YANMD, but my lower-right and center of stomach has a heaviness to it.
January 25, 2022 4:56 PM   Subscribe

Yes, YANMD, but this has been an ongoing struggle for a bit of a while now. I have emailed my doctor, but want to get feelers from the community on what it could be. I've theorized it's appendicitis, but I only have one symptom, and so far, it's not sharp pain. Any helpful suggestions would be ideal, more inside the fold.

Last October, my back gave out. Ended up going to urgent care, getting anesthesia, and it mysteriously went away after that. CT and X-Ray scans came clean.

However, a few weeks after that episode, I noticed whenever I ate specific food, I'd have this weird sensation in the middle of my stomach, kind of felt like a bone or something was moving. It wasn't HURTING, per se, but more of an uncomfortable sensation. I noticed this happened with specific food, but not with other food. Sometimes my lower back, not the BACK itself, but more of in that area, if that makes sense, would have a very slight burning sensation when I stood too long, but again, nothing that was too bothersome.

This has continued, being kind of on and off, but in the past week or so, I've noticed the discomfort has became more recurring and more persistent. Before, it was only after a big dinner I had, for example—now, it's kind of all day. It's, so far, not to the point where I can't breathe, can't walk, etc., but it is uncomfortable, especially when I stand after sitting for a while. It's like some kind of bone is "squirming" in my upper stomach/lower chest area, and sometimes there's this certain heaviness that persists, especially in the lower right stomach (from where I face; if you were facing me, it'd be on the lower left) portion of my stomach. Sometimes it's in the middle of my stomach, kind of a bit lower, but in the middle. It's more annoying than anything else, but it's also concerning, and I want to get this addressed before/if it escalates.

I had an urine test earlier this month to rule out kidney stones/other UTI issues, and again, the CT scan in October (after my back gave out) showed no issues. The only thing I can think of that possibly could be wrong is appendicitis, because it's on the lower right of my stomach, but I have no other symptoms so far (diarrhea, constipation, etc), and the pain isn't sharp or acute. Just more uncomfortable and a bit annoying. It comes and goes, even if I don't eat a meal. Sometimes it's just a general heaviness, if that makes any sense.

To be clear, so far, I have had zero back pain since my back gave out in October. *knock on wood*

I emailed my doctor, but I do want to see what the community might suggest I could be experiencing, so I can add those as suggestions to my doctor. It's really perplexing, and kind of annoying. I wish I could describe it better. Hopefully some of you who had similar experiences can have suggestions on what's going on.

Many thanks!
posted by dubious_dude to Health & Fitness (24 answers total)
It's probably not appendicitis. Maybe gall bladder, since you noticed a connection with food.
posted by cooker girl at 5:03 PM on January 25 [3 favorites]

Response by poster: Oops, sorry, forgot to add very important and (I think) relevant info: taking a shower or bath, and laying down, usually helps with the discomfort, if not making it vanish completely. /end threadsit
posted by dubious_dude at 5:04 PM on January 25

Any change in bowel or bladder movements could be relevant info here I think. If you want to share.
posted by Emmy Rae at 5:21 PM on January 25

I believe your appendix is halfway between your bellybutton and the "crease" where your right leg meets your abdomen. Not near what you describe at all.
posted by SemiSalt at 5:22 PM on January 25 [1 favorite]

Mildly remote, but this turned out to be my issue:

...perhaps there's something still going on with your back musculature? I had a weird persistant pain in my lower right side, and after very expensive blood tests someone pointed out my stance was askew (left shoulder higher than the right). Sorting that out fixed the mystery ache.
posted by aramaic at 5:23 PM on January 25

Response by poster: @Emmy Rae: No, no change at all so far in bowel movements. Earlier this month, I had a bit of a harder time going urine, so got an urinalysis to test for UTI's, etc., but the test came back clean. Since then, that seems to have been resolved (normal urine movements). Only the odd stomach discomfort/pain (with or without meals as of recently) seem to be the issue here.
posted by dubious_dude at 5:26 PM on January 25

My gallstones showed up in an unrelated x-ray of my back. Sounds like you have gallstones, too, but you've probably had enough scans to see that.
posted by Snijglau at 5:38 PM on January 25

fever? can ya gently hop on your right foot?

