Do I have appendicitis ?

For the last few days I have been having pain in my lower right side. I have been feeling nauseous and my stomach has been hurting. My lower back as week has been hurting and i have been lightheaded for a while now. I did go to the docs but its been almost a week and no test results have come back yet. Should i make another appointment or go to the ER or what?? Plz I need advise on what to do.

[ssdw1958]

I have to say if you think it’s your appendicitis or if your unsure you need to get to a doctor or the EM that’s nothing to guess about.

You have to remember we are not doctors here.

I hope you find out what is going on.

Feel better !!

[etheral]

A CT scan will give you a diagnosis. Go to the ER and insist on it. Certainly many other possibilities ( ovarian cyst, pid, etc.

[cyberbarn]

Hi, Looking through your other posts, it seems you are struggling with anxiety and depression after the loss of your son and that you have been having pain in your stomach and surrounding area for a while. One of the things that can happen is that physical things in your body can react too, and one aspect that can develop is irritable bowel syndrome. So if your doctor wanted to wait for test results, it would be worth finding out if they are back again or at least what the hold up is. If this was your appendix it seems that the problem would have been going on for some time which isn't usually how appendicitis works.

And I am very sorry for your loss. People sometimes underestimate how difficult it is to deal with a loss like that. Are you getting any support from a counsellor or support group for that?

[SqueakMouse]

Hello there, CubanGirl619❣️--it's an honor and a delight to "meet" you😋! But of course, I'm so sorry that we're meeting under such distressing circumstances, when you are suffering with pain so severe that you're seriously considering a trip to the ER😢.

So I'll do my utmost best to answer the questions you posed, with as much accuracy and clarity as I can; hopefully, that will help you come to a decision that best supports and honors YOU, and has the greatest likelihood to provide you with the relief and assistance you seek😊

(Note: I just noticed that the time stamp on your post says that you sent it about 17 hours ago, so it's possible that you've already made a decision one way or another--in which case, I'm so sorry that I couldn't offer you advice and support sooner😢, but I hope with all my heart that you have found effective treatment and sufficient relief from pain😊).

Therefore, everything I'm about to write might be useless and/or redundant if you've already resolved the situation, and I sincerely apologize if that's the case😬 But on the off chance that you are still weighing your options--or worse, still suffering from the same level of pain--I thought I should post the information anyway, so it will be at your fingertips if you need it😍

Firstly, I have to say that I agree 110% with ssdw1958's advice; we are not medical professionals, nor do we know your "baseline" (the state of health you normally experience, including symptoms and/or pain that existed before these new ones came along), or have any way to do preliminary diagnostic tests in order to make the picture a little clearer😉

Therefore, it is immeasurably important that you pay attention to any unusual symptoms you experience--especially ones that are so severe as to be disabling--and to listen to the loud messages your body is telling you (It sounds something like, "Get thee to Urgent Care! Pronto!😜")

That means that no matter what any of us fellow forum members might advise or share, you are the final authority in this circumstance--how you feel and what your intuition/instinct is telling you should ALWAYS override the opinions and suggestions of others, including any facts and information you might have read on websites or in books.

Full disclosure: I had appendicitis myself (about six years ago now), and ended up having an emergency appendectomy. When you hear the words "emergency appendectomy", you would probably--and understandably--assume that the pain I felt was so crippling, the fever and nausea so disabling, that I never even considered staying home, and called an ambulance ASAP with the certain knowledge that I had a bad appendix (and even if it was something else, I'd have no doubt that it was something dangerous enough that going to the ER was the only option).

However, you'd be assuming wrong😋. It's true that I was suffering with symptoms that were not normal for me, and that never resolved over the course of the week I spent "watching and waiting" . It sounds so incredibly idiotic now, with 20/20 hindsight😜; as soon as the trio of fever, lower right abdominal pain, and nausea/vomiting appeared in my body and lingered unchanged every day afterwards, I knew that the most likely cause was appendicitis--and I also knew that that being the case, the only cure was surgery.

