years of age and older do not need to be tracked by changes in general condition - the child is already able to describe his sensations and point to the area of ​​pain. Most often, the child names the following symptoms of appendicitis: pain, initially localized throughout the abdomen, and then descending to the lower sections - and specifically to the right side (can point with a finger); increased pain when changing position, bending, turning from back to side; painful nausea and refusal to eat; slightly elevated temperature. Simply put, the symptoms of appendicitis in children 10 years old almost completely coincide with the signs of this inflammatory disease in adults.

Symptoms of appendicitis in children with an atypical location of the appendix

In this case, pain is observed in other places (and not just in the right side of the lower abdomen). In addition, other typical signs may be blurred: pain when palpated and abdominal tension. If the process of the cecum is retroperitoneal, symptoms of pain will appear in the lumbar region (on the right side), in the area of ​​the ureters, and in the groin. In the pelvic position, pain will occur above the pubis, in the perineum. Diarrhea with mucus and pain when urinating are possible. With a subhepatic location, the pain will be in the right hypochondrium.

With atypical localization of the appendix, the gangrenous form of appendicitis is especially dangerous. Her picture is unclear: moderate pain, no abdominal tension, satisfactory condition of the child.

Regardless of the nature of the external manifestations, you cannot delay it - if you have any manifestations of restless behavior or complaints of pain, you should immediately consult a doctor. Considering the rapid development of appendicitis in children, this will allow the disease to be diagnosed in time and measures taken before complications arise.

Gangrenous appendicitis

Symptoms of gangrenous appendicitis

Necrosis (death) of tissue in the gangrenous form of acute appendicitis leads to the death of the nerve endings of the appendix. Because of this, patients begin to feel relief: the pain syndrome decreases and a false feeling appears that suspicions of appendicitis were in vain.

However, gangrenous appendicitis is accompanied by putrefactive inflammatory processes, and therefore the patient may experience symptoms of general intoxication: severe weakness, multiple vomiting, which does not bring relief. Body temperature is not an indicator - it can remain within normal limits. The tongue in the gangrenous form of appendicitis is dry, covered with a white or yellowish coating (this is especially noticeable at the root).

The gangrenous form of acute appendicitis is characterized by the occurrence of the “toxic scissors” syndrome: with a general serious condition and normal body temperature, the development of pronounced tachycardia is observed with a heart rate of up to 120 beats per minute, with a norm of 70-80 beats.

The symptoms of primary gangrenous appendicitis are different. Initially, the patient experiences sharp pain in the right iliac region. The pain goes away very quickly, but the general condition remains severe, and the body temperature is high in most cases. The abdomen is tense, painful, with obvious signs of peritoneal irritation.

Gangrenous-perforated appendicitis

If treatment is not carried out at the stage of gangrenous appendicitis, the stage of gangrenous-perforated appendicitis occurs. During this process, the wall of the appendix is ​​pierced (perforated). At this moment, the patient feels a sharp pain in the right iliac region. The pain syndrome is constant, with intensification spreading throughout the abdomen. Intoxication of the body increases, which is expressed by increased body temperature, tachycardia, and repeated vomiting. The tongue is dry and has a brown coating on it. Abdominal bloating is constantly increasing, peristalsis is absent.

Consequences of gangrenous appendicitis

The gangrenous form of acute appendicitis is a very dangerous disease that provokes severe complications:

• purulent diffuse peritonitis (inflammatory process in the peritoneum). This is a dangerous condition that can only be treated with urgent surgery. If timely assistance is not provided, sepsis (blood poisoning) quickly develops and death occurs;
• appendicular infiltrate - the formation of a local conglomerate of tissues and organs around the inflamed appendix. This complication is treated conservatively. The infiltrate can resolve only after 3-4 months of treatment - only after this can the appendix be removed;
• local purulent abscesses in the abdominal cavity - in the pelvic cavity, between intestinal loops, in the subdiaphragmatic region;
• septic thrombophlebitis (inflammation of the venous walls with further formation of blood clots in the lumens of the portal vein and tributaries).

Diagnosis and treatment of gangrenous appendicitis

Initially, the doctor listens to the patient and conducts a general examination. The abdomen is usually distended, with weak or absent bowel movements. To more accurately determine exactly the gangrenous form, the patient will be advised to undergo blood and urine tests, undergo a computed tomography scan or ultrasound examination. After confirming the diagnosis, an appendectomy (removal of the appendix) will be prescribed, which can be performed traditionally or by laparoscopy.

Traditional surgery is performed through a small incision in the abdominal wall. The operation is performed under general anesthesia (very rarely - under local anesthesia). Laparoscopy is performed through several small holes, which heal faster and leave virtually no scars.

In order to quickly restore the body after surgery to remove gangrenous appendicitis, you must strictly follow all the recommendations of the attending physician on rehabilitation and dietary nutrition. The recovery process takes up to 3 months - during this entire period, reboots and heavy lifting are prohibited.

Appendicitis in pregnant women

Symptoms of appendicitis during pregnancy

In medicine, a distinction is made between catarrhal and destructive forms of appendicitis. Each of them has its own characteristic development of the process. In the catarrhal form, inflammation develops within 6-12 hours, in the destructive form - from 12 to 48 hours, after which perforation can occur and intestinal contents enter the abdominal cavity.

There are no specific symptoms of appendicitis in pregnant women, since each woman’s body is individual, not everyone’s appendix is ​​located in the same place, therefore, changes in the appendix may be different.

If the inflammation begins in the appendix itself, without affecting the abdominal cavity, a pregnant woman is most often bothered by pain in the upper abdomen, gradually spreading to the lower right region. Symptoms of appendicitis include: vomiting. Stomach upset, nausea. Pain can sometimes be insignificant and occur in all areas of the abdomen. A woman may experience painful sensations while lying on her right side. During a medical examination, the source of pain will not be immediately determined.

With the gradual development of inflammation, pain will manifest itself along the entire right iliac region, often moving into the lower and upper parts of the abdominal cavity, and sometimes into the hypochondrium. The severity of pain depends on the stage of pregnancy. It is important to note that the standard symptoms of acute appendicitis in pregnant women may appear mild or appear late.

The location of the appendix also influences pain. If the appendix is ​​located under the liver, the pregnant woman will have symptoms resembling gastritis (pain in the upper abdomen, vomiting and nausea). If the appendix borders the urinary system, the pain will radiate to the perineum and legs, the woman will experience a frequent urge to urinate and other symptoms usually characteristic of cystitis.

The effect of appendicitis in pregnant women on the fetus

If appendicitis develops in the second trimester of pregnancy, its effect on the fetus is clear. The most common complications include the threat of late pregnancy loss, intestinal obstruction and postoperative infections.

Very rarely there are cases of premature placental abruption in pregnant women with appendicitis. If timely diagnosis and proper treatment are carried out, then there are no threats: the pregnancy will be preserved and completed. If the membranes become inflamed, intrauterine infection of the baby will occur, which will require mandatory antibacterial therapy. Postoperative complications most often occur within 7 days after surgery to remove the inflamed appendix. Therefore, for prevention, pregnant women are prescribed antibacterial therapy.

Diagnosis of appendicitis in pregnant women

Only a doctor can make a diagnosis of “acute appendicitis”, guided, as a rule, by high body temperature, pain in the right side when walking, increased pain when palpating the abdomen, etc. In addition, make an accurate diagnosis using a urine test (an increase in white blood cells in the results) together with an ultrasound examination (ultrasound), which can detect an enlarged appendix or even an abscess. However, ultrasound is not an accurate diagnostic method, since the appendix can only be detected in this way in 50% of patients.

Another method for diagnosing appendicitis in pregnant women is laparoscopy. It allows the doctor to see all the abdominal organs, including the appendix. This is the most accurate method, providing 100% objective data on the presence of an inflammatory process. The attending physician must choose the diagnostic method - therefore, it is extremely important to consult a specialist as early as possible, even when the first pain appears.

Treatment

Treatment of the acute form of the disease is followed by therapy with antibiotics and drugs that relieve the symptoms of poisoning. Appendicitis surgery is also performed in cases where there is a suspicion of inflammation, but it is impossible to exclude it by other methods.

Appendiceal infiltration is treated with cold, antibiotics and antiseptics. Painkillers are also used. Physiotherapy is aimed at resolving the infiltrate. Two to four months after appendicitis, an appendectomy is performed.

When an abscess forms, surgical intervention is necessary. The abscess is opened and drained. A few months after the abscess disappears, an appendectomy is performed.

If organ tissue is destroyed, surgical treatment is followed by antibacterial therapy. Medicines are administered parenterally and through drainage, if drainage was performed.

Causes of elevated temperature after appendicitis removal

Fever after appendectomy may occur due to wound infection. This is the most common reason that occurs due to non-compliance with the medical regimen. Damage to internal organs during surgery may also be the cause. As a result, the traumatic inflammatory process develops further.

Also, a fairly common cause of fever after appendicitis surgery can be a decrease in immunity, since any surgical intervention puts quite a lot of stress on the body. During the recovery period, the human body begins to use all internal reserves. For this reason, additional diseases may occur in the form of viral or acute respiratory infections.

Fever may also occur due to severe bleeding during surgery. An infectious process may also occur during surgery. Drainage, which may be installed during surgery, can also cause increased temperature. Once the drainage tubes are removed, your body temperature should return to normal. Often the inflammatory process develops due to poor nutrition. The patient must fully adhere to the diet established by the doctor, otherwise there is a danger of the occurrence and development of general intoxication of the body.

Typically, fever after appendicitis may also be accompanied by profuse sweating and chills. In order to diagnose the causes of inflammation, the following methods are used:

• a clinical blood test that confirms the presence of severe inflammation;
• Ultrasound, which allows you to see the inflammatory process in visualization.