(appendicitis clues)
posted by j_curiouser at 6:06 PM on January 25

Gallstones may not show without an ultrasound. They are not typically x-ray-able.

The differential of abdominal pain is enormous -- there is a lot of stuff in there, not to mention referred pain (crossed wires, essentially. this is why heart attacks can present as vague nausea/left arm tingling).

Just because you mentioned appendicitis: it's not sharp or acute pain until it ruptures. You don't want to get to that point. One of my colleagues once worked through a 24h shift feeling kinda off in the way you describe, stopped by the ED on her way home, and was in surgery by the afternoon. (worst postcall day ever). Another friend had what seemed like the exact same symptoms due to an ovarian cyst.

I'm not saying you have either of those things, but just to illustrate how totally different diagnoses can present the exact same way.

I hope you get to a doctor soon!
posted by basalganglia at 6:11 PM on January 25 [1 favorite]

Not to be indelicate, but do you have a gut/ love-handles? Is the sensation more towards the back (dorsal) or front (ventral)?

If towards the front, I'd advocate for yourself to get an ultrasound imaging. If towards the back, I'd inquire more about potential kidney issues.

If you don't have any "throbbing" symptoms, that also helps rule out kidney involvement.
posted by porpoise at 6:56 PM on January 25

Response by poster: @Porpoise: Definitely more in the front (ventral; that's a new term for me!). Also, no real throbbing sensations — more like a "bubbling" and "squirming" (like a bone is squirming), but not THROBBING.

I think I'll ask my doctor for a referral to an ultrasound — those are what detects gallstones, right? Not CT or X-Ray scans?
posted by dubious_dude at 6:58 PM on January 25

An ultrasound will detect whether there is a solid stuck in there.

But if it's an obvious other, ultrasound will pick it up and it's a 5 - 10 minute procedure. Maybe 15.

It's a handheld unit. The same thing for fetuses in a mother.
posted by porpoise at 8:08 PM on January 25

This sounds like it's pretty textbook gallbladder, from the "squirming" pain and the fact that it happens after you eat. It sounds like attacks are so far relatively mild* with a lot of referred pain in ways that are actually typical for a gallbladder but can muddy up a quick diagnosis. Even moreso if you're a dude/AMAB and under 40, because you're not fitting the oldschool typical patient profile.

*I not minimizing your very real pain. I'm saying that when your body turns up the volume on the attacks, that sensation is of relentless cruel waves of rolling spasms that seem like they'll abate if you shift positions but instead they fade out only a second before roaring right back.

IAMAD. I am a person without a gallbladder. I did an AskMe about it years ago; you can find it in my history.
posted by desuetude at 10:13 PM on January 25 [1 favorite]

Seems like it's not impossible that it could be a hernia.
posted by Artifice_Eternity at 11:25 PM on January 25 [1 favorite]

Do you use cannabis regularly? If so, read up on CHS (cannabinoid hyperemesis syndrome). It sounds a little like the first stage of that, especially since a shower makes you feel better.
posted by jkent at 12:51 AM on January 26

Unlikely, but gout?
posted by redlines at 1:54 AM on January 26

So, I know this seems counter-intuitive, but telling the doctor "I think I have gallstones/appendicitis/etc" is not going to help nearly as much as doing exactly what you've done here: describe your symptoms and what makes it worse/better.

What you want to avoid is the doctor's cognitive biases, and that's why open-ended questions like "what else could it be?" are fantastic. But "hey do I need an ultrasound" is going about it exactly backwards; it's going to skew the conversation in that one direction and not considering the other possibilities.

