Abdominal Pain: Is It Appendicitis or Just Muscle Strain?

Please ask your question?

Hello, Doctor.
I am currently studying high school abroad and would like to ask you a question.
After eating today, I lay on my bed and suddenly felt a sharp pain on the right side of my abdomen near the navel.
I don't feel it anymore, but I recently heard that a family member has appendicitis, and I'm a bit worried that I might have similar symptoms.
Could it be that lying down after eating caused this discomfort, or could it be related to muscle strain from my position? I have experienced similar pains before, sometimes on the left side and sometimes on the right, and it seems to vary in location.
However, when I get up and stretch, the pain usually goes away.
I hope you can help clarify this for me.
Thank you.

Iroha, 10~19 year old female. Ask Date: 2023/06/04

Dr. Liao Zhongxin reply Internal Medicine

A.
What is appendicitis? Appendicitis, medically referred to as acute appendicitis, is an inflammation of the appendix, located in the lower right abdomen.
When appendicitis occurs, patients may experience abdominal pain, nausea, vomiting, fever, and loss of appetite.
Common causes include fecalith obstruction, ascariasis, and less commonly, lymphadenopathy obstruction.
Statistics indicate that there is a 10% chance of developing appendicitis in a person's lifetime.
B.
Diagnosing appendicitis can be challenging, as it is necessary to rule out other conditions before a definitive diagnosis can be made.
Preliminary assessment methods include three questions: (A) Is the current abdominal pain different from past experiences? (B) Does the pain significantly worsen when hitting a pothole while riding in a vehicle or when jumping on one foot? (C) Does fasting alleviate the pain? The pain associated with appendicitis typically localizes to the lower right abdomen and may cause "rebound tenderness," which does not improve with fasting.
Once appendicitis is confirmed, surgical treatment is the primary approach, which can involve either traditional surgery or laparoscopic surgery.
Although antibiotics are sometimes used, they are not the most common treatment method, and surgical intervention may still be necessary.
Appendicitis is an acutely developing condition that can progressively worsen, so prompt treatment after diagnosis is essential to prevent potentially fatal peritonitis.
C.
Symptoms of appendicitis include abdominal pain, particularly focused in the lower right abdomen, and the presence of rebound tenderness (pain increases when jumping on one foot), nausea, vomiting, loss of appetite, and mild fever.
D.
Treatment for appendicitis: (A) Medical treatment: Antibiotics are primarily used, but their effectiveness is quite limited; generally, physicians will still recommend surgical treatment.
(B) Surgical treatment: In cases of early, non-suppurative, and non-perforated appendicitis with minimal adhesions, the surgery is less complicated, and recovery is quicker, with more options available.
Patients may undergo traditional appendectomy through a 2-3 cm incision in the lower right abdomen or laparoscopic surgery involving 3-4 small incisions in the abdomen to remove the inflamed appendix, typically allowing for discharge after about three days of hospitalization.
E.
Care considerations for appendicitis: After a diagnosis of appendicitis, it is crucial to undergo surgical treatment promptly to avoid complications.
After surgery, patients should strictly follow medical advice to prevent wound infection, regardless of the incision size.
Post-operative monitoring for abdominal distension and cramping is important, as these may indicate unresolved bowel function or adhesions.
If symptoms such as fever or chills occur, it is essential to seek medical attention for further evaluation.

Reply Date: 2023/06/04

More Info

When it comes to abdominal pain, particularly in the area around the navel and the right side, there are several potential causes that can range from benign to serious. Given your recent experience of sudden pain after eating and lying down, it is understandable to be concerned about conditions such as appendicitis, especially since you mentioned a family history of this condition.

Appendicitis typically presents with a gradual onset of pain that starts around the navel and then shifts to the lower right abdomen. This pain is often accompanied by other symptoms such as nausea, vomiting, loss of appetite, and sometimes fever. If the pain you experienced was brief and resolved quickly without any accompanying symptoms, it may not be appendicitis. Instead, it could be related to muscle strain or even gastrointestinal discomfort, especially since you mentioned that the pain occurred after eating and lying down.

Lying down after a meal can sometimes lead to discomfort due to increased pressure on the abdomen, particularly if the stomach is full. This can cause temporary pain or discomfort, which may feel sharp or cramp-like. Additionally, certain positions can strain abdominal muscles, leading to localized pain that can mimic internal organ pain.

If you have experienced similar pains in various locations (both left and right sides) and they resolve with movement or stretching, it is more likely to be related to muscle strain or tension rather than a serious condition like appendicitis. Muscle strain can occur from activities that involve the abdominal muscles, such as exercise or even prolonged periods of lying in a certain position.

However, it is crucial to monitor your symptoms closely. If you experience any of the following, you should seek medical attention promptly:
1. Persistent or worsening pain: If the pain does not resolve or becomes more severe.

2. Accompanying symptoms: Such as fever, vomiting, diarrhea, or changes in bowel habits.

3. Pain that worsens with movement: If the pain increases when you move or cough, it may indicate a more serious issue.

4. Changes in appetite or weight: Unexplained weight loss or a significant change in appetite can be concerning.

In summary, while your symptoms may not immediately suggest appendicitis, it is essential to remain vigilant. If the pain recurs or if you develop any new symptoms, it would be wise to consult a healthcare professional for a thorough evaluation. They may perform a physical examination and possibly imaging studies to rule out any serious conditions. Remember, it is always better to err on the side of caution when it comes to abdominal pain.

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