If the temperature rises

Do not forget that elevated temperature after appendicitis removal during the first three days is normal. But if this condition persists for a longer time, measures must be taken. First of all, the attending physician should prescribe a course of antibiotics depending on the causative agent of inflammation. The patient may also take antipyretic drugs (for example, paracetamol or acetylsalicylic acid). Nonsteroidal anti-inflammatory drugs (eg, ibuprofen) are quite often prescribed.

Self-medicated reduction of temperature after surgery for appendicitis is strictly prohibited. The patient spends the first week after the operation in the hospital, during which time doctors monitor the condition of the suture and wound. Such actions make it possible to prevent or detect the inflammatory process in time. The patient will remain in the hospital until the fever subsides. If necessary, the doctor can take radical measures and even perform repeated surgery.

What are adhesions after appendicitis surgery?

Adhesions are films that form between internal organs. They appear due to irritation of the membrane that covers the internal organs. As a rule, adhesions affect the interaction of organs, after which their work becomes difficult. For men, adhesions do not pose a serious danger, but for women, infertility may well be diagnosed, which, unfortunately, is not always treatable.

Symptoms of adhesions after appendicitis

Most often, adhesions occur after appendicitis. The symptoms are as follows:

• pain - it may be absent for a long time. As a rule, it is localized in the area of ​​the postoperative scar. Most often it has a pulling nature and can intensify after physical activity;
• dyspeptic syndrome - digestion is disrupted due to improper bowel function;
• violation of defecation - constipation appears, no stool for more than a day;
• complete absence of stool for more than two days.

Possible complications of the adhesive process

Adhesions after appendicitis can lead to serious complications. For example, acute intestinal obstruction may develop. It occurs due to compression of the intestines, which in turn prevents the passage of food in the intestines. In addition, necrosis of a section of the intestine is possible. Due to a disruption in its blood supply, which is provoked by an artery pinched by a commissure, the walls of the intestine die. This condition requires immediate removal of this section of the intestine.

Diagnosis of the disease

If symptoms of adhesions appear in the abdominal cavity, as well as the presence of surgical intervention to remove appendicitis, diagnostics are necessary.

First of all, a clinical blood test is needed, which will indicate the presence of an inflammatory process in the body. It is also necessary to conduct an ultrasound examination of the abdominal organs. Ultrasound can visualize the presence of adhesions. This examination should be carried out after appropriate bowel preparation.

In addition, radiography with a contrast agent is performed. The patient should drink the barium mixture on an empty stomach. Based on the presence of defects in intestinal filling, the picture of the disease will be clear. Diagnostic laparoscopy is no less important. To do this, a special fiber optic tube is inserted into the peritoneal cavity. It is equipped with lighting and a camera. Using this diagnostic method, the condition of the intestinal loops is studied and the presence of adhesions is determined.

Treatment of adhesions after appendicitis

Adhesions after appendicitis are a fairly common complication after surgery. Treatment of adhesions is carried out by surgical dissection and release of compressed intestinal loops. Before surgery, it is imperative to eat meals in small portions. A cleansing enema is also performed. If intoxication occurs, solutions are injected intravenously that help remove toxins from the body. If acute abdominal pain occurs, painkillers are used.

Surgical treatment of adhesions after appendicitis is possible through laparoscopy or laparotomy. The choice of treatment tactics depends on the patient’s age, concomitant pathologies, the number of adhesions, and the presence of complications of intestinal adhesions.

Diet after appendectomy in adults

Dietary nutrition after surgery to remove appendicitis in adults is characterized by a seriously limited diet at the very beginning with a gradual expansion of the menu in the future. On the first day after surgery, it is not recommended to consume food or liquid - it is enough to occasionally wet your lips. On the first day after surgery, the patient has no appetite due to the fact that the body is in a state of stress. Therefore, it is not recommended to consume food and liquid - it is enough to sometimes wet the lips. After 12 hours, the patient is allowed to eat broth, drink jelly or tea (if the condition allows).

On the second and third days after removal of appendicitis, you should switch to 5 or 6 meals a day (fractional meals). The diet should include low-fat yogurt, puree soups with chicken fillet, zucchini and pumpkin, chicken broth, rice. The exact diet should be compiled by the attending physician based on the patient’s condition, the presence of contraindications, allergies and other factors.

In order to improve intestinal function, in the first 7 days after removal of the appendix, you can add fruits and berries, vegetables and cereals to the patient’s menu. You can eat lean meat and fish. It is very important to chew food thoroughly, and even better, give it to the patient in crushed (puree) form. To heal wounds, you need to drink clean water without gas in large quantities.

In the second week after surgery, you can start eating lean soups, thoroughly boiling all the vegetables and chopping them in a blender. A month after the removal of appendicitis, you can introduce beans that were previously prohibited into the menu. Flour and sweet foods can be eaten after 2 months, but in limited quantities. If after a month the wounds have healed well, then, on the recommendation of the attending physician, you can switch to your usual diet. But you should not overuse it - the body’s recovery will be completed in 4 months.

Diet after appendicitis in children

The diet after surgery in children should be as gentle as possible:

• Serve any food in crushed form: in the form of puree, mashed, boiled, steamed;
• completely eliminate fatty broths and fried foods;
• do not give large pieces of meat and hard fruits;
• give bananas - they are ideal for the daily diet;
• Give low-fat fermented milk products (mainly yoghurts) daily.

Nutrition after appendicitis with peritonitis

Removal of appendicitis with peritonitis falls into the category of complex operations - accordingly, recovery after them is also difficult. Therefore, dietary nutrition in such cases should be as gentle as possible. All foods consumed should not lead to intestinal irritation and, especially, to the formation of excess weight.

The ideal dish is pureed soups without potatoes, well-cooked porridge. Under no circumstances should you consume carbonated drinks, spicy and salty foods, or sweets.

In general, the diet after gangrenous appendicitis is practically no different from the standard diet. Care should be taken to fill the diet with foods with plenty of vitamins - in particular, sour berries and citrus fruits, as well as bananas, pears and apples, which help restore the body.

Nutrition after phlegmonous appendicitis

The diet after phlegmonous appendicitis should be compiled by a doctor depending on the patient’s preferences and his general condition. The menu should include cottage cheese, puree soups, liquid porridges, stewed vegetables, which contain many vitamins and nutrients needed for quick recovery. An important component of the menu should be apple, pear, banana and pumpkin purees, which are well absorbed by the body.

A sample menu after appendicitis surgery is as follows:

• for breakfast - pureed oatmeal in water with pureed cottage cheese and herbal tea;
• for second breakfast - rosehip decoction;
• for lunch - vegetable puree soup, steamed chicken meatballs, rice, fruit jelly;
• for an afternoon snack - blueberry decoction;
• for dinner - pureed buckwheat porridge, steamed omelette, green tea;
• before bed - a cup of warm jelly.

If nutrition after appendicitis was agreed upon with the attending physician, if the diet was followed in good faith, the results will be positive: the body will quickly recover, the wounds will heal well, and the normal functioning of the gastrointestinal tract will be established. Naturally, along with the diet, you should follow other doctor’s recommendations and take medications.

Thank you

Table of contents

General provisions

After removal appendicitis As with other surgeries, the patient must make some changes to his lifestyle. The purpose of such actions is to prevent postoperative complications. The nature of the changes is determined by the type of operation performed, the age of the patient and his general health indicators before the operation.

The actions that the patient should take after appendicitis are:

• physical activity in the first week;
• dietary food;
• special way of life.

Physical activity in the first week after appendicitis

After removal of the appendix, it is recommended to perform special exercises to prevent possible complications after surgery. Physical therapy (physical therapy) helps prevent the development of pneumonia, thrombophlebitis, constipation, and increased gas formation. Also, the goals of exercise therapy include improving the general condition of the patient and stimulating regenerative processes. Special physical activity is especially necessary for elderly patients, as they are more likely to experience complications. You should start doing some exercises soon after the anesthesia wears off.

Exercises on the first day after surgery

After the anesthesia is completed, the patient is taught to painlessly turn onto his healthy (left) side. To minimize pain, you need to rest your feet on the bed, bending your legs for comfort. Then, focusing on your feet and elbows, lift your pelvis and turn it to the left side. After this, you should alternately move your legs to this side. Then, placing emphasis on your elbow, you need to lift your right shoulder off the bed. By performing all movements one at a time and slowly, the patient will reduce pain to a minimum when turning over to one side.
Classes on the first day are performed by the patient in a supine position. They should be started 2–3 hours after completion of anesthesia. The complex consists of 5 exercises, the duration of which should be from 3 to 5 minutes. The complex should be repeated 3-4 times daily.

Exercises for the first day after surgery are:

• rotation of the feet and their flexion, first alternately, then together;
• bringing and spreading the fingers together - first, in turn on the right and left hands, then together on both;
• while inhaling, the patient should bend his arms at the elbows and bring them to the shoulders, while exhaling, lower them along the body;
• with an inhalation, you need to raise your hands and reach towards your knees, and lower them with an exhalation;
• As you inhale, the pelvis should be raised, and as you exhale, lowered; your legs should be bent at the knees and spread to shoulder width.

Exercises on days 2–3 after surgery

Gymnastics at this stage is carried out from a sitting position. In most cases, if the appendicitis was removed using laparoscopy, you can get up the next day. If abdominal surgery has been performed, it is possible to take a sitting position and stand on your feet after 1–2 days. To sit down, the patient must turn to his side, place his hands on the bed, and bring his knees over the edge of the bed. Then you need to lower your legs to the floor and push off with your elbow to sit down.

Exercises for days 2 and 3 after surgery (done while sitting) are:

• As you inhale, bring your hands to your shoulders, as you exhale, lower them;
• while inhaling, bring your arms forward, while exhaling, bring them through the sides to your knees;
• as you inhale, your arms are moved to the sides, as you exhale, your hands are placed on your knees, and your body leans forward;
• rotation of the head clockwise, tilting the head left and right;
• while inhaling, the patient needs to raise his arms up and reach for them with his body, protruding the chest forward; while exhaling, he should relax and take a comfortable position.

