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Lower abdominal pain?

Lower abdominal pain. What to do?

  • Lower abdominal pain and tenderness. What do do? YANMD, I know. I am male, 29, never had something like this happen before. Starting yesterday morning, I had a pretty sudden onset of a pain directly in the middle of my lower abdomen, between my belly button and hip. It comes and goes, at its worst it's like a really bad gas pain. In addition, this same area of my abdomen is extremely tender, hurts when I sit down, lay down, stand up, or move in pretty much any way that involves the area. I went to my doctor yesterday afternoon, he checked me out, gave me a urinalysis, and scheduled an ultrasound on Monday. Dr. called today to say that the urinalysis indicated no blood or sign of infection. I've had no nausea or vomiting. I don't actively feel like eating, but I can eat. Last night I spiked a fever of about 102-102.5f, it broke sometime this morning. Now I am back up to about 100.5f. I can pee, I can poop, I can pass gas. When I belch, it sets off a temporary flare in the pain. Coughing hurts a LOT. The right side does not hurt more or differently than the center or left. My doctor doesn't seem overly concerned about what would happen to me between now and Monday, but increasingly I am as it seems that most lower abdominal stuff is "ER- NOW" territory.

  • Answer:

    Most patients with appendicitis have a normal urinalysis. FWIW your symptoms exactly mirror mine; a GP was convinced I was fine because I didn't have the standard abdominal tap reaction and my urine was fine. My symptoms were not severe enough to transfer me to the ER until my appendix ruptured and put me on her floor. I would go, for sure.

rollbiz at Ask.Metafilter.Com Visit the source

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I am a critical care doctor. If I had the kind of pain and fevers you are describing, I'd be writing this post from the Emergency Department.

drpynchon

Are you insured? YES -- ER (if you have a decent one) or an urgent care clinic. NO -- 1. Go to an urgent care clinic as you can be seen immediately but not get stuck with the astronomical ER bill. As anniecat said, just handle it as having not been seen by anyone. 2. If you can't find an urgent care clinic or you're not happy with how they handled your visit, get at 7 or 8 am and go through the phone book listings for doctors. Offer to show up in an hour and see if they can fit you in. Again, if asked, you don't have a regular doctor. 3. If no dice or you get worse after an urgent care clinic visit or a doctor visit, then go to the ER. And switch doctors... you have abdominal pain and fever, and he wants to run some tests next week? Holy cow.

crapmatic

Fever + abdominal pain? Yeah, call your doctor's office. If they aren't helpful, head to the ER.

zug

Update: I went to the ER about an hour after making this post. Went through a battery of tests, including a CT scan of the area. It turned out to be colitis caused by some sort of infection in my colon, not far off the mark from what Honoriaglossup mentioned. They wound up admitting me to the hospital, and told me I'd be there for a few days of IV antibiotics and morphine for pain-management. I'm happy to report that I actually just got out of the hospital a day before their best case scenario date, because strong antibiotics were exactly what I needed and today I was able to demonstrate that I can eat and keep myself hydrated on my own without my digestive system betraying me. I'm definitely not all the way better yet, and I have another nine days of antibiotic regimen, bed rest/restricted diet, and follow-up exams to go, but the difference between how I feel right now and how I felt 24 hours ago is astounding. In addition, I now have the ease-of-mind that what is making me feel like this isn't going to kill me, which is...you know...huge. Thank you to everyone who weighed in here, you all really did serve as the final tipping point and I am so glad I'm not still sitting here doubled over in pain and freaking out because I don't know why. I most likely would've wound up in the ER anyway, but after much more suffering and a much larger infection. A special thanks to scrump who dropped me an email with advice and followed up to see how I was doing. And yes, I am lucky enough to have what would be considered decent insurance in the US. Our co-pays for major events are pretty high, so this has all cost me almost a grand thus far, but it could've been a lot worse. Sorry if this is disjointed, but I'm on painkillers and I don't think super-well on those. Anyway, the point is: Thank you everyone!

rollbiz

Yeah so general rule of thumb; if your body is saying "take me to the ER" you should let it call the shots.

mckenney

Glad to hear the (relatively) good news. Now call your doctor, tell him the story, and to go fuck himself 'cause you're finding a new doc.

Simon Barclay

L'Estrange Fruit

Call your doctor's office again and bug them; if they can't help, you might want to go to the ER.

infinitywaltz

IANAD but this certainly sounds like appendicitis so listen to everyone else and go to the damn ER.

awesomebrad

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