Because as much as I hated hospitals (and certainly surgery😉), I knew that appendicitis never ever ever resolves on its own, and the longer emergency treatment is postponed, the more likely a catastrophic event (ruptured appendix, which can cause all kinds of really unpleasant results, including potentially life-threatening ones like sepsis, peritonitis, bowel obstruction, internal bleeding, or severe infection).

I knew all that. I've been chronically ill for quite some time with a combination of neurological, immunological, hematological, and inflammatory diseases; therefore, I've been hospitalized many times, and have undergone many surgeries (including three abdominal procedures--pancreatitis, gallbladder removal, internal bleeding)...more than enough time, experience, and exposure to know what symptoms suggest appendicitis, and how it is diagnosed and treated.

And yet....😋😉 I spent the better part of a week in the fetal position on my bedroom floor, struggling against severe abdominal pain, rising fever, and overwhelming nausea. As I said, I knew this was probably appendicitis, so I also knew that surgery was the only way out of this, and that "watching and waiting" was therefore only prolonging the inevitable.

And STILL I waffled...and wailed...and worried. At home. Where there was no access to emergency care. Yikes!, what was I thinking😬? Here's what I was thinking: I spent my time dividing my thoughts into two columns, like the famous childhood game of "He loves me, he loves me not"😄 (but the game I was playing that week looked more like, "I have appendicitis, No I don't😋"; I have appendicitis, No I don't😉").

And oh, the mental gymnastics I performed, trying to convince myself that black was white and up was down😜! "I don't have appendicitis, even though the stabbing pain in my lower right abdomen is severe; I simply must have eaten something that doesn't agree with me." "I don't have appendicitis, even though I've had an unexplained fever for four days now that's higher than I've ever experienced; I have fevers all the time for lots of other things that aren't appendicitis; that's normal for patients with immunodeficiencies." "I don't have appendicitis, even though I haven't been able to keep anything down for five days due to nausea; people get nauseated all the time, for all manner of benign reasons".😜). And so on😉

Even now, I have to shake my head in shame and shock at what a dummy this girl (that unfortunately was me😋!) was being--an especially egregious error, considering that as a chronically ill patient of many years, she had more than enough medical experience and understanding to know the hallmarks of appendicitis, and how it's treated, and what to look for when deciding whether or not to seek emergency care. And STILL, I convinced myself that the pain was "receding" and the nausea wasn't "all THAT bad" and the fever would break any day now"😋😉)

The reason I'm sharing this information with you--and at such length and detail--is to illustrate the point that you can absolutely have appendicitis without being incoherent from fever, writhing in pain, or wishing to die😋. That's the understanding that many people have, thanks to bad medical dramas on TV😉.

As I described above, I did eventually suffer with unrelenting and incapacitating symptoms (which ultimately pushed me to finally call that ambulance😉)--but the symptoms were transient in the early days of illness, and not nearly as terrible as they were at the end. And as a result, it was a relatively easy thing to convince myself that nothing serious was going on, that there was no way it was appendicitis, and that whatever this was would resolve on its own with rest and a few ibuprofen😁

But thanks to this stubborn denial and constant foot-dragging, the appendicitis that was the cause of all my symptoms from the very beginning very nearly became life-threatening appendicitis; I developed a serious blood infection, but at least I didn't end up with some of the scariest outcomes, like peritonitis or internal bleeding.

The 50% humorous, 50% maddening thing about it all was that I could have avoided so much suffering, stress, and expense if I'd only gone to the ER the moment my symptoms tipped over into unmanageable, incapacitating, and very clearly and closely resembling everything I'd ever learned about appendicitis😬

As it was, I ended up with much higher financial costs (a two week stay in the ICU post-surgery, instead of the two or three days in a regular Med-Surg floor that most appendix surgical patients experience); much higher physical costs (I not only lost my appendix--which would have happened in any case--but I was very very sick with sepsis in the weeks after the surgery, and mostly bedridden for several months after that).

Had I gone to the ER in the early days, I would've been sore at the surgical site, but no prolonged stay in an ICU; no struggle with a life threatening blood disease; no 8 week quarantine in bed in my room as I recovered from all this trauma).

