Brief Answer: A thorough clinical examination is required. Detailed Answer: Hi XXXX ! Good evening. I am Dr Shareef answering your query. Appendicitis is more of a clinical diagnosis than with an ultrasound. Many times there is mild recurrent attacks of appendicitis many times known as grumbling appendicitis. However, I would not jump on this diagnosis without a physical examination of yours and some more investigations like a complete blood count, and a CT scan of abdomen if need be after clinical examination. The management would vary accordingly. Although a urinary tract infection could give you similar symptoms, a negative urine culture report and absence of any urinary symptoms practically excludes it. If you eat frequently from outside, I could think collitis (possibly an amebic collitis if you stay in an area where this infection is found) as a possible culprit. I would go for a routine stool test for ova and cyst and if positive would treat it. Mildly enlarged prostate does not cause such symptoms, and is not of much significance without any urinary symptoms. For the mild hepatomegaly, I would advise you for a liver function test including a hepatitis B and C serology tests. Might prescribe you with some liver supportive therapy if need be. It is good that you are a non smoker and non alcoholic. With a such a mild derangement of the cholesterol level, I would advise you for a regular and routine aerobic exercise programme like a brisk walk or a jogging depending on your medical fitness. Also change your dietary habits towards more of roughage (vegetables and fresh fruits) and enough liquids, and avoid fried oily fast and fatty food. This should correct the problem for the time being. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing health care magic to clear doubts on your health problems. Wishing you an early recovery. Dr Shareef.

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