OpenHealth Q&A

Understanding Potential Appendicitis Symptoms

Hello, I am a 28-year-old male, standing at 6 feet 3 inches and weighing 280 pounds. Alongside high blood pressure, which I manage with a daily dose of 10mg Lisinopril, I have been addressing gastrointestinal concerns such as constipation and indigestion with the aid of a gastroenterologist. Currently, I am prescribed 40mg of pantoprazole each day. A CT scan of my abdomen is planned for next week. Additionally, I struggle with health-related anxiety and use hydroxyzine as needed to help manage it. Recently, I took hydroxyzine 50mg for the first time on Sunday evening. On Monday morning, I experienced watery diarrhea twice and felt a general soreness in my abdomen throughout the day. After having worked out on Sunday, I attributed the discomfort mainly to a possible adverse reaction to the medication, along with some general muscle soreness. The following day was similar, but I observed that my soreness seemed localized to what I suspect is the iliopsoas muscle in my right lower quadrant. Today and yesterday, my stomach has continued to feel unsettled, with more frequent bouts of softer bowel movements—though not quite diarrhea. I also feel bloated. While these symptoms align with my usual gastrointestinal issues, I would note that the bloated sensation seems more pronounced than normal. I do not have a fever or nausea and am able to eat relatively normally. However, I do experience right lower quadrant pain when I stand and stretch or use those muscles to sit up. Additionally, pressing on a specific area close to where the appendix is located produces some discomfort. The pain levels hover around 2 out of 10 and are noticeable only when I’m active; I do not feel discomfort when at rest. I have performed tests such as the Rovsing’s, psoas, and obturator maneuvers without experiencing pain. However, lying on my left side and drawing my knees towards my chest does elicit some tenderness. When I press on McBurney’s point, there is pain upon pressing, but not upon releasing—though I have pressed in that area numerous times, potentially influencing the pain response. This leads me to the crucial question: Could this be appendicitis, or is it just a muscular strain? Most sources indicate that appendicitis typically presents with much more severe pain, but I have encountered situations where individuals experienced minimal pain alongside gastrointestinal issues, only to discover later that their appendix was on the verge of rupture after a medical evaluation. I appreciate any insights or thoughts you might have on this matter!

Answers (1)

3/26/2025, 8:01:09 PM

OpenHealth AI

Thank you for sharing your detailed symptoms and concerns. It sounds like you are experiencing a range of gastrointestinal issues alongside some localized abdominal pain, which is understandably concerning. Here’s a breakdown of the information you provided and some steps you can take.

Main Points:

1. You have localized pain in the right lower abdomen, but it’s mild (2 out of 10) and primarily felt when active.
2. Symptoms like bloating, softer bowel movements, and discomfort when pressing on the area near the appendix warrant careful monitoring.
3. While appendicitis typically presents with more severe pain, early or atypical cases can exist.

Explanation: Appendicitis usually involves intense, constant pain that progresses over hours and is often accompanied by nausea, vomiting, and fever. However, everyone experiences pain differently. Your pain level is low, and the absence of fever and nausea are reassuring. You might be dealing with a muscular strain or gastro-related issues, especially since you've had ongoing gastrointestinal symptoms.

The tenderness near the appendix is something to be aware of, especially considering your anxiety about whether this could be appendicitis. You've already performed some physical tests which did not yield strong indicators of appendicitis, but they are not definitive.

Next Steps:

1. Monitor Symptoms: Keep track of your pain levels and any changes. Note if symptoms worsen, especially if pain increases or new symptoms (fever, nausea, vomiting) develop.

2. Hydrate and Rest: Maintain good hydration, especially with gastrointestinal changes. Rest when you can to avoid aggravating any potential muscular strain.

3. Avoid Certain Activities: If you suspect a muscle strain, avoid intense physical activities or movements that worsen your abdominal pain.

4. Dietary Adjustments: Consider a bland diet temporarily to ease your gastrointestinal symptoms, focusing on easily digestible foods to help the bloating and discomfort.

5. Plan for CT Scan: Since you have a CT scan scheduled, it's essential to keep that appointment for a thorough evaluation. Discuss all your symptoms, including the pain and bloating, with the healthcare provider performing the scan.

6. Reach Out if Symptoms Change: If you experience increasing pain, fever, significant changes in bowel habits, or any worrisome signs, seek medical attention promptly.

Your proactive approach to your health is essential, and seeking clarity around these symptoms is wise. Trust the process, especially as you await further evaluation next week. Let me know if you need further clarification or support!