So, here's what you should look for when determining whether or not you're likely to have appendicitis (which as I described above is an unavoidable trip to the ER, no questions asked😁), whether or not you can afford to "watch and wait" for a short time, and whether or not you can safely manage your symptoms at home, and maybe follow up with your GP if you don't feel better relatively quickly:

A few paragraphs ago, I mentioned the "triage" of appendicitis; in reality there's no such thing (at least, no such thing in any medical journal, or being taught in any medical schools), but with my own case of appendicitis, and those of a few friends and family members (as well as what my doctors have taught me), the triage concept is a useful rule of thumb, and it can help you determine how or when you should act when experiencing unusual symptoms.

The first (and often most disabling and the most noticeable) symptom to look out for is abdominal pain in the lower right quadrant, which is approximately where the appendix is located; if you were to press your thumb along the inside edge of your right hip bone, and imagine a circle about the size of a softball drawn on the skin between your thumb and your belly button, that's where appendix pain is most often felt. Though the quality of the pain varies (it can be deep, aching, and constant; sharp and stabbing and intermittent; radiating to the groin, over the hip and around to the lower back; sudden stinging through the belly button; and/or a combination of all these, either in rotation or all at once), and it can come and go or stay mostly tolerable in the early hours/days of the illness (some cases progress very quickly, while others take days to fully manifest), it will eventually become constant and distracting in its severity--even if it's not the worst pain you've ever experienced, it often resembles toothache pain in that it's a generalized ache that's painful enough to absorb almost all of your attention almost all of the time.

Some patients have equated it with labor pain, of similar quality and similar severity, where you feel compelled to pace, bend, stretch, walk, lie on ice packs or a heating pad or anything you can think of to soothe the pain, but nothing works😳 Other patients describe their pain as similar to a ruptured ovary, with a stabbing sharp quality, localized on the inside of the right hip bone.

Note: I've read about confirmed cases of appendicitis where the patient never felt pain in the appendix area (that softball sized area inside the right hip bone), but did feel it in the areas that appendix pain tends to refer (those "referred pain" spots described above), which made the cases quite difficult to accurately diagnose; one patient came into the ER complaining of severe stabbing pain next to his belly button on the right side, with a deep but narrow ache extending below his belly button towards his spine.

Understandably, the doctors thought he had somehow injured his belly button, or perhaps had a groin injury, or even an abdominal hernia. The patient spent two days as an inpatient getting tested for those disorders and many more, but they came up with nothing. And the man's pain was as severe as ever; he described the sensation as "resembling being stabbed with sharpened pencil, right next to my belly button, and pushed deep into my abdomen until only the eraser showed outside the body".

But in the late afternoon of the third day, the patient was writhing in pain; when the doctors examined him, they noted a rigid and distended abdomen, flanks rounded out as though filled with fluid, fever, vomiting, and restlessness. CAT scans showed a ruptured appendix, with free fluid all through the abdomen; therefore, the patient went to the OR for an appendectomy and removal of fluid. Post-surgery the patient reported that the belly button pain had resolved, and after a week

of antibiotic treatment in the ICU to treat any infection caused by the free fluid, the patient was discharged feeling much better😋

The point of that story is to warn you not to dismiss severe pain in these "referred" areas (especially in the absence of pain over the appendix itself) as unrelated to appendicitis. As you can see from the above example, it is very possible--albeit rare--to have appendicitis present in this unusual way. Therefore, if you have fever and nausea and belly button pain like this, don't immediately rule out appendicitis; you can watch and wait a bit longer--as long as the pain is tolerable and you're not developing other severe or incapacitating symptoms--and see if any other symptoms appear that can confirm the diagnosis either way.

But if things are already agonizing or you feel worse and worse by the hour, it's time for the ER (since you're experiencing atypical appendix pain in this example--referred pain without the more common primary appendix pain next to the hip bone--you need a work up for appendicitis at the very least, and possibly treatment for it too, which will mean being admitted and getting surgery. Urgent Care clinics or your GP can't do anything for appendicitis (except maybe give you IV fluids if you're dehydrated), so going there would be a waste of time, energy, and money, not to mention prolonging your pain that much longer😮).