There are also a number of exercises that are performed from a standing position. The first attempts to stand on your feet should be made under the supervision of medical personnel or relatives who will help you maintain your balance. After 5–10 times, the patient can begin to stand up without assistance, using a chair or bedside table for support.

Exercises for days 2 and 3 after surgery (done standing) are:

• bring your hands to your shoulders and make rotational movements forward, then back;
• make circular movements with your pelvis, keeping your hands on your belt and without straining your abdominal muscles;
• you should sit on a chair and, while inhaling, spread your arms and legs to the sides, while exhaling, bring your legs together, and place your hands on your knees.

When performing any of the exercises, the patient is recommended to wear a special bandage or support belt. The bandage will help prevent deformation of the postoperative suture. In addition to exercises on days 2 and 3, the patient is recommended to walk around the ward. You need to start walking gradually, first using the headboard or other furniture as support.

Exercises from 4 to 7 days after surgery

All exercises of this period are performed standing with feet shoulder-width apart. During exercise, you should control your breathing, inhaling during physical effort and exhaling when relaxing.

Exercises from days 4 to 7 are:

• circular movements with the arms (arms bent at the elbows are brought to the shoulders);
• movements of the torso left and right (hands on the belt);
• rotation of the pelvis in a circle (hands on the belt);
• alternate bending and extension of the legs at the knees (palms behind the head);
• you need to sit on a chair and get up from it (hands on your belt).

Diet after appendectomy

The diet in this case has 2 goals. The first is to ensure the most gentle effect on parts of the digestive tract. The second is the restoration of lost energy and physical resources after surgery. The entire period of patient recovery in medical practice is divided into three stages (first, second, third). Each stage has separate recommendations for the diet and a list of products that need to be included or excluded from the menu.

What to eat after appendectomy?

The first stage lasts from 1 to 7 days after the operation. For the first 12 hours, the patient must refrain from eating and drinking plenty of fluids. During this period, lips are moistened with a damp cloth, and in case of severe thirst, you are allowed to drink 30 - 50 milliliters of clean water without gases. Over the next 12 hours (unless prohibited by the doctor), the patient is given weak chicken broth or unsweetened fruit jelly. In the next week, feeding a person whose appendix has been removed is carried out according to strict rules and in accordance with the list of permitted and unauthorized products.

Products that can be included in the menu at the first stage include:

• cereals – rice, buckwheat, oatmeal;
• fruits – apples;
• vegetables - pumpkin, zucchini, broccoli, carrots;
• meat – chicken, turkey;
• fish - hake, pollock, cod.

Despite significant restrictions in choice, the patient's diet should be varied. So, the daily menu must include all types of permitted products. They must be prepared and eaten in accordance with a number of rules.

The nutritional rules for the first rehabilitation period are:

• The first meal in the postoperative period is allowed after the first bowel movement. As a rule, this happens on the second day after surgery. For the first meal, the best option would be chicken fillet crushed to a puree in an amount of no more than 50 grams.
• For 2 and 3 days, rice cooked in water, oatmeal jelly, and broths made from lean chicken are also allowed.
• Starting from day 4, permitted fruits and vegetables are gradually introduced into the menu to provide the body with dietary fiber (fiber). They should be consumed after being boiled or processed in the oven.
• To compensate for the carbohydrate deficiency, the diet from days 4 to 7 is supplemented with porridges from permitted cereals, which are boiled in water. Porridges should be well boiled.
• Boiled meat and fish should be consumed in small quantities (no more than 50 grams per day). These products will make up for the lack of protein in the body.
• All food consumed by the patient during the first period of rehabilitation should be in the form of a paste. To do this, ready-made products are crushed using a blender or meat grinder.
• The food temperature should be medium, as too hot or cold food can cause irritation of the gastrointestinal tract.
• All dishes are prepared without salt, pepper and other spices.
• The patient should eat every 2 to 3 hours. The volume of food for one meal should fit in the palm of your hand folded into a ladle (approximately 100 grams).
• A prerequisite for a postoperative diet is to drink enough fluids. The total daily volume of fluid should be at least 1.5 liters. It is necessary to replenish the recommended norm with broths and clean still water. Pure water is drunk half an hour before meals or an hour and a half after a meal.

Prohibited Products
To prevent inflammatory processes and to ensure a gentle effect on the gastrointestinal tract in the first seven days after surgery, you should refrain from any sour, salty, sweet foods. For the same purpose, strong rich broths, smoked, dried, fried or baked products are excluded. You should not consume products that can lead to increased gas formation (any legumes, milk and any products made from it, white cabbage). You should also exclude flour products of any type, as they lead to constipation. Sauces such as mayonnaise, ketchup, and mustard are excluded. Alcohol and any carbonated drinks are strictly prohibited. Prohibited products also include any food products that are not on the list of permitted ones.

Nutrition after appendicitis removal at the second stage of rehabilitation

The second stage lasts from 7 to 14 days and is characterized by an increase in the activity of all body systems. Therefore, the list of permitted products is supplemented with some items and, accordingly, the list of prohibited dishes changes.

Permitted products and rules of the second stage
Starting from day 7, it is necessary to gradually increase the daily volume of liquid so that by the end of the second stage it reaches two liters. At the same time, you can replenish the norm not only with clean water, but also with some drinks. Gradually, observing the body's reaction, weak black or green tea, chamomile and rose hip decoctions are introduced into the diet. Also, no more than 150 milliliters per day of juices from vegetables and fruits is allowed. By juice we mean drinks prepared independently using a juicer. Industrial juices contain large amounts of sugar and preservatives, which are not allowed during this period. Fresh juice (freshly squeezed juice) can be prepared from pumpkin, carrots, apples, celery.
The basic diet of the second rehabilitation period is based on the rules of the first stage with some additions.

Additions to the second stage diet are:

• The volume of a single serving is gradually increased to 150 grams.
• The emphasis in the daily menu is on vegetables, of which there should be at least 300 grams. Advantage should be given to carrots, zucchini and pumpkin, as they prevent constipation.
• The list of permitted vegetables and fruits is supplemented by potatoes and peaches. They should be consumed no more than 100 grams per day in boiled form. Towards the end of the second period, beets are introduced into the diet. Any vegetables are not consumed on an empty stomach, but after porridge or a meat dish.
• The list of meat products includes lean veal. In addition to meat broths, steamed cutlets or souffles are prepared. The same dishes are prepared from lean fish.
• Gradually, in the second stage, some dairy products should be introduced. This can be low-fat cottage cheese, natural yogurt, unsweetened cheese masses.
• If there is no constipation, you are allowed to eat one boiled egg per day. You can also eat steamed omelettes.
• Soups made from vegetables, cereals, meat or fish are added to broths and porridge-like dishes.

When introducing a new product or increasing the portion, it is necessary to monitor the patient's condition. If he develops vomiting, diarrhea, or constipation, all dietary changes should be discontinued.

Products that are excluded from the menu at the second stage include:

• bread (white, rye, bran);
• crackers, crackers;
• peas, lentils, beans;
• hard cheeses, feta cheese, tofu (soy cheese);
• milk, kefir, fermented baked milk, cream;
• sauces and salad dressings;
• meat with a high fat content;
• any sausages, even dietary ones;
• fish of medium and high fat content;
• dumplings and other semi-finished products;
• pizza, hot dogs, hamburgers;
• pickles and marinades;
• coffee, cocoa, chocolate;
• baked goods and other confectionery products;
• industrial juices, carbonated drinks;
• any alcohol.

Some experts recommend including dried bread or crackers in the menu at this stage. These products can be included in the diet if the patient does not have constipation, which is a common occurrence after removal of the appendix of the cecum.

What can you eat after appendicitis at the final stage?

The third, final stage begins on the 15th day after surgery and lasts 3 to 4 weeks. The diet of the second stage is taken as a basis, which is gradually expanded by adding new products and dishes. The portion size is also increased to 200 - 300 grams.

The changes that are made to the menu at the third stage are:

• Leafy greens and leafy salads (parsley, dill, iceberg, lettuce, arugula, spinach) are added to the vegetables. Mushrooms (champignons, honey mushrooms, saffron milk caps), any cabbage, and cucumbers are also allowed. Vegetables that can be eaten raw, closer to the end of the third stage, do not need to be subjected to heat treatment (except for cabbage).
• The list of fruits is supplemented by citrus fruits (limitedly), strawberries, raspberries, and blueberries, which can be eaten fresh. Dried fruits (prunes, dried apricots, figs) are allowed.
• Meat products include lean beef, rabbit, and turkey. By-products are consumed in small quantities - liver, heart, tongue. It is better to use beef or chicken by-products. Steamed or boiled meatballs and cutlets are prepared from meat and offal. You can also bake whole pieces of meat without allowing a crust to form. In addition to natural meat, the menu may include low-fat boiled sausages (doctor's sausage, chicken sausages, boiled ham).
• Gradually, medium-fat fish (mackerel, tuna, pink salmon, herring, herring) are being introduced into the menu. The fish is used to prepare steaks (baked on the grill or in the oven), cutlets or soufflé. You can also prepare fish broth for fish soup or other first courses.
• Kefir, butter, skim milk, processed cheese, low-fat sour cream, and sweet cheeses are added to the permitted dairy and fermented milk products.
• Wheat, millet and pearl barley are added to the cereals. In addition to boiled porridges made with water, crumbly porridges made with milk and seasoned with butter are allowed.
• Sweets that can be consumed at the final stage include honey, marmalade, and marshmallows. Fruit jellies are also allowed as dessert.
• Among flour products, pasta, unsweetened dry biscuits, and dried bran bread are allowed.
• Salads from vegetables, fish and meat are added to soups, cereals and pureed dishes. To dress salads, use vegetable oil, low-fat sour cream or yogurt. Various casseroles are prepared from cottage cheese, eggs, and pasta.

