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December 21, 2010 2:24 PM   Subscribe

I have many of the symptoms of appendicitis, but the doctors say that nothing is wrong with me. I'd like to see a GI doctor, but I'm going out of town for Christmas on Thursday. What's the best way to manage these symptoms so that I can enjoy my holiday?

I'm a petite female in my mid-twenties. I've been dealing with severe abdominal cramps, nausea, and lack of appetite since Sunday evening. Went to urgent care on Monday evening, they gave me a pain shot and sent me to the ER. At the ER, they did CT scans, drew blood and tested my urine (3 times), yet they found nothing wrong with me.

Now that the pain shot has worn off, the nausea and lack of appetite have returned, along with some slight cramping (feels a bit like gas, but all throughout my upper and lower abdomen). I haven't had a bowel movement since early Monday morning (probably because I haven't really eaten anything substantial, a few kid-sized portions of food). No vomiting, no more diarrhea.

I know you're not my doctor, but maybe you can recommend some over-the-counter remedies to handle the symptoms until I can get some professional advice.
posted by chara to Health & Fitness (20 answers total)
 
So I actually had appendicitis and didn't know it. Lots of warm baths and masturbation took the edge off for 30-120 minutes each time. Seriously. Also gentle attention to the breath in a quiet room. Anxiety slows down or actively disrupts the entire digestive tract. The docs couldn't find anything--be gentle with yourself and distract yourself.
posted by zeek321 at 2:30 PM on December 21, 2010


IANAD. You are missing one symptom of appendicitis: the pain builds up and up and up, then goes away really quickly when your appendix bursts (of course, this is bad). Also, appendicitis is relatively easy to spot on a CT.

Easy to stomach, bland food and rest. Kind of sounds like bad food poisoning/norovirus (although norovirus can be tested for easily and it likely wasn't that).
posted by Mister Fabulous at 2:38 PM on December 21, 2010


I have many of the symptoms of appendicitis, but the doctors say that nothing is wrong with me.

Also, appendicitis is relatively easy to spot on a CT.

Appendicitis is actually still one of those things that gets missed a lot. It's one of the leading reasons for malpractice suits. So you ought to continue to have a high suspicion about your symptoms. What does that mean? It means that just because you went to the ER once doesn't mean you shouldn't go later.

I'd like to see a GI doctor, but I'm going out of town for Christmas on Thursday.

Do you have a primary doctor? You don't need to go straight to a GI specialist. If you call your primary and say something like, "I went to the emergency room for abdominal pain and need to make a follow-up appointment ASAP," you may be able to get in. Your own scheduling needs should be important.

I've been dealing with severe abdominal cramps, nausea, and lack of appetite since Sunday evening.

...yet they found nothing wrong with me.

This doesn't sound like any emergency room I'm familiar with. You should have been given discharge paperwork that listed a discharge diagnosis-- maybe something like gastroenteritis. Those discharge instructions should also include recommendations for future pain relief and when to return to the emergency room or how urgently to seek followup care from your primary physician. It's easy to forget about instructions when you're under the influence of drugs. If you don't have discharge paperwork, contact the records department for your emergency room and say that you need a copy of your discharge instructions.

This can be a lot of different things. I notice you don't mention pain specifically, beyond the cramps. If your pain is ever unbearable, that is a good time to go to an emergency room.

I haven't had a bowel movement since early Monday morning (probably because I haven't really eaten anything substantial, a few kid-sized portions of food).

Well, that, and the fact that they gave you opioid analgesia. Lacking a bowel movement for 48 hours is not a terrible sign, but if you don't have one in the next 48 hours, that is also a good reason to return to an emergency room.

No vomiting, no more diarrhea.

Were you previously suffering diarrhea? That's important to include in the information you provide, should you see a doctor.

...but maybe you can recommend some over-the-counter remedies to handle the symptoms until I can get some professional advice.

It sounds as if the pain medications you received earlier resolved your issues. If you have a primary care doc, you should mention that you need pain medication when you call for an appointment. Even if they are unable to see you, they may be willing to call in a prescription for something useful.