So if you notice you're having severe pain (Specifically, pain that you've never had before: That's an important detail, because appendicitis always always always ends up with the appendix surgically removed--and as you know, it never heals on its own either, so there's no way you can have a "flare up" of appendix pain, recover at home, and be pain free for another stretch of time before another flare occurs. So if you're having abdominal pain that you've experienced before, you can rule out appendicitis --even if it's severe.

But if the pain is new (and located either in the appendix area/lower right quadrant, and/or in the referred pain areas commonly connected to the appendix), a work up is warranted, especially if the pain is severe. And this would be a scenario that calls for a trip to the ER; urgent care can't do surgery and therefore can't treat appendicitis , so they'd just send you over to the ER anyway, and you'll have spent even more hours in great pain while you travelled this roundabout, and postponed the relief the ER could provide even longer😳

The second aspect of the triage is fever. If you're dealing with an actual case of appendicitis, a fever will very likely develop (and will very likely begin to climb) the longer symptoms persist. High fevers with things like confusion, agonizing belly pain, a rigid abdomen, etc., are more likely to be signs of trouble beyond simple appendicitis; they often signal a ruptured appendix, bowel obstruction, sepsis/blood infection, surgical abdomen, etc.

One thing to look for that will confirm an emergency situation is something called "petechiae", which resemble small dark reddish-brown dots anywhere on the skin; they can be as small as pinpricks or larger like thumbprints. They are signs of spontaneously rupturing blood vessels/capillaries, which results from things like severe systemic infection. When you push on the spot and release the pressure, the skin might go white and then quickly regain its color; however, the blood spot does not fade or move or change color. And since it's under the skin, you can't scrape them off. Petechiae are always an emergency, whether or not they are accompanied by fever (though they often are).

An uncomplicated appendicitis can cause lower grade fevers due to pain and inflammation rather than infection; even if you don't develop a fever, you'll probably still feel quite miserable--muscles aching, body pain, exhaustion, and other flu-like symptoms. But for the reasons I described above (the chance of a serious complication like sepsis, ruptured appendix, etc.), it's extremely important to monitor your temperature, and if it's very high, go straight to the ER. If it's lower or comes and goes--and you're not experiencing any other symptoms of appendicitis and/or truly unusual and worrisome symptoms--you can watch and wait a little longer, but don't wait until it suddenly shoots up to 104 to act.😬

The third and last sign worth monitoring when seeking to confirm appendicitis is nausea/vomiting. This symptom accompanies many illness, from benign to life-threatening, so experiencing it for a few hours to days doesn't necessarily mean you have appendicitis, or that something serious is going on.

But if you've been experiencing the characteristic appendix pain in the lower right quadrant (and/or pain where referred pain from appendix trouble is usually felt), and most especially if you've been having this appendix pain AND fever issues, the nausea/vomiting is very likely a sign of appendicitis, and most likely justifies a trip to the ER.

If the appendix hadn't ruptured (and therefore hadn't yet caused an infection, sepsis or otherwise), the fever/nausea/vomiting are not caused by any infection process; rather, its most often a sign of inflammation, a response to severe pain, the result of a digestive tract that has slowed way down (which is the body's adaptation to certain severe illnesses--it preserves energy so it can direct it towards healing the damaged organ or other major injury), and/or the result of abdominal bloating, acid reflux, etc. that often results from this slowing of the digestive tract or the inflammation in/around the surgical appendix.

And if all three aspects of the triage formula are present, it's about 99.99% likely that you do indeed have an inflamed appendix, and it's highly recommended that you go to the ER for evaluation. And even if for some unusual reason this is proved to be something else than appendicitis, this something else requires ER evaluation too (because the body is sending plenty of signals through those three severe symptoms that suggest professional intervention is crucial, and that it's very unlikely to be an uncomplicated flu, a viral illness, or some other benign disorder that can be addressed at home with symptom management).

