OpenHealth Q&A

Navigating the Mysteries of Acute Appendicitis: A Concerned Mother Seeks Insight

I want to start by apologizing for any potential over-explanation or lengthy details in my post. My experiences recently have heightened my health anxieties, so please bear with me. You can skip the sections enclosed in curly brackets for brevity if you prefer. **BACKGROUND:** I am a 41-year-old woman generally in good health and without any significant past medical issues. I’m married and a mother of three boys aged 7, 9, and 14. On Wednesday, July 2nd, while returning from a lengthy car trip, I developed classic symptoms indicative of acute appendicitis. Around 2 PM, I felt a sharp, pulling sensation near my belly button, which progressed later that evening into severe cramping and pain localized in my lower right abdomen. This discomfort roused me from sleep around 2-3 AM and persisted for about two hours, and I ended up vomiting three times along with experiencing chills and sweating. Initially, I suspected I might have strained a muscle from sitting for too long in the car, and attributed the rest of my symptoms to menstrual cramps since my period had just begun the previous day. I also hadn’t eaten much for lunch or dinner, which I thought might be contributing to the nausea. On Thursday, I took it easy and noted that my discomfort didn’t return to the intensity I had felt overnight. The area around my belly button and lower right abdomen was tender, yet not unbearably painful. We opted to cut our trip short and return home that Thursday, just in case the pain reemerged. By Friday, July 4th, I felt mostly back to normal with just a slight tenderness, no pain, no fever, and a good appetite. {It’s worth mentioning that all of this transpired while we were away on vacation, which influenced my decision not to seek emergency medical care right away. At the time, appendicitis wasn’t even on my radar; I believed it could just be muscle strain combined with menstrual discomfort (even though I typically don't have intense cramps, I have noticed that my periods have become heavier as I've entered my 40s, which I assumed might be a part of perimenopause).} On Saturday, July 5th, I decided to visit Urgent Care to rule out the possibility of a urinary tract infection, umbilical hernia or ovarian cyst, which I thought could be responsible for my initial intense pain. Given the typical symptoms and pain location, the medical staff sent me to the ER for a CT scan to evaluate my appendix. The results were not definitive but indicated a possibility of mild acute appendicitis, showing slight dilation at 7mm (with a cutoff at 6mm) and mild edema of the wall. No fecalith, blockages, or masses were found. I was presented with the choice of having an appendectomy the next morning or opting for antibiotic treatment. I chose to proceed with just the antibiotics and remained in the hospital for observation. I received IV antibiotics (Piperacillin/Tazobactam) during the night and left the hospital the following day with a prescription for a 10-day course of Augmentin. The surgeon I consulted during my discharge was supportive of my decision. He noted I wasn’t showing signs of pain upon repeated examinations and had no elevated white blood cell count or fever. He even expressed that “I don’t think you have appendicitis,” a statement that offered me considerable reassurance because I worried about being subjected to surgery and not being able to go home that day. I have a follow-up scheduled in two weeks to discuss the possibility of an interval appendectomy and a future colonoscopy. {To clarify my thought process: I was exhausted from a prolonged ER wait, taken aback by the CT findings, and genuinely frightened at the thought of immediate surgery, which I had never undergone. I generally prefer to keep my body as intact as possible and didn’t want to lose an organ that seems to have immune functionality unless absolutely necessary. Given that I didn’t display acute symptoms at that moment, I believed immediate surgery wasn’t justified. One ER physician was comfortable with my decision to go home and return for follow-up assessment, which helped me perceive the situation as less critical than a surgical emergency. However, another ER doctor insisted on continued observation.} Since getting back home, I have experienced no new symptoms other than some mild diarrhea linked to the Augmentin. I began taking probiotics yesterday and had a solid stool this morning (July 9th, Day 3 of Augmentin). I've noticed some minor abdominal rumbling and discomfort an hour or two after taking my medication, but that's gradually diminishing. In an effort to understand everything I can about appendicitis and its implications, I have been devoting a significant amount of time to research, which has led to an increase in my anxieties and doubts regarding my decisions and next steps. **QUESTIONS/CONCERNS:** - What are the chances that my acute appendicitis resolved on its own? - Is it plausible that my appendix could have perforated early Thursday morning, leading to a subsequent relief from pain without any signs of infection or sepsis? Is that scenario even possible? - Considering the risk of a future recurrence, how risky was my decision to choose the non-operative approach with only antibiotics, especially since the acute episode had occurred three days prior to my hospital visit? The non-operative method seems to be more widely accepted outside of the United States, where I currently reside, although the supporting studies are relatively new and somewhat contentious. - What steps should I take next to alleviate my worries? As a mother to three young sons, I am deeply unsettled by the research indicating that acute appendicitis in individuals over 40 might be an early sign of colon or other cancers. Though it remains exceedingly rare, the potential for appendix cancer is, at this moment, my greatest fear. I was very disturbed by a Reddit thread I encountered that kept me awake last night, filled with dread about the possible spread of cancer cells in my abdominal cavity while I slept. --- Thank you to anyone who has taken the time to read through my entire post. I understand how I might come across. I would greatly appreciate any insights or feedback you could provide. Thank you in advance!

