OpenHealth Q&A

Severe Abdominal Discomfort Led to ICU Visit, But Was Dismissed as Anxiety (23M)

(Please excuse any language errors, as English is not my first language and I have not slept well.) I awoke at 4 AM yesterday after only about four hours of rest, jolted by a sudden and intense aching in my lower stomach. I rushed to the bathroom and was able to urinate and have a bowel movement without issues, but the pain persisted. **Symptoms:** - The pain is intermittent, coming and going in waves with varying intensity. - It feels more acute when I’m lying down compared to when I sit or stand. - No diarrhea, nausea, fever, constipation, or blood in my stool. - I do experience a mild burning sensation around the anus, though I haven’t consumed any spicy foods lately. - My abdomen feels distended to the touch. - There is tenderness when I press on the lower right area of my abdomen (just beneath the belly button and slightly to the right). - The initial pain was excruciating, nearly bringing me to tears. - While the pain has lessened, it remains significant enough to interfere with my ability to sleep. I took 80mg of Nospa (Drotaverine hydrochloride, unsure of the US equivalent), but it didn’t bring any relief. **Hospital Experience:** Around 6 AM, my mother took me to the hospital, where I was admitted to the ICU under suspicion of appendicitis. A CT scan of my abdomen revealed no abnormalities: no signs of appendicitis, polyps, or kidney stones. Blood tests indicated low potassium and sodium levels, but everything else appeared normal. The doctors inquired about my bladder health (which is fine). I received an IV of a basic saline solution and 200mg of Nospa. Afterwards, the doctor concluded it was purely due to anxiety (which he likely inferred from my medical history) and suggested I head home. I’m firm in my belief that anxiety isn’t the sole issue here. Although I have experienced anxiety-related stomach aches in the past, they were never this severe, nor was the discomfort localized to one side of my abdomen. Typically, my anxiety manifests as an overall tightening sensation rather than isolated pain. Additionally, I have been consistently taking Fluvoxamine (an SSRI) for anxiety and haven’t missed a dosage lately. **Current Situation:** It is now 2:17 AM the following day, and I have yet to sleep as the pain endures. Throughout the day, I attempted to have bowel movements with limited success, often needing to force it, which didn’t help my situation. For a period, the pain subsided, replaced by a constant pressure in my abdomen, similar to bloating, but it gradually returned by evening. The discomfort has reduced slightly, yet it still affects my ability to drift off to sleep, especially when I try lying on my side. **Additional Notes (Possibly Minor Details):** *Diet:* My blood tests show low sodium and potassium, and I have been advised to increase my salt intake, which is puzzling since I already consume quite a bit of salt regularly. I typically eat two meals daily, avoid excessive fats, fibers, and spicy foods, have a high sugar intake (but normal blood sugar levels), consume carbonated drinks (one can every couple of days, along with distilled water), and drink green tea (three bags daily without caffeine). *Medication and Background Information:* - My height is 177cm, weight is 64.4kg, and I am a 23-year-old male. - Diagnosed with ADHD, I take methylphenidate (20mg and 10mg) regularly, in addition to Fluvoxamine for anxiety, which I’ve been taking for years with only short breaks. - I have a history of using NSAIDs frequently for headaches and took Ketoprofen about eight PM two days ago (the evening prior to my hospital visit). I suspect this could be relevant, but it’s also possible it’s unrelated since it’s been over 24 hours and the pain persists. - I do not consume alcohol, smoke, or frequently drink caffeine, and I haven’t used drugs for an extended time. - I have no history of gastrointestinal or stomach disorders, and none has surfaced in the past. - Two nights ago, I had dinner with family, and no one else has reported feeling unwell, so I doubt food poisoning is a cause.

Answers (1)

9/5/2025, 12:31:15 AM

OpenHealth AI

I'm sorry to hear about the severe abdominal discomfort you're experiencing. Your symptoms are concerning, particularly the intermittent pain, tenderness in the lower right abdomen, and the impact on your ability to sleep. While a previous hospital visit ruled out serious conditions like appendicitis, it’s important to approach this matter very thoughtfully since you still have significant pain.

Summary of Key Points:

1. Persistent Pain: Ongoing abdominal pain, especially with tenderness in a specific area, needs careful monitoring.
2. Recent Health Concerns: Low potassium and sodium levels may also require attention.
3. Anxiety Considerations: While anxiety may contribute to symptoms, your discomfort’s specific characteristics suggest it’s important to rule out other potential causes.

Explanation:

• Pain Characteristics: The acute, localized pain you describe, particularly with tenderness in the lower right abdomen, may indicate possible issues such as a muscular problem, referred pain, or another abdominal issue that wasn't identified in the initial exams.
• Bloating & Distension: These symptoms could relate to gastrointestinal issues. It's not uncommon for digestive issues to cause symptoms like yours, especially if you've been taking medications like NSAIDs.
• Electrolyte Imbalance: Low sodium and potassium levels can lead to a variety of symptoms, including muscle cramps, fatigue, and in some cases, abdominal pain. It would be beneficial to address this.

Next Steps:

1. Increase Hydration & Electrolyte Intake:

   • Drink fluids rich in electrolytes, such as oral rehydration solutions or electrolyte drinks. Aim to include both sodium and potassium-rich foods, such as bananas, oranges, potatoes, and broths, based on your diet tolerance.

2. Monitor Symptoms:

   • Keep a detailed diary of your symptoms over the next few days, noting any changes in pain location, intensity, or associated symptoms (like changes in bowel habits). This can help in identifying patterns.

3. Gentle Movements & Positions:

   • Try to find comfortable positions to alleviate the pain (sitting up may help). Engage in gentle movements or stretches if they can be tolerated. Avoid lying flat if it increases pain.

4. Diet Considerations:

   • You might want to reassess your diet briefly, focusing on easily digestible foods like toast, rice, or bananas to prevent potential gastrointestinal irritation.

5. Rest and Sleep Strategies:

   • If pain keeps you from sleeping, try relaxation techniques like deep breathing or mindfulness exercises to help reduce anxiety and promote rest.

6. Consulting a Healthcare Professional:

   • If the pain persists or worsens, or if you develop other concerning symptoms (like fever, substantial changes in bowel habits, or prolonged discomfort), it is advisable to seek a second opinion or additional follow-up with a healthcare provider, such as a gastroenterologist.

I understand this situation is quite distressing. Listen to your body, take care of your nutritional needs, and monitor your symptoms closely. Please feel free to reach out if you need further guidance or support.