In general, if your symptoms include fever and nausea but not pain in the appendix area, it's probably OK to watch and wait. If the fever and nausea persist but abdominal pain never develops, it's not very likely to be a case of appendicitis. Depending on how dehydrated you are, how high the fever is, and what other symptoms you have, you can either continue home management or make an appointment with your GP, but a trip to the ER isn't likely to be necessary (yet).

If you've had a high fever and multiple bouts of vomiting for three or more days, or if you start to feel symptoms of severe dehydration (dizziness, muscle cramps, lightheartedness, thirst, dry skin and mucus membranes, "tenting" of skin (healthy hydrated skin "snaps back" instantly if you pinch a small patch of skin and release it; dehydrated skin tends to hold the "tent" shape fir a few seconds after releasing it, and is slow at flattening down and smoothing out), you need medical care, especially if you've been running a high fever (that's dehydrating in itself)--depending on how bad you feel, either urgent care/GP or an ER.

If you only have a fever (of any number), it's unlikely to be appendicitis. Unless the fever is very high, long lasting, soaking, causing night sweats, and/or showed up alongside other symptoms of infection (chills, exhaustion, loss of appetite, cough, paleness, etc.), you are probably OK to stay at home and manage symptoms there.

But if any signs of a serious infection appear (high fever, red or swollen limb or red streaks radiating from a wound, delirium or confusion, uncontrollable sleepiness, cough, shortness of breath, pain in chest or shoulder blade when breathing, hearing rattling or crackling in chest when breathing, very pale skin and mucus membranes--lips, gums, inside of eyelids--severe incapacitating headache, stiff neck, light sensitivity, hot dry skin or clammy cold skin), that's a ticket straight to the ER, without question😉

I know this is a TON of information, and I'm so SO sorry if I buried you under an avalanche of details😬. I didn't think I was going to be writing anything close to the length of this letter when I first began it😳!; it just sort of ended up that way, because I wanted to be sure you had all the detail you might need in order to monitor your condition or decide upon a treatment/trip to ER, or GP, or Urgent Care clinic. Having had appendicitis myself, I know how confusing and complex it can be when making these decisions, but there is always the chance of an emergency with appendicitis, so making a timely and accurate evaluation is important. I tried to give you all the the various factors that I used when I was trying to decide what to do when I had appendicitis, and I hope they are helpful to you as well😍.

But if you have any questions about any of this, please don't hesitate to let me know; I'd be happy to try to clarify or expand upon a certain topic or whatever you might need in order to address your symptoms and decide upon a treatment plan😋

I don't know if you've already gone to the ER or if you've decided upon some other avenue since you first posted your questions about 17 hours ago, but if you did, I pray that you're getting the help and relief you need😌, and that you feel safe and cared for each and every moment😉. But if you haven't yet made any decisions, I hope you find the clarity and certainty you need to evaluate your state of health, whether or not you require medical intervention, and which health resource to approach if you do decide to go to an ER/urgent care clinic/GP. 😍

Best of luck❣️, and a speedy and comfortable recovery to you😍❣️

[SqueakMouse]

Hey there CubanGirl, it's SqueakMouse again😍❣️ I just sent you a really long message that I hope will be able to answer your questions😉 But I forgot to ask if you've gotten any more tests or treatments since you posted your text about 21 hours ago(?). If you haven't, I would say the following in response to your post:

Pain in the lower right side is often digestive tract/intestinal pain, which can be caused by dozens of things, from a simple flu or gluten intolerance or chronic inflammation in reaction to diet allergies, to diverticulitis, Crohn's Disease, Ulcerative Colitis, bacterial overgrowth/imbalance (like SIBO), or malabsorption. With your stomach hurting at the same time (along with nausea), it suggests to me that your symptoms are more likely related to an inflammatory response (say, celiac disease, or dairy allergy, or something called MCAD, Mast Cell Activation Disorder) , rather than an auto-immune disease or ulcers.

Pain/inflammation in the stomach is often felt in the back, by a phenomenon called "referred pain". The type of pain and it's exact location (along the spine? Muscle aches? Stabbing pain? Only on the left side?, etc.) would help identify the cause.

