ABSTRACT
Objective: Gynecological patients receiving abdominal surgery commonly experience bowel symptoms which result from impairment of bowel motility after the surgery. The purpose of this study was to identify abdominal distention symptom in gynecological patients receiving abdominal surgery. Methods: Gynecological patients who received elective abdominal surgery at Gynecological Unit, Obstetrics and Gynecological Department, Siriraj Hospital from December 2003 to February 2004 were recruited in this study. The data were collected five days after surgery by using Abdominal Distention Assessment Record for Gynecological Patient Receiving Abdominal Surgery which was applied from Abdominal Distention Assessment Record by Wattanawetch (2002). Abdominal distention was defined as belching, flatus excretion, perception of fullness, bowel sound, and difference of abdominal girth. The total score is ranged from 1 to 20 points. The severity of abdominal distention symptom is presented as: 1-10 points= mild abdominal distention; 10-15 points= moderate abdominal distention; 16-20 points= severe abdominal distention. The data were analyzed by using descriptive statistics. Results: All participants were hospitalized three days after surgery while 15.4% and 42.3% of them were discharged on the forth and the fifth day after surgery. Since the first through the third day after surgery, most of the participants experienced moderate to severe abdominal distention (PO day 1= 98.7%; PO day 2=93.6%; PO day 3= 67.9%). Most of the participants had no belching (61.5%) and no flatus excretion (83.3%), with mild to severe perception of fullness (50.0%); their bowel sound was less than three times per minute (88.5%), and the difference of abdominal girth was less than 1.3 centimeters (61.5%) on the first day after surgery. On the second day after surgery most of them were belching 1-5 times in the last 4 hours (55.1%), no flatus excretion (46.2%), with mild to severe perception of fullness (66.4%); their bowel sound was less than 3 times per minute (53.8%), and the difference of abdominal girth was less than 1.3 centimeters (57.7%). On the third day most of them were belching 1-5 times in the last 4 hours (59.0%); their flatus excretion was 1-3 times in the last 4 hours (50.0%), with mild perception of fullness (60.3%); their bowel sound was 3-5 times per minute (51.3%), and the difference of abdominal girth was less than 1.3 centimeters (73.1%). On the forth and on the fifth day after surgery, 1.3% and 2.6% of the participants still experienced severe abdominal distention symptom while 41% and 15.4% of them had moderate distention score. Conclusion: This study revealed that more than a half of the gynecological patients receiving abdominal surgery had moderate to severe abdominal distention after surgery. This indicates the need for an improvement of abdominal distention management program for gynecological patient receiving abdominal surgery.