Post-Antibiotic Appendicitis: Ongoing Discomfort - Gastroenterology and Hepatology

After antibiotic treatment for appendicitis, there are still unusual symptoms?

On January 28, I experienced severe pain in my lower abdomen while walking and was unable to lie on my side.
The emergency diagnosis suspected early appendicitis (the doctor mentioned it was 0.7-0.9 cm).
I was hospitalized that day, and the pain subsided.
After three days of antibiotic treatment, I returned home without any issues.
However, starting from February 17, I occasionally feel a subtle sensation in my lower right abdomen, with a few sudden, minor sharp twinges each day.
It's not painful, just a noticeable feeling.
My bowel movements are normal and regular, and it doesn't affect my daily life.
It just catches me off guard at times, and I am starting to worry about a possible recurrence of appendicitis.
I wonder if this could be related to intestinal motility?

Niming, 20~29 year old female. Ask Date: 2024/02/19

Dr. Lin Minghui reply Gastroenterology and Hepatology

Right lower abdominal pain should be monitored, and regular bowel movements should be maintained.
Differential diagnoses for right lower abdominal pain include appendicitis, gastroenteritis, diverticulitis, gynecological issues, urinary tract problems, and gastrointestinal dysfunction.
Generally, appendicitis may recur after antibiotic treatment, and most cases of appendicitis are recommended for appendectomy.
Continued follow-up is advised.
Best wishes for your health!

Reply Date: 2024/02/19

More Info

Post-antibiotic appendicitis can be a perplexing situation, especially when you experience ongoing discomfort after an initial diagnosis and treatment. Your symptoms, which include occasional mild sensations in the right lower abdomen, can be attributed to several factors, and it's important to understand them in the context of your recent medical history.

First, let's consider the nature of appendicitis. Appendicitis is an inflammation of the appendix, often requiring surgical intervention if it progresses. However, in some cases, especially when diagnosed early, antibiotics can effectively manage the condition without surgery. Your experience of pain subsiding after antibiotic treatment suggests that the inflammation was likely controlled, but it does not completely eliminate the possibility of lingering sensations or discomfort.

The sensations you describe—occasional mild "stabbing" feelings—could be related to several factors:
1. Post-Inflammatory Sensitivity: After an episode of appendicitis, the tissues in the abdomen may remain sensitive for some time. This sensitivity can manifest as unusual sensations or discomfort, even after the inflammation has resolved. The body may still be in a healing phase, and the nerves in the area can be hyperactive, leading to sensations that can be alarming but are not necessarily indicative of a serious problem.

2. Gastrointestinal Motility: The gastrointestinal tract is a dynamic system, and the movements of the intestines (peristalsis) can sometimes cause sensations that feel like discomfort or mild pain. If your bowel movements are regular and you are not experiencing any significant changes in your digestive habits, it is possible that these sensations are simply a result of normal gastrointestinal activity.

3. Psychological Factors: After experiencing a medical issue like appendicitis, it is common for individuals to become more aware of their bodies and to interpret normal sensations as concerning. Anxiety about the potential for recurrence can heighten your awareness of bodily sensations, leading to a cycle of worry and discomfort.

4. Residual Effects of Antibiotics: Antibiotics can alter the gut microbiome, which may lead to changes in digestion and bowel habits. While you mentioned that your bowel movements are regular, the balance of gut bacteria can still be affected, potentially leading to sensations of discomfort as your body readjusts.

Given that your symptoms are mild and do not interfere with your daily life, it may be reassuring to know that many individuals experience similar sensations after an episode of appendicitis. However, it is crucial to monitor your symptoms. If you notice any significant changes, such as increased pain, fever, changes in bowel habits, or any other concerning symptoms, it would be wise to consult your healthcare provider.

In summary, while your ongoing discomfort may be unsettling, it is often a normal part of the recovery process after appendicitis. Understanding the potential causes of your symptoms can help alleviate some of the anxiety associated with them. If you continue to have concerns or if your symptoms worsen, do not hesitate to reach out to your healthcare provider for further evaluation and peace of mind.

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