OpenHealth Q&A

Struggling with Abdominal Pain and Appendix Concerns

Hello everyone, I’m reaching out for genuine advice, particularly from those in the medical field or anyone who has faced similar recurring abdominal discomfort. I’m a 31-year-old female, standing at 5’1" and weighing 105 pounds. In the last month, I found myself in the emergency room four times due to severe pain in my lower right abdomen and back. Here’s a breakdown of my experience: **June 25:** I visited the ER because of acute pain in my right abdomen and back, paired with painful urination. The diagnosis was a urinary tract infection (UTI) along with a dilated appendix measuring 0.8 cm. I left with a prescription for oral antibiotics. **June 29:** After experiencing an allergic reaction to the antibiotics and a worsening of my symptoms, I returned. Blood tests and a CT scan revealed that the infection had progressed to my kidneys, classified as pyelonephritis. I was hospitalized and treated with IV antibiotics, then discharged with additional medications meant for home recovery. **July 10:** The pain resurfaced in the same regions. A follow-up CT scan indicated that my appendix had increased in size to 1.1 cm. On this occasion, the ER doctor diagnosed appendicitis based on the imaging and my reported symptoms. He reached out to the surgeon on-call to discuss potential surgery. However, the surgeon who examined me disagreed with the initial assessment. She attributed the pain to the previous kidney infection, stating it didn’t seem like appendicitis. She did a brief physical exam, acknowledged some tenderness, but dismissed the need for surgery, arguing that I did not appear to be in sufficient distress to warrant an operation. Despite my imaging and previous medical history, she recommended only continued antibiotics and did not create any additional plan. In a rather unusual approach, she suggested I eat a small piece of a sandwich to see if I would vomit—a scenario that didn’t occur, although I infrequently vomit, even when quite ill. Overall, I felt the entire encounter lacked a sense of urgency and empathy. The ER physician still believed appendicitis was a concern but ultimately deferred to the surgeon’s judgment. I was discharged with a different antibiotic and a referral to an outpatient surgeon for further investigation. **July 17:** During my surgical consultation, the surgeon spent less than 10 minutes with me, acknowledged the tenderness upon examination, and instructed me to complete the antibiotic course. He failed to provide a surgical plan, follow-up guidance, or document any meaningful details from our meeting—only my vital signs were recorded. When I reached out to discuss my escalating pain, he suggested returning to the ER if my condition worsened. Each time I go back, I receive pain relief, more tests, and additional antibiotics, with repeated prompts to return if my situation deteriorates. I respect the professionals in charge but also wish to advocate for myself without overstepping. My main worries include: - I’ve been on four different antibiotics (many of which I’m allergic to) and my symptoms continue to recur. - My appendix is still dilated despite receiving treatment. - The surgeon seemed dismissive and did not keep proper records of our visit, which is unusual compared to my experiences with other healthcare providers. - Although I may not visibly display pain, I communicate my discomfort clearly, yet feel my concerns are overlooked. - It seems as if there’s a wait-and-see approach until my appendix ruptures before any decisive action is taken. Is this approach typical? Should I be more assertive in seeking surgical intervention or a second opinion? Any advice or insights you could share would be greatly appreciated.

Answers (1)

7/21/2025, 1:20:43 AM

OpenHealth AI

I'm sorry to hear about the challenges you're facing with your abdominal pain and the uncertainty in your diagnosis. It's understandable to feel concerned, especially with your recurring symptoms and interactions with healthcare providers. Let's break down your situation and emphasize what steps you could consider next.

Key Points

1. Your symptoms and imaging results have raised legitimate concerns about appendicitis and other conditions.
2. Multiple visits to the ER and varying opinions from healthcare professionals can be frustrating and exhausting.
3. It’s important to advocate for your health and seek clarity on your diagnosis and treatment.

Explanation

Abdominal pain, particularly in the lower right quadrant, can stem from various issues, such as appendicitis, kidney problems, or other gastrointestinal conditions. The dilated appendix size you mentioned raises questions while the recurring urinary infection and its complications indicate additional factors complicating your case. Given your history of allergic reactions to antibiotics, it’s crucial to ensure that your treatment plan is tailored to your specific needs.

Next Steps

1. Document Your Symptoms:

   • Keep a detailed record of when your pain occurs, its intensity, any additional symptoms, and your medication history. This will be invaluable for any medical professional you consult next.

2. Seek a Second Opinion:

   • Consider reaching out to a gastroenterologist or a surgeon with expertise in appendiceal issues. A second opinion can provide clarity and perhaps a different perspective on whether surgery is necessary.

3. Inquire about Further Testing:

   • Ask your healthcare provider if further imaging (like a repeat CT scan or an ultrasound) could be beneficial to evaluate your appendix and other organs. Sometimes conditions evolve and may present differently over time.

4. Express Your Concerns:

   • When speaking with your doctor, clearly express your feelings about the current management plan. Highlight that you want more definitive answers regarding your appendix and pain management.

5. Consider Pain Management:

   • Discuss pain management options with your healthcare provider. There may be alternatives to antibiotics for managing discomfort or inflammation.

6. Monitor for Warning Signs:

   • Pay attention to specific severe symptoms, such as increased pain, fever, vomiting, or changes in bowel habits. If these occur, don’t hesitate to return to the ER.

Remember, your health is a priority, and it’s essential to find care that you feel comfortable with and that adequately addresses your concerns. Persistence in asking for clarity and support from medical professionals is key. Please take care, and don’t hesitate to reach out for more information or guidance.