Products that should be limited at the last stage
Most products that were included in the category of prohibited products in the early stages, in the final period of rehabilitation, move into the group of those that must be consumed in limited quantities. They can be included in the diet in small volumes (no more than 30–50 grams) starting from 3 weeks.

Foods that should be consumed sparingly include:

• hard cheeses, feta cheese;
• fatty fish (salmon, mackerel, halibut, sprat);
• white bread and other products made from wheat flour;
• beans, peas and other legumes;
• fruits and vegetables that were not allowed until now;
• medium and high fat milk, cream;
• coffee, chocolate, cocoa.

Meats with a high fat content, sweets and alcohol continue to be prohibited throughout the third stage.

Lifestyle after appendectomy

To minimize the negative consequences of surgery for appendicitis, the patient must adhere to a number of recommendations.

The rules for quick recovery after appendicitis are:

• seam care;
• temperature control;
• wearing a bandage;
• restrictions in sports;
• refusal to lift heavy objects;
• refusal of sex;
• normalization of stool;
• complete rest.

Suture care after appendicitis

Suture care is aimed at preventing possible complications and accelerating the process of regeneration of damaged tissue.

Seam care measures are:

• dressings;
• treatment with antiseptics;
• control of possible complications.

Dressings
If a standard operation was performed, then the dressing is done every two days. After operations for appendicitis with peritonitis, drainage remains in the patient’s abdominal cavity. Therefore, in such cases, dressings are carried out daily. When removing appendicitis using the open method, there are 2 types of sutures - internal and external. External ones are removed 10–12 days after surgery. Internal sutures are made of special surgical material, which dissolves after 2 months. Until the postoperative sutures are removed, the patient is not allowed to take a shower or other water procedures.

Treatment with antiseptics
After the sutures are removed, the body is often left with an incompletely healed scar that is not completely covered with epithelium. The wound is an “open door” for various infectious agents to enter the body. Therefore, even after removal of postoperative sutures, it is necessary to treat the skin damaged during surgery with antiseptic solutions.

Treatment of an unhealed scar is carried out until all the crusts disappear from its surface. The procedure is carried out after taking a shower (bathing is strictly prohibited for 2 - 3 weeks after removal of stitches). Hydrogen peroxide (3 percent) and Castellani liquid can be used as an antiseptic. It is recommended to refrain from using iodine, brilliant green and other solutions that stain tissue, because the patient may not pay attention to the onset of inflammation. To speed up regeneration, you can also use ointments or emulsions that contain panthenol or levomekol. Ethnomedicine suggests treating the wound after surgery with sea buckthorn or milk thistle oil.

Monitoring possible complications
A common complication after appendix removal is suture dehiscence. This may occur due to increased physical activity, improper care, or the patient’s weak immunity. In addition to suture separation, an inflammatory process may begin in the suture area due to an infiltrated infection. The sooner treatment is carried out, the less negative impact the developed complications will have on the body. Therefore, the patient needs to inspect the wound daily and if any symptoms of inflammation or suture dehiscence are detected, consult a doctor.

Symptoms of complications after appendicitis are:

• bloody and/or purulent discharge appears from the wound;
• a swelling has formed in the suture area;
• the skin on the wound turned red;
• pain in the suture area persists 10–12 days after surgery.

Temperature control after appendicitis

Fever after appendix removal is common. In some cases, an increase in body temperature is a natural reaction of the body to surgery. The duration of this phenomenon and its features largely depend on the type of operation performed. Various pathological processes that are complications after surgery can also provoke a high temperature. Therefore, the patient needs to systematically monitor body temperature and, if necessary, consult a doctor.

Temperature after laparoscopy
Removal of the appendix by laparoscopy occurs with minimal negative consequences for the patient. After such operations, the temperature rarely rises. If this happens, it fluctuates at 37 degrees and goes away in 2 to 3 days.

Temperature after abdominal surgery
Removing the appendix using the open method, like any other abdominal surgery, is stressful for the body. Often after such operations, patients are worried about increased temperature, which can reach 37 - 38 degrees. This physiological reaction can last from 3 to 5 days. Then the temperature begins to gradually decrease and returns to normal within a few days.

Temperature after purulent appendicitis
With this type of appendicitis, patients experience high body temperature even before surgery. Removal of the appendix and purulent contents is accompanied by a high degree of tissue damage and blood loss. Therefore, most often after operations for purulent appendicitis, the patient remains at a high body temperature, which can reach 38 - 39 degrees. It is often accompanied by increased sweating and chills. If the patient’s recovery occurs without complications, his condition returns to normal within 3 to 5 days. In some cases, after phlegmonous appendicitis, the patient remains at low-grade fever (37 degrees) for up to 10 days.

If a patient is given drainage after surgery, in most cases the immune system reacts to this with an increase in temperature. In such cases, normalization of body temperature occurs after removal of the drainage.

When should you see a doctor?
You should consult a doctor because of an elevated temperature if it lasts more than 10 days (regardless of the type of surgery you underwent). You should not try to eliminate this problem on your own using antipyretic drugs. A fever that persists for such a long time, even in the absence of other symptoms, is in most cases a sign of infection. Therefore, it is necessary to eliminate the root cause, and not its consequence, which only a doctor can do.

Another case in which you should consult a doctor is a sudden increase in temperature a few days after surgery. So, the temperature rises to 37 - 38 degrees on the 5th - 7th day after surgery in case of purulent inflammation. At the same time, seals are formed in the seam area.
When the temperature rises on the 8th - 10th day and reaches 38 - 40 degrees, there is a high probability of an abdominal abscess. In this case, the patient experiences severe abdominal pain and chills.

Wearing a bandage after appendicitis

After surgery, patients are advised to wear a bandage (tight bandage). This advice is especially relevant for people who are overweight. The bandage ensures the integrity of postoperative sutures and helps prevent adhesions, hernia and other complications. In addition, wearing a bandage can reduce pain, irritation and stretch marks on the skin.

Types of bandages
The most common type of bandage is a wide belt made of thick material that wraps around the waist. This type of bandage is the best option, since it covers the largest part of the abdomen, while relieving the load from the back and abdominal cavity. In addition to waist models, there are also bandages in the form of high-waisted panties. There are also bandages in the form of elastic shorts with a high waistband. Models in the form of panties or shorts are more comfortable to wear in the cold season.

In addition to the shape, the bandage can also differ in the material from which it is made. The best choice is cotton headbands with the addition of synthetic fibers. Such bandages fit tightly to the body, but at the same time allow the skin to breathe and do not pinch or squeeze internal organs. There are also bandages made of rubberized fabric, which are rigid and recommended for obese patients.

The bandage is secured with Velcro, lacing or ties. When purchasing, it is recommended to try on the product to make sure that it fits well on your figure, and that the fixing elements do not irritate the skin and the seam area.

Rules for wearing a bandage
The bandage, regardless of the model and material from which it is made, is not intended for constant wear. The period during which it must be worn depends on the nature of the operation performed and the general condition of the patient. On average, after removal of appendicitis, the bandage is worn for 2–3 weeks. Immediately after the operation, the product is worn during the day and removed only before bed. During the rehabilitation period, the patient needs to wear a bandage only when he is busy with housework or other types of physical activity.

Avoiding heavy lifting after appendicitis

Immediately after removal of appendicitis and over the next 2 to 3 months, the patient should not lift objects that weigh more than 3 kilograms. If a standard (without complications) operation was performed and there are no complications, then after the specified period the restriction is canceled. After complicated operations (appendicitis with peritonitis), the restriction on lifting weights is extended for several more months, during which the patient should not lift weights that weigh more than 5 kilograms. It is necessary to adhere to the same recommendations for those patients whose postoperative sutures were difficult to heal or had any complications.

In the future, for six months, all patients should refrain from lifting anything weighing more than 10 kilograms.
It should be noted that not all patients are able to consistently follow recommendations for avoiding heavy lifting. Often a person cannot visually determine how much his luggage weighs and therefore violates the necessary restrictions. To minimize possible risks, if you plan to lift bags, suitcases or other heavy objects, the patient should first put on a bandage.

Restrictions in sports after appendicitis

Limiting physical activity during the recovery period is necessary in order to prevent suture dehiscence and hernia formation. Limiting does not mean completely giving up any physical activity. To return all the resources expended during the operation, the patient must engage in work or sports activities, choosing the type of load appropriate to his condition.

• 7 to 10 days after surgery, it is recommended to start daily walks in the fresh air. The duration of walks should be at least 30 minutes. Staying in the fresh air strengthens the immune system, and physical efforts contribute to the rapid healing of the postoperative suture.
• A walk can be combined with simple exercises that do not involve the abdominal muscles. This can be lateral bending of the torso, flexion-extension of the arms and legs.
• After a month, if you feel well, you can start some sports. Patients are allowed to swim in the pool, perform aerobics in water, and practice walking.
• You should start taking up more active sports (football, volleyball) after 3 months.
• Strength training (using dumbbells, weights, barbells) is allowed six months after surgery.
• Before returning to any sports activities, you must obtain permission from your doctor.
• If your health worsens, sports activities should be stopped.

Refusal of sex after appendicitis

For 2 weeks after surgery for appendicitis, a person should abstain from sexual activity. During sex, blood pressure jumps, and the heart begins to work at an accelerated rate. This can cause overstrain of the abdominal muscles and the development of various complications. The most likely consequences if this recommendation is not followed is a hernia or suture dehiscence. In addition to tension in the abdominal muscles during sex, pressure is placed on the suture area, which inhibits its healing.

Normalization of stool after appendicitis

Many patients experience bowel problems after surgery. This problem is contributed to by limited physical activity, impaired intestinal motility due to surgery, and other factors. Most often, disorders manifest themselves as constipation, the duration of which can reach 7–10 days. The main methods of combating this phenomenon are diet, self-massage of the abdomen and feasible physical activity.

