Brief Answer:
Please get your condition confirmed after consulting the surgeon

Detailed Answer:
Hi XXXX
Thanks for writing in to us.

I have read through your query in detail.
Please find my observations below.

1. Appendicitis is one of the important causes of moderate to severe pain in right lower abdomen. In appendicitis, the pain is usually recurrent in nature in the beginning and soon becomes continuous and is aggravated on coughing, bending and tightening of muscles. It also causes symptoms like nausea, vomiting, occasional diarrhea and loose stools.

2. Appendicitis is always to be confirmed clinically after consulting a surgeon. They will look for a phenomenon called rebound tenderness. In this maneuver, the right lower abdomen is deeply palpated with the hand and released suddenly, appreciation of pain at that time is called rebound tenderness and is a sign of acute appendicitis.

3. Some people continue to have bouts of sudden pain which are mild to moderate in nature and the patient might stay asymptomatic for few weeks in between. This is seen in chronic appendicitis.

4. If clinically suspected, appendicitis must be reviewed using ultrasound scan and if required CT scan of the abdomen. Ultrasound is a quick technique and shows an inflammed appendix in over half the patients. There are other conditions that might mimic acute appendicitis and if the ultrasound scan is indecisive then CT scan is asked for.

5. Other causes of right lower abdominal pain in a 70 year old male includes the following
(i) diverticulitis
(ii) stone in right kidney and ureter
(iii) inflammation of distal small bowel
(iv) inflammation of proximal large bowel
(v) lymph node enlargement in the mesentery
(vi) inflammatory conditions like epiploic appendagitis
(vii) any mass or tumor in the region

6. Keeping in mind your symptoms and their recurrence it is suggested that you consult the surgeon at an emergency room and get your diagnosis confirmed.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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