If all you want are some OTC recommendations, try tylenol (acetaminophen) and simethicone. Some people swear by ginger for nausea, and it's safe. Avoid nsaids (aleve, aspirin, ibuprofen) until you have more information regarding your discharge instructions. Avoid OTC anti-emetics (scopalamine) until you have more information. Keep active-- you don't have to go to the gym, but don't lie on the couch for 24 hours. Continue to eat and drink small amounts as long as you can keep them down-- if you become unable to keep anything down, consider returning to the emergency department.
posted by nathan v at 2:56 PM on December 21, 2010 [1 favorite]


As someone who has had both appendicitis and god-awful food poisoning - they feel pretty similar. The thing that helped with the discomfort in either case was avoiding food altogether, which probably isn't convenient for you! But do stick to wee portions of light, non-spicy things like soup, porridge etc. (NOT chorizo sausage. Or so I've heard.)

Generally if you rock up at the doctor and say "I have appendicitis" they will say "no, you have gastro. Here, have some Buscopan." This may happen two or three times in one day, with multiple doctors at the walk-in clinic and at the hospital. (Sample size = 2) If you badger them enough, then they will do blood, urine and CT, at which point if you do have appendicitis they will look rather embarrassed and then remove it. If all your tests came back OK, I would not worry about your appendix too much.

Also - warm baths. Long ones. Or curling up in the foetal position under a hot shower. I found these helpful.
posted by jaynewould at 2:56 PM on December 21, 2010


Because my imagination runs wild as soon as I leave the doctor's office, I now make a point of asking (or calling back to ask): "Explain to me why I don't have appendicitis/brain tumor/mrsa." There's often some simple reason, ie, "you don't have a fever". This quiets my worry. So call the doctor who saw you and ask.

And while you've got him, ask him why you don't have a burst ovarian cyst, which has similar symptoms.
posted by apparently at 2:58 PM on December 21, 2010 [1 favorite]


Could be gallstones, which an ultrasound apparently does a better job of catching than a CT scan. I'm surprised the ER did not prescribe stronger painkillers to tide you over until you see your doctor. If you get a fever or vomiting, or generally feel worse, you should give yourself permission to go back to the ER.
posted by Blazecock Pileon at 4:13 PM on December 21, 2010


You could try an enema.
posted by JJ86 at 5:01 PM on December 21, 2010


Ask them about diverticulitis...you're a little young for it, but the symptoms sound similar.
posted by unccivil at 5:15 PM on December 21, 2010


I had what the surgeon described as a "classic case" of appendicitis years ago and, as Mister Fabulous said, you're missing a couple of the symptoms. Appendicitis will typically run you a very high fever, and give you INTENSE vomiting. I couldn't even keep water down. The pain was also concentrated specifically in the right side of my abdomen, midway down. The specific symptom that sealed the doctors' diagnosis for me was that when they pressed down on the area where I was having the pain, it hurt way more when they took their fingers off then when they were pressing down with them.

All that said, fetal position is always good, but nothing helped me over appendicitis other than having it taken out.
posted by just_ducky at 6:05 PM on December 21, 2010


Well, obviously something's wrong with you--you're having severe pain and some gastrointestinal symptoms that aren't part of your baseline. If you keep having pain, or if you have another round of diarrhea that feels exhausting to you, please go back to the ER.

But I'm seconding everyone who suggests that this really doesn't sound like appendicitis. It sounds like irritable bowel syndrome or another gastrointestinal issue. You're not having fever or specifically localized pain (especially that "hurts more after the pressure stops" thing just_ducky talked about). And the tests didn't show any indication of appendicitis, so I don't quite see why you're continuing to worry about that (instead of moving on to the next set of worries; getting good treatment for gastrointestinal issues is a bit time-consuming and hassle-full, and of course pain is bad, yo.)

Not having had a bowel movement for two days is not particularly illustrative. It might be the pain medicine constipating you; it might be a reaction to your previous diarrhea. (If you do turn out to have irritable bowel syndrome, get ready for many, many bouts of alternating diarrhea and constipation, and I hope you don't.)

You need to see your doctor and to get a referral to the gastroenterologist. As for over-the-counter stuff, the challenge here is to balance pain relief with being kind to your digestive system--acetaminophen and similar are probably a better bet than aspirin or ibuprofen. Using a heating pad might help.

Good luck!
posted by Sidhedevil at 6:28 PM on December 21, 2010 [1 favorite]


If it makes you feel better, I went through something almost exactly like this about two weeks ago, and now I'm totally fine. I went to a doc and by the time i got there i wasn't even feeling meaningfully sick anymore.

Definitely stick to bland food - the biggest mistake i made was eating difficult food too early and bringing my stomach pain back with even more intensity.
posted by amycup at 7:22 PM on December 21, 2010


IANAD, but it could be a severe hormone imbalance. Have you recently gone off or on birth control? What are your periods normally like? Where in your cycle are you?