Laxatives
If stool does not come for a long time, the doctor may prescribe a laxative. Such drugs are prescribed in exceptional cases, as they reduce intestinal tone. Some laxatives work by absorbing water from the body, which is not desirable after surgery. The best option is glycerin suppositories, which have a local laxative effect and have minimal side effects.
In addition to pharmacological drugs, there are folk remedies for normalizing stool. If constipation is short-lived, decoctions of chamomile, prunes, and wheat bran can help.

Complete rest

After any surgical intervention, even minimally invasive (low-traumatic) laparoscopy, the human immune system becomes more vulnerable. Weak immunity impedes recovery and can cause postoperative complications. Also, after removal of appendicitis, the functionality of the nervous system is often disrupted due to concerns about health and work. Restrictions (in sports, sex, food) that must be observed after surgery also have a negative impact on a person’s emotional state.

One of the effective ways to support the nervous and immune systems is a healthy night's sleep. The absence of sleep problems allows the body to recover at night, which has a positive effect on the mental and physical state of the patient. Following some recommendations will help you organize healthy sleep.

Among the rules for healthy sleep are the following:

• The recommended daily walks are best done before bed;
• two hours before going to bed, you should refuse to eat, and the last meal should include light foods (vegetables, fruits, dairy products);
• You should go to bed between 22 and 23 hours, as this corresponds to human biological rhythms;
• the optimal time for waking up in the morning is from 5 to 6 o'clock;
• the absence of a mechanical ticking clock or a clock with an electronic display in the bedroom will allow you not to control the time and fall asleep faster;
• the air in the room should be fresh; for this, the room must be ventilated before going to bed, and in the warm season the window must be left open.

Before use, you should consult a specialist.

Appendicitis is an inflammation of the appendix, a rudimentary extension of the cecum. Its dimensions are relatively small: length 2-13 centimeters, diameter only 3-4 centimeters. The disease can be either acute or chronic.

The acute form is the most common, and in many cases provokes the development of inflammation of the peritoneum. According to statistics, within a year, 4 or even 5 people out of 1,000 are diagnosed with this disease. Mostly children over 10 years of age and young people under 30 are affected.

Classification

• simple or catarrhal;
• destructive (gangrenous, phlegmonous, perforative);
• complicated.

The simple form is characterized by the fact that inflammation affects the mucous membrane of the organ with the prospect of migration to all its tissues, or may undergo extinction.

The phlegmonous form is different in that with it the inflammation progresses and pus accumulates inside the organ.

If the amount of pus is critical, swelling increases, resulting in inflammation of the blood vessels and the formation of blood clots, which leads to the death of the appendix wall - gangrene develops.

In the perforated form, destruction of the epithelial tissue of the appendix occurs due to the development of phlegmon or gangrene. This leads to the pus accumulated inside the organ pouring into the peritoneum, causing complications.

Causes

The main culprit behind inflammation of the appendix is ​​its blockage. This occurs due to the accumulation of fecal stones and foreign bodies in the appendix (this is how appendicitis usually occurs in children). The bending of the organ under the influence of various factors, such as scars and adhesions, also plays a role. In rare cases, the provocateur is a helminth or a neoplasm on the tissues of the appendix.

There is a theory that the disease is caused by an insufficient amount of plant fiber entering the body with food.

It is possible that the syndrome occurs due to suppression of the body's immune function. The walls of the appendix are permeated with lymph cells, which are part of the immune system. The appendix tissue and lymph cells act as a shield. Disruption of the functions of this shield and the presence of infection provoke inflammation.

Symptoms

• acute pain in the lower abdomen on the right;
• nausea, which is accompanied by vomiting;
• a sharp jump in temperature (37.5-38 degrees);
• pulse 90-100 contractions per minute;
• rigidity of the abdominal muscles.

The course of the acute form of the disease is influenced by such conditions

• position of the diseased organ;
• phase of the pathological process;
• changes in the tissue structure of the appendix;
• the ability of the circulatory and immune systems to respond quickly and adequately;
• painful conditions and complications present in the body.

Pain appears unexpectedly and increases quickly, worsening with movement or coughing.

The location of the appendix influences where exactly a person feels pain. When the first signs of appendicitis appear, it is impossible to clearly determine the location of the pain. It is felt throughout the abdomen and only after a while it descends into the iliac region.

In cases of an uncharacteristic position of the diseased organ, the pain may have a different nature and be located in some other place. If the cecum is located low enough, the onset of the attack is characterized by aching or stabbing pain over the pubic area.

When the appendix is ​​located behind the cecum, pain is felt in the lower back, iliac region and lower abdomen on the right.

When the appendix is ​​located behind the peritoneum, the pain is localized in the lower back, but it can be felt in the genital area and in the thigh. In this case, the upper part of the appendix may be quite close to the bladder, right kidney or appendages in women. Because of this, inflammation of the celiac appendix can be mistaken for problems with the kidneys or disease of the uterine appendages.

Another sign of the acute form of this disease is vomiting. It is observed in 30% of those who are diagnosed with inflammation of the appendix. Some time after the onset of pain, loss of appetite and nausea with vomiting are noted, attacks of which are sometimes repeated. If this happens after a relatively long period of time, it is a clear symptom of peritonitis.

At the initial stage of the acute form of the disease, body temperature does not exceed the normal limit or reaches 38 degrees, but if the disease actively worsens, it increases. For those cases of inflammation when destruction of organ tissue is observed, low temperature and rapid pulse are characteristic, which is not the norm. In addition, increasing intoxication borders on inappropriately low blood pressure.

Body temperature rarely rises during acute inflammation of the appendix. Usually it reaches 39 degrees and higher when the process is perforated.

The chronic form follows from the acute one, when the attack subsides without medical intervention.

Types of chronic appendicitis

• recurrent;
• residual.

A recurrent inflammatory process is a kind of return of an acute one, only with weaker manifestations.

Residual inflammation manifests itself as damage to the cecum or adhesions.

Complications

• appendicular infiltrate;
• (inflammation of the peritoneum).

The formation of infiltrate occurs on the third, sometimes on the fifth day from the moment when acute appendicitis occurred. Organs adjacent to the appendix participate in the inflammatory process. When the course of the disease becomes unfavorable, an abscess develops.

An abscess can occur in various areas of the abdominal cavity.

Depending on this, the following types of abscess are distinguished:

• periappendicular;
• localized between the intestines;
• developing under the diaphragm;
• pelvic.

Diffuse peritonitis is the most dangerous complication.

Can provoke diffuse peritonitis

• migrating inflammation;
• rupture of the appendix wall;
• penetration of the abscess into the abdominal organs.

Appendicitis in men

Diagnosis of appendicitis in men

To make an accurate diagnosis, the doctor will prescribe a series of examinations. In particular, these are blood and urine tests. A blood test is a fairly informative diagnostic method, which mainly monitors the presence of leukocytes and their level, as well as the erythrocyte sedimentation rate. A urine test can detect the presence of protein (which should normally be absent).

X-ray is an outdated diagnostic method, since all it can reveal is the presence of fecal stones. Therefore, the patient will be referred for an ultrasound examination, which is the most optimal diagnostic method today. Using ultrasound, you can most accurately identify signs of appendicitis in men, in particular, an increase in the appendix up to 5 mm. However, in approximately 50% of patients, ultrasound will not detect appendicitis due to an unnatural position or obesity.

Therefore, the most productive research method can be prescribed - computed tomography. It makes it possible not only to see the inflamed appendix, but also the inflamed tissue itself near the appendix. True, the cost of diagnostics is quite high, and only modern or very large clinics have such equipment.

Laparoscopy is the most objective diagnostic method. However, they resort to it in very complex and controversial cases, when standard methods do not give the whole picture of the problem. A probe with a camera is inserted into the patient under anesthesia through a small incision, with the help of which the doctor will accurately see the source of inflammation and provide adequate treatment.

Symptoms of appendicitis in men can be similar to those of other diseases. Even an experienced doctor may not make an accurate diagnosis the first time (which is why an examination is prescribed). In general, along with appendicitis, the patient may be suspected of having urolithiasis or renal colic (a urine test will verify the accuracy of the version). A perforated gastric ulcer may also be suspected (to rule out this possibility, laparoscopy is performed). Another “similar” disease is right-sided pneumonia, which can be excluded or confirmed with x-rays.

Type of appendicitis in men

Signs of appendicitis in men may depend on the type of inflammation. The first stage of the disease is acute catarrhal appendicitis - at this stage the symptoms are quite weak (or do not appear at all). But if the disease is detected at this stage, treatment will be very easy, and recovery after removal of the appendix will be quick.

Destructive appendicitis is an inflammation with pronounced symptoms and unpredictable signs. During the course of the disease, symptoms may change - in particular, sharp fluctuations in body temperature are possible. In any case, discomfort, pain, nausea and other signs should be a signal to consult a doctor. It’s better not to delay - and then the help will be more effective, and you will be able to return to your usual way of life faster.

Appendicitis in women

The main signs of appendicitis in women:

• nausea;
• vomit;
• acute abdominal pain;
• muscle tension;
• Shchetkin-Blumberg syndrome;
• heat.

It is important to identify appendicitis in women in time in order to put her health at risk as little as possible. One of the most important signs is pain. At the very beginning of inflammation, the pain is pulling and pressing. They occur not only on the right side; it is quite normal for the pain to radiate to the left side or concentrate around the navel. In pregnant women, pain often occurs in the upper abdomen. After some time, the pain can spread throughout the abdomen, and then concentrate in the appendix area. At this time, they can be either constant or attacks similar to contractions. Another feature of pain with appendicitis is that it intensifies when coughing or even laughing.

Another sign by which you can understand how to determine appendicitis in women is vomiting and nausea. This is a completely typical manifestation of appendicitis. Vomiting occurs once or twice during the course of the disease. In addition to nausea, pregnant women also experience severe shortness of breath.

