Incisional Hernia progressing to constipation, nausea and severe bloating
I underwent a laparoscopic appendectomy 13 years ago, I was 19 years old at the time and the surgery appeared be completely successful without complications. I resumed normal activity within a few weeks (probably sooner than I should) and remained relatively healthy through my mid-twenties. One of the areas of incision, however, always bothered me – the incision is on my left side (why is it on my left for an appendectomy?), just along line that separates the pelvis area from the left flank. It started out as just a dull ache, sort of like a deep muscle knot/strain and there was definitely a palpable “bulge” just under the scar. Some days it was easier to feel than others. The pain was minor and would come and go so I simply ignored it for the first few years.
Then, in my mid twenties, when the pain/bulge would recur, it was a bit more noticeable, but also came with additional symptoms: constipation and bloating. It occurred to me that the two issues may be related so I saw a standard internist who felt the lump, but guessed it might be scar tissue and didn’t believe I had a hernia, nor did he think it was related to my constipation/bloating. I accepted his diagnosis (or lack thereof) and went on my way.
A year later the pain/constipation recurred again rather severely and I didn’t want to wait around for appointments/referrals this time so I went to the ER. They performed a CT scan and told me it came back clean, without no sign of crohn’s or UC, prescribed me some laxatives and sent me on my way.
It has been several years since that ER visit and the issues have only gotten more severe. The relapsing/remitting nature of the problem makes it more complicated to diagnose and easier for me to ignore during periods of remission. Over the past 3 years however, the relapses have been much longer (lasting 2-3 months) and more frequent. Now, I’m able to predict an attack several days before the real symptoms set in as I’ll feel a “pull” or “kink” just around that incision, which usually occurs after an unusual movement like a golf swing or a sitting row. The symptoms are now much more systemic: alternating bouts of constipation, diarrhea, frequent undigested bowel movements (usually in that order), severe bloating, nausea, burning, and acid reflux – it almost feels as though when I eat food it just sits in my stomach for hours.
I have seen dozens of different gastroenterologists and have undergone endoscopies and colonoscopies. I’ve been told I have SIBO, Gastritis, Esophagitis, Acid Reflux, and IBS. I’ve followed every type of treatment I’ve been prescribed: antibiotics, antispasmodics, PPI’s, probiotics without any lasting relief. Not a single one of them seemed particularly interested in the pulling/kinking pain emanating from under my incision nor could they explain the relapsing nature of ALL of these symptoms which always follow after. I finally got a gastro to listen to me and after he theorized it could be a hernia and/or adhesions so he ordered a MR enterography. The scan is a month off and meanwhile I’m sitting in bed in pain with no energy – eating makes everything worse so I try to do as little of that as possible.
So I have a few questions:
1. How effective is an MR enterography at diagnosing hernia and/or herniated related issues?
2. Is there anything else besides a hernia that the pulling/kinking pain leading to gastrointestinal issues could be?
3. Are there solutions? My understanding is that incisional hernias and adhesions are notoriously difficult to repair.
Thank you for any help or guidance on this issue.
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