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Suggest Treatment For Epiploic Appendagitis, Pain And Inflammation In Abdomen

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Posted on Sat, 27 Jun 2015
Question: I recently went to a urgent care facility because I was having right lower abdomen pain. The doctor there suspected I had appendicitis and send me to the ER for a CT scan. After having the scan the ER doctor said I didn't have appendicitis but had Epiploic Appendagitis. That was Monday. I'm running a 100-101 fever still having lower abdomen pain. Constipated as well. The only medication the ER doctor gave me was some naproxen and hydrocodone for pain and inflammation. Are the systems I'm having normal or should I be concerned about something else.
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Answered by Dr. Bonnie Berger-Durnbaugh (1 hour later)
Brief Answer:
Usually better in 10 days.

Detailed Answer:
You should be getting gradually better with the NSAID you were given (naproxen). If you had the CT on Monday and you are not getting worse, I'd give it another couple days to see if it is starting to improve. Epiploic Appendigitis usually resolves within 10 days.

BUT, if you feel you are getting worse such as higher fever or worsening abdominal pain, then do go back to the ER asap.

A CT can distinguish Epiploic Appendigitis from appendicitis because with EA, the inflammation is in the appendage part and not in the bowel wall. The CT is usually accurate and saves people from having unnecessary surgery, but there can be error in how it is read or what the CT shows. And there are a few other things that can mimic EA (for example acute diverticulitis).

The meds the ER dr. gave you are pretty standard - NSAIDs treat the inflammation, and the hyrdrocodone helps (in addition to the NSAID) with the pain. Antibiotics are not routinely prescribed for this.

The constipation can be either from the EA or from the hydrocodone (narcotics slow down the bowel motility). You can try a stool softener such as dulcolax for right now.

If you don't start to see at least some improvement (regarding pain and fever) in the next few days, then it is time to be reevaluated.

Also - it should COMPLETELY resolve. If you continue to have fevers or pain after a couple weeks, then you should be seen again.

I hope this information helps. Please let me know if I can provide further clarification or information. And I hope you start feeling better soon.
Note: Revert back with your health reports to get further guidance on your gastric problems. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Bonnie Berger-Durnbaugh

General & Family Physician

Practicing since :1991

Answered : 3133 Questions

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Suggest Treatment For Epiploic Appendagitis, Pain And Inflammation In Abdomen

Brief Answer: Usually better in 10 days. Detailed Answer: You should be getting gradually better with the NSAID you were given (naproxen). If you had the CT on Monday and you are not getting worse, I'd give it another couple days to see if it is starting to improve. Epiploic Appendigitis usually resolves within 10 days. BUT, if you feel you are getting worse such as higher fever or worsening abdominal pain, then do go back to the ER asap. A CT can distinguish Epiploic Appendigitis from appendicitis because with EA, the inflammation is in the appendage part and not in the bowel wall. The CT is usually accurate and saves people from having unnecessary surgery, but there can be error in how it is read or what the CT shows. And there are a few other things that can mimic EA (for example acute diverticulitis). The meds the ER dr. gave you are pretty standard - NSAIDs treat the inflammation, and the hyrdrocodone helps (in addition to the NSAID) with the pain. Antibiotics are not routinely prescribed for this. The constipation can be either from the EA or from the hydrocodone (narcotics slow down the bowel motility). You can try a stool softener such as dulcolax for right now. If you don't start to see at least some improvement (regarding pain and fever) in the next few days, then it is time to be reevaluated. Also - it should COMPLETELY resolve. If you continue to have fevers or pain after a couple weeks, then you should be seen again. I hope this information helps. Please let me know if I can provide further clarification or information. And I hope you start feeling better soon.