Appendicitis provokes an increase in body temperature. The normal temperature for this disease is 38 degrees. Quite often, the inflammatory process in the abdominal cavity provokes tension in the abdominal walls, as a result it becomes hard. In pregnant women, such a belly is a sign of uterine tone, so confusion often arises.

Another sign of how appendicitis manifests itself in women is lack of appetite. In addition, there is general weakness and poor health. The first signs of acute appendicitis in women most often appear in the late afternoon or even at night.

Signs of chronic appendicitis in women

The main symptoms of chronic appendicitis in women are pain in the right iliac region. The nature of pain varies. Attacks occur both at night and early in the morning. Moving with chronic appendicitis is extremely difficult. In addition, the woman simply cannot lie on her left side, as very severe pain occurs.

In addition to pain with chronic appendicitis, women experience constipation or intestinal upset. Frequent urination also appears, which is also accompanied by quite painful sensations. When examined by a gynecologist, intense pain occurs. On palpation, the compacted and painful process can be clearly felt.

Features of the course of appendicitis in women

Acute appendicitis in women is characterized by severe pain in the right hypochondrium and a tense abdomen. The disease in women is difficult to identify due to the characteristics of the female body. Diagnosing a disease during pregnancy is a rather difficult task, because all organs are displaced from their usual places, which means it is problematic to determine the localization of pain. It is worth noting that abdominal pain during pregnancy is quite common. After all, they are provoked by: fetal tremors, tissue stretching. And nausea and vomiting are quite traditional companions of pregnant women.

In order to identify appendicitis in women, you should not focus specifically on pain. But the presence of painful nausea and vomiting are some of the signs of appendicitis in women. In most female diseases, despite abdominal pain, these signs are absent.

Do not forget that any female inflammation and appendicitis can provoke peritonitis, as well as other serious consequences. This means that if you have any acute abdominal pain, you should immediately consult a doctor.

Diagnosis of appendicitis in women

The examination of the patient usually begins with a general examination. The presence of inflammation of the appendix can indicate:

• palpation of the abdomen, which causes the patient pain in the area of ​​the right ilium;
• the occurrence of painful sensations when palpating the area of ​​the cecum when the patient lies on his left side;
• increased pain when simultaneously pressing on the stomach and lifting the straight right leg;
• increased pain after pressing and abruptly releasing the painful area.

Of course, the most informative are modern methods for diagnosing appendicitis: ultrasound, computed tomography, endoscopy. Laboratory tests are also needed that can confirm the picture of the inflammatory process in the body.

Quite often, even doctors can confuse acute appendicitis in women with right-sided pyelonephritis, rupture of an ovarian cyst, intestinal obstruction, etc. To make a final diagnosis, laparoscopy is performed - instruments and video cameras are inserted into the abdominal cavity through microcuts, with the help of which the cecum is examined and neighboring organs. If a hypertrophied appendix is ​​detected, it is immediately removed.

Causes and risk factors for appendicitis in children

Closing the lumen of the appendix leads to a deterioration in the blood supply in it, stagnation of venous blood, and proliferation of microbial contents. 12 hours is enough for inflammation to develop. If surgery is not performed within 1-3 days, the appendix will rupture and pus and fecal matter will enter the abdominal cavity.

Acute appendicitis is very rare in children under 2 years of age. This is due to the feeding habits and anatomical characteristics of the appendage (it is shorter and wider).

Risk factors for developing inflammation of the appendix in children:

• binge eating;
• lack of fiber in the diet;
• increased sugar consumption;
• frequent constipation;
• diseases of the gastrointestinal tract;
• dysbacteriosis;
• ascariasis.

Types of appendicitis in children

Inflammation of the appendix in children is usually classified according to the characteristics of the destructive processes, as well as the degree of severity:

• simple (catarrhal) - appendicitis without complications, manifested in the form of slight thickening of the walls with a mild inflammatory process;
• destructive - can be phlegmonous (increase in the size of the appendix, vascular thrombosis) and gangrenous (tissue necrosis);
• empyema is an acute purulent inflammation of the appendix.

In the second and third cases, perforation of the appendix (rupture) is possible, but this does not happen all the time - the integrity of the rudimentary organ may well be preserved. Occasionally, cases of spontaneous recovery are recorded. There is also a risk of inflammation becoming chronic, with relapses occurring periodically.

When diagnosing appendicitis in children, one should take into account a characteristic feature - a large selection of options for localizing the appendix. It can be located in various places in the abdominal cavity: in the right or left hypochondrium, in the pelvic space, under the liver, etc. This makes diagnosing appendicitis in children very difficult.

Main symptoms and diagnosis of appendicitis in children

Acute appendicitis in children is a disease with frequent cases of misdiagnosis. On the one hand, vague symptoms do not give the doctor the opportunity to immediately suspect appendicitis (plus, not all children can accurately describe complaints). As long as the doctor doubts and makes other diagnoses, appendicitis will progress until it reaches dangerous stages.

However, on the other hand, the symptoms of appendicitis in children are similar to the symptoms of other diseases, so a child with a preliminary diagnosis of appendicitis may develop a completely different disease. Modern methods of ultrasound diagnostics greatly facilitate the solution of these problems.

Classic symptoms of appendicitis in children, characterized by their ability to progress:

• Pain around the navel or in the pit of the stomach, which is then localized on the right side in the iliac region (the standard location of the appendix). The child tries to change the position so that the pain is felt less (most often on the right side or back). In young children who cannot indicate the location of pain, the first signs should be discomfort, crying, lack of appetite, and sleep disturbances.
• Vomiting, after which there is no feeling of relief. Vomiting can be repeated (typical of small children) or single (most often in older children).
• The inflammatory process in young children is most often characterized by elevated temperature. The temperature also rises in older people if appendicitis is complicated. In its simplest form, the temperature can fluctuate in the sub-range.
• One of the indicators of inflammation is the condition of the tongue. Most often, the disease can be recognized by an abundant white coating. The more severe the inflammation, the larger the area of ​​the tongue turns white. With gangrenous appendicitis, not only whitening is diagnosed, but also dryness of the tongue.
• Abnormal bowel movements: diarrhea in small children and constipation in older children. If the appendix is ​​located close to the urinary organs, there may be problems with urination.

Symptoms of appendicitis in children of different ages

Even a professional doctor will practically not be able to detect signs of appendicitis in newborns or infants. True, at this age appendicitis develops only in exceptional cases. Characteristic symptoms are expressed only as signs of general malaise. These are: monotonous sharp crying, short and restless sleep, sluggish sucking or complete refusal to eat, frequent belching, rapid movements of the legs or pulling them towards the stomach (a symptom of abdominal pain). Most often, the diagnosis is confirmed only during surgery. The appendix erodes quickly enough and there is a risk of peritonitis.

Signs of appendicitis in children 3 years old manifest themselves in the form of changes in general condition. The presence of pain itself is very difficult to establish. Symptoms of appendicitis in children 5 years old are also expressed in a deterioration in the general condition, and the child cannot describe the pain. Given the similarity of symptoms with a large number of other diseases, appendicitis is difficult to diagnose not only for parents, but sometimes also for doctors. To begin to suspect appendicitis in a child, you should look for the following signs:

• peculiarities of behavior (whims, causeless crying);
• constant change of position in order to reduce pain, restlessness;
• refusal to eat (even your favorite dishes);
• single or repeated vomiting;
• diarrhea (however, this occurs rarely);
• sleep disorders - the child cannot fall asleep because pain interferes;
• an increase in body temperature to 37°C in the absence of a runny nose and cough.

Symptoms of appendicitis in children 8 years of age and older do not need to be tracked by changes in general condition - the child is already able to describe his sensations and point to the area of ​​pain. Most often, the child names the following symptoms of appendicitis: pain, initially localized throughout the abdomen, and then descending to the lower sections - and specifically to the right side (can point with a finger); increased pain when changing position, bending, turning from back to side; painful nausea and refusal to eat; slightly elevated temperature. Simply put, the symptoms of appendicitis in children 10 years old almost completely coincide with the signs of this inflammatory disease in adults.

Symptoms of appendicitis in children with an atypical location of the appendix

In this case, pain is observed in other places (and not just in the right side of the lower abdomen). In addition, other typical signs may be blurred: pain when palpated and abdominal tension. If the process of the cecum is retroperitoneal, symptoms of pain will appear in the lumbar region (on the right side), in the area of ​​the ureters, and in the groin. In the pelvic position, pain will occur above the pubis, in the perineum. Diarrhea with mucus and pain when urinating are possible. With a subhepatic location, the pain will be in the right hypochondrium.

With atypical localization of the appendix, the gangrenous form of appendicitis is especially dangerous. Her picture is unclear: moderate pain, no abdominal tension, satisfactory condition of the child.

Regardless of the nature of the external manifestations, you cannot delay it - if you have any manifestations of restless behavior or complaints of pain, you should immediately consult a doctor. Considering the rapid development of appendicitis in children, this will allow the disease to be diagnosed in time and measures taken before complications arise.

Gangrenous appendicitis

Symptoms of gangrenous appendicitis

Necrosis (death) of tissue in the gangrenous form of acute appendicitis leads to the death of the nerve endings of the appendix. Because of this, patients begin to feel relief: the pain syndrome decreases and a false feeling appears that suspicions of appendicitis were in vain.

However, gangrenous appendicitis is accompanied by putrefactive inflammatory processes, and therefore the patient may experience symptoms of general intoxication: severe weakness, multiple vomiting, which does not bring relief. Body temperature is not an indicator - it can remain within normal limits. The tongue in the gangrenous form of appendicitis is dry, covered with a white or yellowish coating (this is especially noticeable at the root).

The gangrenous form of acute appendicitis is characterized by the occurrence of the “toxic scissors” syndrome: with a general serious condition and normal body temperature, the development of pronounced tachycardia is observed with a heart rate of up to 120 beats per minute, with a norm of 70-80 beats.