For me, the symptoms you described are exactly like the ones I had before I got on BC, and when I went off of it (terrible pain, volleying between expulsion and retention, etc, etc) so I almost wonder if your poor body is experiencing hardcore PMDD or something, rather than appendicitis.
posted by patronuscharms at 7:26 PM on December 21, 2010


IANAD, what you described could just be a stomach bug. Apparently a really bad one is going around NYC right now, maybe in your area too? Try eating some plain yogurt.
posted by wondermouse at 7:57 PM on December 21, 2010


IANAD, but as someone who has first hand experience with people dying of complications of a appendicitis, don't just look for a way to "get through the pain" so you can "enjoy your holiday". Nothing ruins the holiday for everyone like, oh, your brother finally giving in to the pain in the middle of Thanksgiving dinner with "I'm sorry, but I need to go to the hospital" after his appendix burst (he, stubborn as he is, did not die).

Pay attention to what is going on with your body. Don't take "meh" for an answer at the ER. There is a reason you are this sick...push them to figure it out. If it's food poisoning, constipation, virus, etc., it'll work itself out in a day or three, and they can help you manage the symptoms. If it's not, you want to be fully engaged with your health care providers, because if you go *pop*, time is of the essence.

That said...while I know at least one person (my invincible brother) who had undiagnosed appendicitis and did not have significant nausea, I don't know anyone with it who didn't have a raging fever and wildly skewed white blood cell counts. I'm also under the distinct impression that things like diverticulitis and IRB don't just show up one weekend; there's a history leading up to major events. So I'd guess you've got something unpleasant but transient, or gallstones or kidney stones, which aren't fatal, but really, really suck.

Hope you get better soon.
posted by kjs3 at 10:31 PM on December 21, 2010


IANYD but I would really keep an eye on this. I know it feels like the holidays are the priority here, but they really-really-REALLY-are not. Could be any of the minor things mentioned above, could still be appendicitis or even a flair up of Crohn's or U.C. (two diseases that often don't manifest themselves until the early-mid twenties, as was my case, rather suddenly, wrongly diagnosed, right before christmas--if we're talking worst case scenario here) Don't be afraid, i'm just rambling possibilities... the point is:

If it gets worse- even if you're sitting in the pew halfway through the Christmas pageant--you go to a hospital- pronto.

If it gets better, have an awesome holiday, and i'd say stay away from caffeine, alcohol, coffee, acidic foods, nuts, and high fiber greens (like spinach) which contribute to gastroenteritis/other bowel inflammations.

Sometimes it's just gas trapped, or a blockage, but if you feel like you're not getting the advise you need from a doctor or emergency room, then you go find another one until you feel safe and sound that the issue has been correctly diagnosed and resolved. Even the best doctors miss something sometimes- you know your body. Listen to it. I really hope it's nothing and you have a safe holiday- good luck!
posted by billypilgrim at 2:33 PM on December 22, 2010


Also, next time someone pushes on your stomach, pay very close attention to whether it hurts when they press down, or conversely, when they let go. That makes a big difference in the diagnosis and i saw 6 doctors before one thought to ask me that, and then we knew it was time for surgery. You have to figure, it's the doctors holiday's too- their minds could just as easily be on presents and dinner as yours. Demand results.
posted by billypilgrim at 2:36 PM on December 22, 2010


Thank you for the advice everyone. I'm pretty sure it's just a stomach bug. I threw up (once) last night and had pretty bad diarrhea all last night until this morning. I called a Dial-a-Nurse service, gave the nurse all the details, and she told me to drink lots of fluids (pedialyte/gatorade) and take some Immodium-AD, which I've done. She said if I don't feel better after 48 hours, I should go to the ER.

Diarrhea is gone. I still have slight stomach pains, but it feels more like gas than anything. I'm taking some anti-gas caplets as well.

It sucks that this is happening during Christmas. It also sucks that I haven't really been able to eat anything for days. I think my next AskMe question will be 'How can I regain all the weight I lost while I was sick?"
posted by chara at 5:10 PM on December 22, 2010


Oh, also, I'm going to a GI doctor when I get back from Christmas vacation, just in case.
posted by chara at 5:10 PM on December 22, 2010


Did you try eating plain yogurt? I'm serious! It can really help (if that is the problem).
posted by wondermouse at 7:53 PM on December 22, 2010


Also try acidophilus and green apples if you can keep them down. :) feel better!
posted by patronuscharms at 10:53 AM on December 25, 2010


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