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How is chronic appendicitis treated ?

Hi, i am 27 years old and i have been experiencing lower right abdominal pain for about half a year. The pain is constant and it becomes worse after i have any form of bowel movement or bending movements. I did an ultrasound scan and nothing wrong was found with my reproductive organs. Subsequently, i saw a colorectal specialist who initially thought that my constipation problem is causing the pain. However, after being on mild laxatives for 3 weeks, the pain did not improve of go away. The doctor says he is unsure of what is wrong with me. I have also sought help alternatively from Traditional Chinese Medicine who has diagnosed me with Chronic Appendicitis . Basically, he identified this condition by first pressing on the lower right quadrant of my abdomen (where the pain is). After which, he lifted up my right leg and pressed on the same spot again and that set me off into a yelping pain in which i literally jumped up a little from the bed. Hence, i will like to seek other opinions as to what can be causing this constant lower right abdominal pain. Is it indeed a condition of chronic appendicitis? This is bearing in mind that the pain intensifies after bowel movements or during any bending motions. Thank you very much for your kind help and time.
Asked On : Sun, 22 Apr 2012
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Addiction Medicine Specialist 's  Response
Hello. There is such a thing as chronic appendicitis. This usually occurs when fecoliths (small rock-hard pieces of stool) get inside the appendix stump and cause inflammation. The pain you described with right leg flexion is characteristic of a "psoas sign" which helps support this diagnosis. In "chronic" appendicitis, the omentum (a curtain of fat overlying the gut) will usually start sticking to the inflammed portion of gut, causing more discomfort that can be constant.
Alternative diagnosiis would include diverticular disease, irritable bowel syndrome, functional constipation, or ovarian pathology.
The most usefull test in this case would be a Cat-Scan of the abdomen and pelvis with PO/Rectal and maybe IV contrast. If normal, I would then order a colonoscopy.
If it is chronic appendicitis, this could be potentially dangerous. It usually responds to a long coarse of antibiotics, which can also be considered empircally if you dont have access to testing.
Answered: Sun, 22 Apr 2012
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