The symptoms of primary gangrenous appendicitis are different. Initially, the patient experiences sharp pain in the right iliac region. The pain goes away very quickly, but the general condition remains severe, and the body temperature is high in most cases. The abdomen is tense, painful, with obvious signs of peritoneal irritation.

Gangrenous-perforated appendicitis

If treatment is not carried out at the stage of gangrenous appendicitis, the stage of gangrenous-perforated appendicitis occurs. During this process, the wall of the appendix is ​​pierced (perforated). At this moment, the patient feels a sharp pain in the right iliac region. The pain syndrome is constant, with intensification spreading throughout the abdomen. Intoxication of the body increases, which is expressed by increased body temperature, tachycardia, and repeated vomiting. The tongue is dry and has a brown coating on it. Abdominal bloating is constantly increasing, peristalsis is absent.

Consequences of gangrenous appendicitis

The gangrenous form of acute appendicitis is a very dangerous disease that provokes severe complications:

• purulent diffuse peritonitis (inflammatory process in the peritoneum). This is a dangerous condition that can only be treated with urgent surgery. If timely assistance is not provided, sepsis (blood poisoning) quickly develops and death occurs;
• appendicular infiltrate - the formation of a local conglomerate of tissues and organs around the inflamed appendix. This complication is treated conservatively. The infiltrate can resolve only after 3-4 months of treatment - only after this can the appendix be removed;
• local purulent abscesses in the abdominal cavity - in the pelvic cavity, between intestinal loops, in the subdiaphragmatic region;
• septic thrombophlebitis (inflammation of the venous walls with further formation of blood clots in the lumens of the portal vein and tributaries).

Diagnosis and treatment of gangrenous appendicitis

Initially, the doctor listens to the patient and conducts a general examination. The abdomen is usually distended, with weak or absent bowel movements. To more accurately determine exactly the gangrenous form, the patient will be advised to undergo blood and urine tests, undergo a computed tomography scan or ultrasound examination. After confirming the diagnosis, an appendectomy (removal of the appendix) will be prescribed, which can be performed traditionally or by laparoscopy.

Traditional surgery is performed through a small incision in the abdominal wall. The operation is performed under general anesthesia (very rarely - under local anesthesia). Laparoscopy is performed through several small holes, which heal faster and leave virtually no scars.

In order to quickly restore the body after surgery to remove gangrenous appendicitis, you must strictly follow all the recommendations of the attending physician on rehabilitation and dietary nutrition. The recovery process takes up to 3 months - during this entire period, reboots and heavy lifting are prohibited.

Appendicitis in pregnant women

Symptoms of appendicitis during pregnancy

In medicine, a distinction is made between catarrhal and destructive forms of appendicitis. Each of them has its own characteristic development of the process. In the catarrhal form, inflammation develops within 6-12 hours, in the destructive form - from 12 to 48 hours, after which perforation can occur and intestinal contents enter the abdominal cavity.

There are no specific symptoms of appendicitis in pregnant women, since each woman’s body is individual, not everyone’s appendix is ​​located in the same place, therefore, changes in the appendix may be different.

If the inflammation begins in the appendix itself, without affecting the abdominal cavity, a pregnant woman is most often bothered by pain in the upper abdomen, gradually spreading to the lower right region. Symptoms of appendicitis include: vomiting. Stomach upset, nausea. Pain can sometimes be insignificant and occur in all areas of the abdomen. A woman may experience painful sensations while lying on her right side. During a medical examination, the source of pain will not be immediately determined.

With the gradual development of inflammation, pain will manifest itself along the entire right iliac region, often moving into the lower and upper parts of the abdominal cavity, and sometimes into the hypochondrium. The severity of pain depends on the stage of pregnancy. It is important to note that the standard symptoms of acute appendicitis in pregnant women may appear mild or appear late.

The location of the appendix also influences pain. If the appendix is ​​located under the liver, the pregnant woman will have symptoms resembling gastritis (pain in the upper abdomen, vomiting and nausea). If the appendix borders the urinary system, the pain will radiate to the perineum and legs, the woman will experience a frequent urge to urinate and other symptoms usually characteristic of cystitis.

The effect of appendicitis in pregnant women on the fetus

If appendicitis develops in the second trimester of pregnancy, its effect on the fetus is clear. The most common complications include the threat of late pregnancy loss, intestinal obstruction and postoperative infections.

Very rarely there are cases of premature placental abruption in pregnant women with appendicitis. If timely diagnosis and proper treatment are carried out, then there are no threats: the pregnancy will be preserved and completed. If the membranes become inflamed, intrauterine infection of the baby will occur, which will require mandatory antibacterial therapy. Postoperative complications most often occur within 7 days after surgery to remove the inflamed appendix. Therefore, for prevention, pregnant women are prescribed antibacterial therapy.

Diagnosis of appendicitis in pregnant women

Only a doctor can make a diagnosis of “acute appendicitis”, guided, as a rule, by high body temperature, pain in the right side when walking, increased pain when palpating the abdomen, etc. In addition, make an accurate diagnosis using a urine test (an increase in white blood cells in the results) together with an ultrasound examination (ultrasound), which can detect an enlarged appendix or even an abscess. However, ultrasound is not an accurate diagnostic method, since the appendix can only be detected in this way in 50% of patients.

Another method for diagnosing appendicitis in pregnant women is laparoscopy. It allows the doctor to see all the abdominal organs, including the appendix. This is the most accurate method, providing 100% objective data on the presence of an inflammatory process. The attending physician must choose the diagnostic method - therefore, it is extremely important to consult a specialist as early as possible, even when the first pain appears.

Treatment

Treatment of the acute form of the disease is followed by therapy with antibiotics and drugs that relieve the symptoms of poisoning. Appendicitis surgery is also performed in cases where there is a suspicion of inflammation, but it is impossible to exclude it by other methods.

Appendiceal infiltration is treated with cold, antibiotics and antiseptics. Painkillers are also used. Physiotherapy is aimed at resolving the infiltrate. Two to four months after appendicitis, an appendectomy is performed.

When an abscess forms, surgical intervention is necessary. The abscess is opened and drained. A few months after the abscess disappears, an appendectomy is performed.

If organ tissue is destroyed, surgical treatment is followed by antibacterial therapy. Medicines are administered parenterally and through drainage, if drainage was performed.

Causes of elevated temperature after appendicitis removal

Fever after appendectomy may occur due to wound infection. This is the most common reason that occurs due to non-compliance with the medical regimen. Damage to internal organs during surgery may also be the cause. As a result, the traumatic inflammatory process develops further.

Also, a fairly common cause of fever after appendicitis surgery can be a decrease in immunity, since any surgical intervention puts quite a lot of stress on the body. During the recovery period, the human body begins to use all internal reserves. For this reason, additional diseases may occur in the form of viral or acute respiratory infections.

Fever may also occur due to severe bleeding during surgery. An infectious process may also occur during surgery. Drainage, which may be installed during surgery, can also cause increased temperature. Once the drainage tubes are removed, your body temperature should return to normal. Often the inflammatory process develops due to poor nutrition. The patient must fully adhere to the diet established by the doctor, otherwise there is a danger of the occurrence and development of general intoxication of the body.

Typically, fever after appendicitis may also be accompanied by profuse sweating and chills. In order to diagnose the causes of inflammation, the following methods are used:

• a clinical blood test that confirms the presence of severe inflammation;
• Ultrasound, which allows you to see the inflammatory process in visualization.

If the temperature rises

Do not forget that elevated temperature after appendicitis removal during the first three days is normal. But if this condition persists for a longer time, measures must be taken. First of all, the attending physician should prescribe a course of antibiotics depending on the causative agent of inflammation. The patient may also take antipyretic drugs (for example, paracetamol or acetylsalicylic acid). Nonsteroidal anti-inflammatory drugs (eg, ibuprofen) are quite often prescribed.

Self-medicated reduction of temperature after surgery for appendicitis is strictly prohibited. The patient spends the first week after the operation in the hospital, during which time doctors monitor the condition of the suture and wound. Such actions make it possible to prevent or detect the inflammatory process in time. The patient will remain in the hospital until the fever subsides. If necessary, the doctor can take radical measures and even perform repeated surgery.

What are adhesions after appendicitis surgery?

Adhesions are films that form between internal organs. They appear due to irritation of the membrane that covers the internal organs. As a rule, adhesions affect the interaction of organs, after which their work becomes difficult. For men, adhesions do not pose a serious danger, but for women, infertility may well be diagnosed, which, unfortunately, is not always treatable.

Symptoms of adhesions after appendicitis

Most often, adhesions occur after appendicitis. The symptoms are as follows:

• pain - it may be absent for a long time. As a rule, it is localized in the area of ​​the postoperative scar. Most often it has a pulling nature and can intensify after physical activity;
• dyspeptic syndrome - digestion is disrupted due to improper bowel function;
• violation of defecation - constipation appears, no stool for more than a day;
• complete absence of stool for more than two days.

Possible complications of the adhesive process

Adhesions after appendicitis can lead to serious complications. For example, acute intestinal obstruction may develop. It occurs due to compression of the intestines, which in turn prevents the passage of food in the intestines. In addition, necrosis of a section of the intestine is possible. Due to a disruption in its blood supply, which is provoked by an artery pinched by a commissure, the walls of the intestine die. This condition requires immediate removal of this section of the intestine.

Diagnosis of the disease

If symptoms of adhesions appear in the abdominal cavity, as well as the presence of surgical intervention to remove appendicitis, diagnostics are necessary.

First of all, a clinical blood test is needed, which will indicate the presence of an inflammatory process in the body. It is also necessary to conduct an ultrasound examination of the abdominal organs. Ultrasound can visualize the presence of adhesions. This examination should be carried out after appropriate bowel preparation.

