Appendicitis and PMR?

[Loco99]

I’m 67, have well controlled PMR and take 5mg of Prednisolone. I have been on a low carb diet because of a diagnosis of pre diabetes. On occasion I have been feeling tired recently and put that down to the change of diet.

Ten days ago I got severe stomach cramps and a temperature and went to the GP nurse who referred me straight to the A&E department of our local hospital. Appendicitis was diagnosed and after a night in a corridor ( The infrastructure at our local hospital leaves a bit to be desired but the staff were fantastic) I had laparoscopic surgery.

While in hospital I had plenty of time to think, there was precious little chance for sleep as the ward was very noisy. I realised that I have had least five episodes of the severe stomach cramps over the years but somehow my body managed to fight back each time. The consultant said that my appendix was perforated. I did some online searching and realised I most probably had a grumbling appendix for at least 30 years. The consultant said that the previous episodes may well have been appendicitis.

I wonder if my pesky appendix has been causing havoc to my system, affecting my immune response and inflammation levels? Could it have been a contributing factor for the onset of PMR? Has anyone else had a similar experience?

[piglette]

Your appendix could have caused stress to trigger PMR, but I suppose we will never know. You are the third person in three weeks I have come across who has had appendicitis. The neighbour who lives opposite had her op a couple of weeks ago, by laproscopy. She had hers during the strike. My brother in law’s appendix burst at 3.30pm in the morning, his screams could have been heard miles away I was told.

[Loco99 in reply to piglette]

I hope your brother in law has recovered. While in the ward I heard the screams of another patient in an adjacent ward, they were bloodcurdling, a burst appendix, I suspect. None of this is fun, I think I had a very lucky escape in that mine didn’t burst.

[piglette in reply to Loco99]

It does sound incredibly painful to have a burst appendix.

[PMRpro Ambassador]

I and my elder daughter both had grumbling appendices - she was sent home from the University hospital on a Friday after extensive tests and we were told it definitely WASN'T appendix. On the Saturday we went in the other direction to the regional hospital with the same symptoms and they thought it was reasonable to suspect appendix and they would whip it out on the Sunday at the latest. They removed a visually apparently normal appendix and sent it for histology - where they found there were bands of damaged tissue remaining from previous episodes and if there had been another it would have perforated. The uni clinic was dicing with death! The general opinion was that the uni clinic couldn't cope with the simple stuff ...

My PMR happened MANY years later though!

[SheffieldJane]

This worries me as the lower right abdominal pain that I experience is exactly where the appendix is situated. Sometimes the pain is intense like a boil. Appendicitis was dismissed by a GP when he pressed hard on the area and it didn’t hurt. He told me that I would have reacted dramatically to the pain had my appendix been involved. In spite of all the colonoscopies and camera examinations it has never really been explained - ie the initial point of pain being in that area.

I agree that something like this would drag your health down to the extent of triggering PMR symptoms.

[Loco99 in reply to SheffieldJane]

Mine was probably missed quite a few times because I have scar tissue from two caesareans and a hysterectomy. Years ago when I had severe stomach pain I was told that appendicitis can be difficult to diagnose. Last week I was told that I might be given antibiotics and sent home instead of having surgery. I was given a CT scan which must have shown something that decided them on surgery. Going home without surgery would have been like having a ticking time bomb inside my body. One thing that set the alarm bells ringing as far as the medics were concerned was a high temperature.

[Kendrew in reply to SheffieldJane]

I was taught during one of my nursing in-house training sessions that if you place the thumb tip of your right hand pointing towards or touching your bellybutton, and your little finger pointing towards or touching the outer hip bone, and then simply press down with your forefinger, any inflammation of the appendix will cause quite significant pain as you do this.

An indicator at least that there's a potential issue...particularly if nausea, vomiting and a temperature are in evidence also.

This action definitely prompted my friend to take her son to A&E after I'd suggested she try this. Two hours later he'd had a severely inflammed appendix removed!

It's certainly not a 100% reliable way of diagnosing appendicitis but its another technique to help build up a picture of what might be wrong.

[SheffieldJane in reply to Kendrew]

Thank you Kendrew. It is a little bit tender. There is a lot of padding these days 😊 I had unexplained vomiting a few months back. You do know a lot about a lot Kendrew.

[Kendrew in reply to SheffieldJane]

Haha!.... no ones ever said that about me before! Can you tell my husband that please?🤭

[SheffieldJane in reply to Kendrew]

He is a fortunate man!

[SheffieldJane in reply to SheffieldJane]

…….and remained tender for the remainder of the evening. Maybe it isn’t alway peel me off the ceiling stuff.

[Kendrew in reply to SheffieldJane]

You can definitely experience a 'grumbling' appendix where symptoms come and go over time but don't really seem severe enough to warrant a visit to the GP. Unfortunately, it almost always will eventually escalate to the point where some kind of medical intervention is required though. Interestingly though, the onset of appendix pain frequently starts in the middle of the lower abdomen (around & under belly button area) and then moves to the right hand side.

As mentioned before though, if accompanied by nausea, vomiting and high temperature, that should always be checked out by a medical professional and should probably be treated as a medical emergency.

[SheffieldJane in reply to Kendrew]

My pain starts in the Appendix area though and spreads along the lower abdomen. I have diahorrea alternating with very sluggish bowels. Prescribed Buscopan and Lansoprazole - help somewhat plus paracetamol. The pain has been there since before the pandemic. I have had every test you can imagine.

[Kendrew in reply to SheffieldJane]

That's a bit of a mystery isn't it!

It sounds a little like diverticulitis. My dad suffered from it and my sister does.

She has episodes of terrible lower abdominal cramps, very bad diarrhoea and sometimes vomiting too. She'll also feel bloated with a tender and distended abdomen. It can make her very poorly for several days till it settles down again.

Very simply, it's caused by little appendages (diverticulae) in the intestine becoming blocked by food 'debris' and then becoming infected. A mild episode might clear up itself eventually but more often than not my sister will require some antibiotics.

Don't know if any of that sounds similar to your episodes.

It's reassuring though that your tests have all showed nothing that's needed serious intervention. Unfortunately, it's still very frustrating to not have a diagnosis and be able to move forward with effective treatment. I know that myself....I've still no definitive reason for my current symptoms that began five months ago!

I do hope things improve for you soon.

[SheffieldJane in reply to Kendrew]

I do have the diagnosis of diverticulitis and a small hiatus hernia and possibly IBS. I am not totally convinced by all of that causing my symptoms. The only thing that hasn’t been tested is my bladder - I get cystitis type symptoms on and off - urine tests clear though. My GP seems never to give antibiotics.

[Kendrew in reply to SheffieldJane]

That's a lot of potentially unanswered questions and unresolved issues. It seems like you've done almost everything you can though to find out what's going on. I don't really know what else you can do to be honest. Very frustrating for you .

[SheffieldJane in reply to Kendrew]

🐢+ the 🐇(hare).

[Bridge31]

I had suspected appendicitis when I was 7 months pregnant. I had been crawling round the floor in terrible pain. Taken to hospital just before midnight where I had two junior doctors one either side of me discussing ( arguing ) as to whether I should have a laparotomy. It was duly done and I spent 11 days in hospital minus a healthy appendix and plus a 22 stitch train track. They decided it was a kidney infection.

However I did go full term half a stone lighter than my first pregnancy 😀