I could tell you a million stories about people who were misdiagnosed due to cognitive bias and inappropriate testing/treatment. Most of them I can't, because HIPAA, but one notorious example is Eleanor Roosevelt (or, for that matter, FDR, who did not, in fact, have polio).
posted by basalganglia at 3:02 AM on January 26 [9 favorites]

What about diverticulitis? Try going on a low fiber diet for a week and see if that resolves the issue. If so, likely diverticulitis. Also, a retired ER doc who is a friend told me that appendicitis usually means you stop eating. So, it seems like that is not likely the issue.
posted by eleslie at 5:30 AM on January 26

Response by poster: Good morning!

Wow, thanks for all of the replies! A bit of a follow-up here:

Do you use cannabis regularly? Not at all.

What about diverticulitis? I doubt it — so far, no pain at all with bowel movements, and no redness in my poop at all.

...perhaps there's something still going on with your back musculature? Possibly? How did you get that checked into? Did you go to a back specialist?

Seems like it's not impossible that it could be a hernia. Could be! Once I get the ultrasound done, and if it's clean/free of gallstones, I could also check into that.

So, I know this seems counter-intuitive, but telling the doctor "I think I have gallstones/appendicitis/etc" is not going to help nearly as much as doing exactly what you've done here: describe your symptoms and what makes it worse/better. Interesting! I thought by giving my doctor a laundry list of different possibilities, that would make their job easier and less daunting. I can see your point, though.

Thanks for the responses! What I will do now is ask for an ultrasound, to at least rule out (or in) gallstones. If none are detected, then I'll move on to a hernia and/or other possibilities.
posted by dubious_dude at 5:55 AM on January 26

I want to say this as gently as possible: given your posting history here, it's at least possible that this is anxiety. The reason I know this is that it's happened to me - I basically turned a routine bout of stomach discomfort into a multi-month saga that involved a CAT scan and a stool sample (the grossest thing I've ever done) purely through a combination of worrying and relentless attention.
posted by Ragged Richard at 6:15 AM on January 26 [7 favorites]

When I had gallstones some years ago, my attacks would generally start with a weird kind of grinding, clenching sensation in my "middle front" stomach area. I mean, it was pain, but it was more of a miserable sensation generally than a sharp pain, so it does sound like it could be something like that. (the attacks intensified to the worst pain I've ever felt [never had kidney stones or given birth though].) - if that data point helps.
posted by Occula at 7:25 AM on January 26

High fiber is now the recommended diet for diverticulitis. Just so you know. It is also possible to have the common bile duct to plugged up. The large intestine can loop down or displace if the mesentery gets torn. Lying down, putting your heels up near your buttocks, with a foot of distance between the heels, raise your buttocks a few times and feel if there is a shift back into the comfort zone.
posted by Oyéah at 5:00 PM on January 26

Interesting! I thought by giving my doctor a laundry list of different possibilities, that would make their job easier and less daunting.

Noooooo. It makes their job harder, because they have to untangle your actual objectively experienced symptoms from your confirmation bias after you read up on various diseases.

(I mean, that's what happens when you have a good doctor. With a less-good doctor, they'll get all cranky and possibly smarmy.)
posted by desuetude at 9:32 PM on January 26 [4 favorites]

My appendicitis presented very strangely. No real fever, no sharp stabbing pains, no nausea. I didn't catch it at first because it felt very similar to bad menstrual cramps/discomfort/gas plus the sensation of a slight stitch in my side. I did some telemedicine visits with my doctor and a nurse (this was height of the 2020 pandemic so didn't want to go in unless I absolutely had to) and their "press down on the area and see if it hurts when you let go" test was inconclusive. Neither one thought it was appendicitis.

Then I almost fainted in the hallway and decided to go to the ER. Yep -- appendicitis.
posted by egeanin at 11:19 PM on January 26

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