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jbmd
jbmd, Board Certified Physician
Category: Medical
Satisfied Customers: 615
Experience:  Board Certified physician in Internal Medicine - 30+ years experience
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I feel sick almost like i want to be sick and i have severe

Customer Question

I feel sick almost like i want to be sick and i have severe pain in the lower right abdominal area, it keeps coming and going but i am doubled up with pain to the point of tears, i have been told for the last 12 years it is a grumbling appendix but this is the worst it has EVER been, i cant walk im in so much pain, but last time i went to hospital they did several tests and told me they couldnt find anything wrong but there has to be SOMETHING wrong if im feeling sick and doubled over in pain, i know appendics pain is normally constant but could i be developing early stages of full blown appendicitis? please help as i dont know what to do my husband wants me to call 999 but im afraid that they will say nothing is wrong with me again. Thanks Mrs Laura Pankhurst oh ps i am not pregnant that is impossible.
Submitted: 3 years ago.
Category: Medical
Expert:  jbmd replied 3 years ago.

jbmd :

Hi--are you available to chat?

JACUSTOMER-jxdmhufa- :

yes

jbmd :

I have seen symptoms like yours before, including off-and-on appendicitis

jbmd :

The appendix is a little worm-like hollow organ off the end of the small bowel where the large bowel starts.

jbmd :

It has a lot of lymph nodes in and around it and if they get irritated they can swell and close off the appendix opening and pus builds up and causes pain.

jbmd :

Sometimes the obstruction at the end, from the swelling or from a bit of food/bowel movement, moves out of the way, the appendix empties and the pain goes away BUT

jbmd :

I have also seen this kind of pain from endometriosis and from adhesions from surgery AND

jbmd :

Even just from gas building up from irritable bowel.

jbmd :

I have seen women in the ER with pain EXACTLY where the appendix.

jbmd :

and then, waiting for their tests to come back, they suddenly feel better.

jbmd :

Are you having nausea or vomiting or constipation or diarrhea?

JACUSTOMER-jxdmhufa- :

my bowels are fine but i have been sick and now i just feel sick almost to the point i actually want to be sick

JACUSTOMER-jxdmhufa- :

the pain started this morning but has gradually gotten worse throughout the day that i in tears with it

jbmd :

Is it tender to touch if you push GENTLY at the right lower side of your belly?

JACUSTOMER-jxdmhufa- :

yes, i layed on my bed and did the pressure check like a doctor would do, it really hurts when pressing but even worse after letting go.

jbmd :

Well, that is the classic test for appendicitis--you'd better go get checked out. The test these days is a localized CT scan of the belly where the appendix is or an ultrasound.

jbmd :

Then, if they say it isn't that, please come back and I'll work with you some more.

jbmd :

(I want to know if you ever had any abdominal surgery)

JACUSTOMER-jxdmhufa- :

my temp is 37.5 i have been told nothing is wrong after having those tests before, but this is the worst the only surgery i have ever had is an emergency c section in november 2008.

jbmd :

The risk of a ruptured appendix is peritonitis. This could also be an ovarian cyst (if you have your ovaries--when you say pregnancy is impossible, I am not sure of you having them) or a problem in your Fallopian tubes.

jbmd :

C-sections, any pelvic surgery, can cause adhesions--thin filmy sheets of scar tissue like the silver skin on meat and they can tie an area down or the incision can have the gut scar to it and gas can't pass easily.

JACUSTOMER-jxdmhufa- :

what i meant by immpossible was the fact that i havent had sexual intercourse for the past 15 months and i have a 'thing' in my arm too.

jbmd :

But if this is the worst, you need to be checked out.

jbmd :

Then it's NOT a pregnancy--just the lack of sex is enough!

JACUSTOMER-jxdmhufa- :

Haha like that little comment!! i think i best get in touch with my out of hours gp service then?

jbmd :

37.5 temp is not really up--just the irritation and pain is enough!

jbmd :

Yes. I wish I could say, "It was always for nothing before, so it's for nothing now" but obviously you only know that after the pain is gone. The risk is too high to wait.

jbmd :

Still if it's NOT appendix, I listed the things it could be above.

JACUSTOMER-jxdmhufa- :

i always thought that appendicitis included high temp, vomiting and constent severe pain this is why i am unsure about it as i do have severe pain in the lower right abdomen area, and i have brought my lunch back up and still feel sick but pain is coming and going in very bad spasms

jbmd :

(The hormones in your arm help keep away endometriosis, too)

jbmd :

Appendicitis can vary from classical presentation--it is spasmodic until it gets so bad it's near rupturing and then if it ruptures...peritonitis

jbmd :

If it were always classic and easy to diagnose, we wouldn't need CT scans and ultrasounds. would we?

jbmd :

Early appendicitis can be like early pregnancy. By the time you're dead sure without any tests, it's late in the game

JACUSTOMER-jxdmhufa- :

well i know something is causing the pain but what if nothing shows up on ct scan then what??

jbmd :

Then you have to consider adhesions and irritable bowel or Crohn's (if you have chronic diarrhea, esp with blood--or even not.

jbmd :

But they cannot let you live with this forever, not knowing when it's going to double you over.

jbmd :

I've had people get better with IBS gas pain off free carbs, with meds, etc. Some always got pain about where the appendix is because that's where the ilio-cecal valve is, too

JACUSTOMER-jxdmhufa- :

ok think i better pick the phone up and call my out of hours gp service and make sure its nothing that is life threatening like appendicitis, my husband has had it and he told me it could be that by the way im doubled over in pain but i will get checked out to be on safe side, thank you for your advice.

JACUSTOMER-jxdmhufa- :

one question? would they remove the appendics if they are unsure weather it is them or not?

jbmd :

Yes, that's what I want all along--for you to get care--the one time you don't go is when it could be the appendix

jbmd :

Only if they decide there is cause to do surgery. Here they often take the appendix in c-sections so you never have to consider it.

JACUSTOMER-jxdmhufa- :

the reason i havent bothered recently is because i have delt with it for 12 years the only reason im concerned now is because like i said it is the worst it ever has been before

jbmd :

But like I said, the c-section could have caused scarring in the area.

JACUSTOMER-jxdmhufa- :

so it could be a number of things including the scar? hmmm definetly going to get it checked out thanks : )

jbmd :

It could be appendix or gas trapped. You must determine which with your doctor. If I could reach across the ocean, examine you, CT or US you, and treat you, I would! But I can only give advice--go call! Tell me later what was up!

JACUSTOMER-jxdmhufa- :

ok i will bye.

jbmd :

Refer to this for other things it could be. They need to work it out for you. 12 years makes me suspicious for IBS as but check out is required.

jbmd :

Bye!

Expert:  jbmd replied 3 years ago.
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