Acute Appendicitis Spontaneously-Resolved? but Triggering Existential Crisis in 41F Mother of Three : Seeking Guidance
Apologies in advance for any over-explaining or general verbosity. My health anxiety has definitely spiked from this experience. For brevity, feel free to skip the curly bracketed paragraphs.
BACKGROUND:
41 year old female, in generally good health with no past health concerns. Married with three children (7, 9, and 14).
I experienced classic presentation of acute appendicitis on Wednesday (2 July) with a sharp, pulling pain in my belly button after a long car ride around 2pm, followed by fairly severe pain and cramping in my lower right quadrant later that night. The pain woke me up around 2-3am and persisted for maybe two hours until I was able to go back to sleep. I also vomited three times and experienced sweating and chills.
At the time, I thought I had possibly pulled an abdominal muscle after sitting in the car for a while and attributed the rest to possible menstrual cramps because my period had started the day before. I also didn't eat very much lunch and dinner, which I thought could have caused the nausea and vomiting.
I rested in bed on Thursday and the pain never returned to the severity that I had overnight. My belly button and the LRQ area felt tender but not especially painful. But we decided to come home a day early, on Thursday, just in case the pain returned again. I felt generally fine on Friday (4 July), with only very minor tenderness, no pain, no fever, and a full appetite.
{All of this happened while out of town on a family trip, which factored into the decision of not immediately going to an emergency room. Appendicitis was also not at all on my radar at the time, and I thought it could just be a pulled muscle and period pain. (Despite generally not having very painful cramping, but my periods have gotten heavier at times in my 40s. I thought it might just be another lovely perk of perimenopause.)}
I decided to go to Urgent Care on Saturday (5 July) to rule out a possible UTI/umbilical hernia/ovarian cyst that I thought may have caused the initial acute pain. Because of the location and classic presentation of the pain, I was sent to the ER for a CT scan to check my appendix. CT scan was inconclusive, but suggested possible mild acute appendicitis, with slight dilation (of 7mm, with a 6mm cutoff) and mild wall edema. No fecalith, no blockage, no masses.
I was given the option of an appendectomy (the following morning) or antibiotic treatment, and decided on antibiotics only and staying overnight for observation.*
I received IV antibiotics (Piperacillin/Tazobactam) overnight and was sent home the next day with a 10 day course of Augmentin. The surgeon I spoke to the morning of discharge was supportive of this approach, as I was showing no signs of pain after repeated abdominal palpations, no elevated WBC or inflammation markers, and no fever. He even said "I don't think you have appendicitis" during the consult, which I found very reassuring at the time, mostly because I was afraid of being pushed towards the surgical route and not being discharged that day. I have a follow-up appointment with him scheduled for two weeks from now to discuss an interval appendectomy and future colonoscopy schedule.
{*To further over-explain my thought process, I was very tired after a long ER wait, completely taken back by the CT results, and fairly terrified of the idea of immediate surgery, which I've never had before. I'm also generally of the mindset of wanting my body to remain as intact as possible and I didn't want to lose an organ that appears to assist in immune function, unless I absolutely needed to. And with no acute symptoms at the time, I wasn't convinced immediate surgery was warranted.
Also, one of the ER physicians was comfortable with me going home that night and returning on Monday for further evaluation, so that didn't give me the impression of an acute emergency at the time. I ended up staying overnight for observation only after a second ER physician pushed for it.}
No new symptoms since returning home, aside from diarrhea/loose stool from the Augmentin. Started a probiotic yesterday and had solid stool this morning (9 July, Day 3 of Augmentin). I'll occasionally feel some minor rumbling/general tenderness in abdomen in the hour or two after Augmentin dose, but that's lessening more today.
Since returning home, I have been researching everything I can about appendicitis and the appendix, in general. Basically driving myself crazy, second guessing my decision and the next steps that need to be taken.
Which brings me here.
QUESTIONS/CONCERNS: -- What are the odds that my acute appendicitis spontaneously resolved on its own? -- What are the odds that my appendix actually perforated/burst early Thursday morning? Providing the subsequent pain relief, with zero follow-up pain/signs of infection or sepsis? Is that even possible?
-- Accepting the risk of future recurrence, how risky was it (in your opinion) for me to choose the non-operative/antibiotic only approach, given that the acute episode has happened three days prior to my hospital admission?
The non-operative approach seems far more accepted outside of the US (where I'm located), but the studies supporting this are fairly recent and very much up for debate.
-- What should my next steps be, to alleviate my concerns?
As a mother of three young boys, I'm completely terrified by the studies that suggest acute appendicitis in patients over 40 may be an early warning sign of colon or other cancers.
Extremely rare as it may be, appendix cancer is probably my greatest fear at the moment. [This reddit thread] (https://www.reddit.com/r/cancer/comments/174aazv/comment/ljy490z/) kept me up last night, utterly dreading that I may have irreversibly doomed myself to cancer cells potentially dispersing throughout my abdominal cavity as I slept.
Thank you to anyone who's actually made it this far. I know how I must sound.
Absolutely any guidance or feedback would be appreciated.
Thank you in advance
Posted Jul 9, 2025, 11:26 PM UTC