In addition, radiography with a contrast agent is performed. The patient should drink the barium mixture on an empty stomach. Based on the presence of defects in intestinal filling, the picture of the disease will be clear. Diagnostic laparoscopy is no less important. To do this, a special fiber optic tube is inserted into the peritoneal cavity. It is equipped with lighting and a camera. Using this diagnostic method, the condition of the intestinal loops is studied and the presence of adhesions is determined.

Treatment of adhesions after appendicitis

Adhesions after appendicitis are a fairly common complication after surgery. Treatment of adhesions is carried out by surgical dissection and release of compressed intestinal loops. Before surgery, it is imperative to eat meals in small portions. A cleansing enema is also performed. If intoxication occurs, solutions are injected intravenously that help remove toxins from the body. If acute abdominal pain occurs, painkillers are used.

Surgical treatment of adhesions after appendicitis is possible through laparoscopy or laparotomy. The choice of treatment tactics depends on the patient’s age, concomitant pathologies, the number of adhesions, and the presence of complications of intestinal adhesions.

Diet after appendectomy in adults

Dietary nutrition after surgery to remove appendicitis in adults is characterized by a seriously limited diet at the very beginning with a gradual expansion of the menu in the future. On the first day after surgery, it is not recommended to consume food or liquid - it is enough to occasionally wet your lips. On the first day after surgery, the patient has no appetite due to the fact that the body is in a state of stress. Therefore, it is not recommended to consume food and liquid - it is enough to sometimes wet the lips. After 12 hours, the patient is allowed to eat broth, drink jelly or tea (if the condition allows).

On the second and third days after removal of appendicitis, you should switch to 5 or 6 meals a day (fractional meals). The diet should include low-fat yogurt, puree soups with chicken fillet, zucchini and pumpkin, chicken broth, rice. The exact diet should be compiled by the attending physician based on the patient’s condition, the presence of contraindications, allergies and other factors.

In order to improve intestinal function, in the first 7 days after removal of the appendix, you can add fruits and berries, vegetables and cereals to the patient’s menu. You can eat lean meat and fish. It is very important to chew food thoroughly, and even better, give it to the patient in crushed (puree) form. To heal wounds, you need to drink clean water without gas in large quantities.

In the second week after surgery, you can start eating lean soups, thoroughly boiling all the vegetables and chopping them in a blender. A month after the removal of appendicitis, you can introduce beans that were previously prohibited into the menu. Flour and sweet foods can be eaten after 2 months, but in limited quantities. If after a month the wounds have healed well, then, on the recommendation of the attending physician, you can switch to your usual diet. But you should not overuse it - the body’s recovery will be completed in 4 months.

Diet after appendicitis in children

The diet after surgery in children should be as gentle as possible:

• Serve any food in crushed form: in the form of puree, mashed, boiled, steamed;
• completely eliminate fatty broths and fried foods;
• do not give large pieces of meat and hard fruits;
• give bananas - they are ideal for the daily diet;
• Give low-fat fermented milk products (mainly yoghurts) daily.

Nutrition after appendicitis with peritonitis

Removal of appendicitis with peritonitis falls into the category of complex operations - accordingly, recovery after them is also difficult. Therefore, dietary nutrition in such cases should be as gentle as possible. All foods consumed should not lead to intestinal irritation and, especially, to the formation of excess weight.

The ideal dish is pureed soups without potatoes, well-cooked porridge. Under no circumstances should you consume carbonated drinks, spicy and salty foods, or sweets.

In general, the diet after gangrenous appendicitis is practically no different from the standard diet. Care should be taken to fill the diet with foods with plenty of vitamins - in particular, sour berries and citrus fruits, as well as bananas, pears and apples, which help restore the body.

Nutrition after phlegmonous appendicitis

The diet after phlegmonous appendicitis should be compiled by a doctor depending on the patient’s preferences and his general condition. The menu should include cottage cheese, puree soups, liquid porridges, stewed vegetables, which contain many vitamins and nutrients needed for quick recovery. An important component of the menu should be apple, pear, banana and pumpkin purees, which are well absorbed by the body.

A sample menu after appendicitis surgery is as follows:

• for breakfast - pureed oatmeal in water with pureed cottage cheese and herbal tea;
• for second breakfast - rosehip decoction;
• for lunch - vegetable puree soup, steamed chicken meatballs, rice, fruit jelly;
• for an afternoon snack - blueberry decoction;
• for dinner - pureed buckwheat porridge, steamed omelette, green tea;
• before bed - a cup of warm jelly.

If nutrition after appendicitis was agreed upon with the attending physician, if the diet was followed in good faith, the results will be positive: the body will quickly recover, the wounds will heal well, and the normal functioning of the gastrointestinal tract will be established. Naturally, along with the diet, you should follow other doctor’s recommendations and take medications.

Medical specialists classify appendicitis as one of the most dangerous inflammatory diseases, since it can affect a person of any age and gender. The causes of the disease can be different, the main one is considered to be blockage of a small lumen in this part of the intestine with pieces of undigested food, seeds, small, hard fragments of bones. It is treated with surgery; no types of home or drug treatment are suitable in this case; only a doctor can diagnose the disease.

Appendectomy is an operation that involves surgical removal of the inflamed appendix of the cecum. After it, the patient requires careful care, rest and a special diet to promote a speedy recovery.

Following the correct diet according to the exact instructions of the doctor and a special set of foods included in the diet after appendicitis removal day by day will help not only reduce the regeneration time of the operated areas, but also improve the functioning of the digestive organs and improve overall well-being. It must be strictly followed for at least 14 days, longer if any complications arise. During the recovery period, fatty, salty, unhealthy foods, fast food, alcoholic beverages and various preservatives are strictly excluded.

First days after surgery

After surgical removal of appendicitis, they are very important. At this stage, an emergency recovery of the body from internal changes occurs. Much depends on how the functioning of the operated intestine will normalize and how soon its peristalsis will start.

During the first day after surgery, the patient should not eat anything, as it is necessary to exclude any damaging or aggravating factors, including the impact of pieces of food on internal organs. As a last resort, you can lightly wet his dry lips with warm water.

On day 2, you can start feeding the patient small portions of chicken broth without pieces of meat and vegetables, fruit or sticky rice jelly. The main principle of nutrition for the next week will be fractional feeding, 5-6 times a day. Under no circumstances should you add spices, salt or large amounts of sugar. Products are given to eat only in a warm, easily digestible form. Any food that causes increased gas formation is excluded from the diet: legumes, milk.

On days 3-4 after surgery to remove appendicitis, depending on the patient’s well-being and individual preferences, you can eat:

• Chicken bouillon.
• Soft mashed potatoes, mixed with a mixer or blender until semi-liquid.
• Rice cooked in water.
• Pumpkin or zucchini puree.
• Natural drinking yoghurt, unsweetened, with a minimum percentage of fat content.
• Boiled white chicken meat, preferably chopped so that there is no indigestible fiber.

The introduction of each new product into the diet should occur under the careful supervision of a specialist. You can track the intestinal reaction to additions to the food composition by peristaltic noise and the release of gases.

On day 6, you can gradually introduce new foods containing fiber:

• Porridge from small grains, cooked in water.
• Steamed small pieces of hypoallergenic, non-acidic fruits and berries.
• Dried fruits soaked in water until soft.
• Vegetables.
• Puree soups.
• Lean fish and meat, cut into small pieces, which the patient should chew thoroughly.
• Fermented milk products, no more than half a glass per day.
• Butter.

Depending on how the patient feels after removal of appendicitis, you need to see whether it is worth grinding the food to a paste before giving it to eat or not.

Authorized Products

At the end of the most difficult period after removal of appendicitis, the diet menu expands significantly. After a week, you can eat fresh greens, carrots, cottage cheese and baked fruits. Pumpkin will be a good source of useful minerals, beta-carotene, vitamin K, which increases blood clotting and accelerates recovery of the body.

The regeneration processes will work very quickly and productively, so you need to remember to follow the drinking regime. The patient needs to drink at least 2 liters of clean, boiled water at room temperature per day in order to quickly start metabolic processes. Unlike conventional recovery diets, in this diet it is forbidden to take water with food; they drink at a very slow pace in small sips so as not to increase the load on the internal organs.

Gradually, you can introduce different drinks into the menu: weak, unsweetened black tea, decoctions of chamomile flowers and rose hips, preferably diluted to a low concentration. Juices from fresh fruits or vegetables are allowed to be taken no more than 1.5 glasses per day and must be diluted with boiled water before use. Added sugar is completely eliminated in the first week. The best choice would be semi-thick pureed juices made from carrots or pumpkins.

Since the patient is forced to remain in bed after inflammation of appendicitis, intestinal obstruction and constipation may occur due to low activity and inactivity. To eliminate the risk of developing these unpleasant symptoms, foods containing fiber are gradually introduced into the diet menu: boiled carrots and beets, dried fruits, baked apples and pears, pumpkin and zucchini. In order to avoid constipation, you need to eat at least 300 g of them per day. Of course, the diet excludes the addition of heavy sauces.

A mandatory requirement of the diet is still pureeing or finely chopping any product. It is not recommended to eat vegetables and fruits on an empty stomach, only after eating a main dish with a lot of protein, which at first will not be varied. Broths and chicken meat soufflés remain on the menu. If the doctor agrees, you can introduce lean beef into your diet. Fish after appendicitis is recommended only in the form of steamed cutlets and broth. Portions of protein foods should be small, no more than 120 g.

You can eat not only mashed potatoes mixed with milk or water, but also simply boiled ones. Allowed up to 60 g of white bread crumb per day. Eggs, cheeses, fatty dairy products, desired amounts of salt, sugar and spices to taste are consumed at least a month later.

Two months after the elimination of appendicitis, you are allowed to fully return to your usual diet. If, after consuming any product, disturbances in the functioning of the intestines, pain, vomiting, diarrhea appear, then immediate correction of the diet is required.