Answers (1)

7/9/2025, 11:31:10 PM

OpenHealth AI

Thank you for sharing your detailed experience and concerns regarding your recent health situation. Your anxiety is completely understandable, especially when it comes to the health of a parent. Let's address your main questions and concerns regarding your symptoms and decision for treatment, while offering some reassurance and next steps.

Main Points:

1. The chances of your acute appendicitis resolving on its own are possible, and your symptoms may indicate improvement.
2. It's unlikely that your appendix perforated without causing significant symptoms or signs of infection.
3. While there is some risk in opting for a non-operative approach, many patients respond well to antibiotics, especially at an early stage.
4. Focus on symptom monitoring and follow-up care to alleviate your worries.

Explanation:

1. Resolution of Appendicitis: There is some evidence that mild cases of appendicitis can sometimes resolve on their own, particularly when symptoms improve significantly, as you've experienced. With conservative management, many patients recover without surgery.

2. Risk of Perforation: While perforation can indeed cause a reduction in pain initially due to the release of pressure within the abdomen, it's generally accompanied by severe symptoms, including fever, rapid heart rate, and further abdominal distension. Since you did not observe these signs, it's more likely that your appendix did not perforate.

3. Non-Operative Treatment: Choosing antibiotics over immediate surgery, especially when you were not exhibiting acute symptoms like fever or elevated white blood cell counts, is a valid approach. Many healthcare systems are increasingly supportive of this method, especially for low-risk patients with mild appendicitis.

4. Understanding Risks and Symptoms: Since you have a follow-up appointment scheduled, it’s important to monitor any new or recurring symptoms, such as increased abdominal pain, fever, or persistent changes in bowel habits. These would necessitate prompt medical attention.

Next Steps:

1. Symptom Monitoring: Keep a journal of any abdominal symptoms, including their intensity, duration, and any associated signs (like fever). This can help identify patterns and make it easier to discuss with your healthcare provider during your follow-up.

2. Follow-Up Care: Attend your scheduled follow-up appointment in two weeks. Discuss any concerns regarding cancer or further tests, such as a colonoscopy, with your doctor. They can provide reassurance and clarity regarding screening recommendations.

3. Manage Anxiety: Address your health anxieties by considering relaxation techniques such as deep breathing exercises, mindfulness, or talking with a mental health professional if you feel overwhelmed. Engaging in activities that distract and engage you positively can also be beneficial.

4. Balanced Information: While conducting research, focus on reputable health sources and discussions with healthcare professionals rather than anecdotal accounts, which might exacerbate fears.

It's completely normal to feel unsettled after such a health scare, especially with so much information circulating about various health conditions. Remember that you made thoughtful and informed choices based on your situation, and staying engaged in your health management is the best path forward. I'm here if you have more questions or need further clarification.