Appendicitis pain isn't often felt in the side; it's usually localized to the LRQ (Lower Right Quadrant). If you press your right thumb to the inside curve of your hip bone--approximately parallel to your belly button--and imagine drawing a circle (about the size of a softball) in the space between your thumb/right hip bone and your belly button, you'll see where the appendix lies, and where appendicitis pain is most commonly felt (inside that circle).

But appendix pain is also felt as referred pain, usually right next to the belly button (and usually the right side of your belly button); down into the groin area and/or the inside/upper right thigh; or sweeping up and around the right hip, towards the right lower back.

Appendix pain can be felt in all these locations in combination, or just one of the location, or a shifting between the areas. Rarely, only the referred pain is felt (for example, deep aching pain around and under the belly button--but no where else), and the quality of the pain is often variable as well--sharp and stabbing, deep and aching, burning and pressure, etc.

If you're experiencing your pain in any of these "appendix areas" (especially if it is really disabling, and your nausea isn't resolving), I would recommend the ER. The only treatment for an inflamed or ruptured appendix is surgery, and no medical professional worth his or her salt would let you walk out the hospital doors with an inflamed but intact appendix; the danger of rupture--and more specifically, the effects of the rupture, like sepsis, peritonitis, bowel obstruction, internal bleeding, etc., which are often life threatening--is too great to "watch and wait" , so it will always ALWAYS be surgically removed (usually laparoscopic, if possible).

A "bad" appendix is diagnosed primarily by CAT scan (or MRI ), and ultrasound . Blood work is not much help, unless there is a suspicion that the appendix already ruptured and free fluid is causing inflammation or infection.

Therefore, your GP would be of little help if your concern/diagnosis is appendicitis. All the tests that would be done to confirm it, and the surgery that is done to cure it, are only available at a hospital. Your GP's recent blood tests might give you some helpful details (say, if you've got inflammatory markers that could suggest an auto-immune disease like lupus is contributing to your back pain; or you might have low hemoglobin and red blood cells, which could suggest that your stomach pain is caused by bleeding ulcers, and the slow blood loss is making you nauseous, light headed, and suffering severe stomach pain), but none of those confirm or even remotely address an appendix problem😳

So in your case, it's worth it to have a follow up appointment to go over your blood work, just to see if some of your symptoms can be explained by those results (like the lightheadedness being related to anemia); if his office will send you those results without an appointment, that's good too😋. But if your side pain is actually localized in that appendix area, and nothing in your blood work can explain your back pain/lightheadedness/nausea/stomach pain, I would seriously consider a trip to the ER (especially if your pain is disabling, and/or getting worse with time instead of better, or is accompanied by persistent nausea or fever).

If your side pain isn't in the appendix area (and you don't experience any pain in the appendix referred pain areas either), I'm thinking you probably would benefit from a referral to a gastroenterologist. That's because that side pains for even lower back pain) is often caused by an inflamed or ulcerated intestine/digestive tract. With the nausea and lightheadedness and stomach pain, I wouldn't be surprised if your entire digestive tract is sore, or ulcerated, or inflamed. A GI doctor has the tools and knowledge to order the right tests (probably includes an endoscopy and/or a colonoscopy), to decipher the causes of any problems he sees, and how to treat any issues he finds.

I hope that helps😍❣️. I put more information in my first post, so if you want to get more detail on the subjects I discussed above, there's much more in my first message if you ever need or want it😋

You're in my thoughts and prayers 😇!, and I wish you the best of luck deciding what you want to do regarding the questions you posed in your text😍 (but of course, the best outcome of all would be if you had a miraculous complete recovery, and didn't ever have to think about ER's or GP's or the like ever again😋😉❣️❣️❣️

[Simbistaffy]

In 2011 I ended up with a pain in abdominal area ended up going in paramedics said that it was gall bladder was admitted they said constipation till it flared up next day I complained to hospital and won. It was removed in Nov 2011 that was. Hell

[Hidden]

If you put your right thumb in your belly button and your little finger on your hip bone, where the tip of your middle finger lands is where your appendix is. If thats where the pain is, go see your gp asap. If you start being sick, go straight to A&E. Appendix pain has you doubled up in agony.