Epiploic appendagitis is a condition that can cause severe stomach and abdominal pain. It’s relatively rare and has only recently become more easily noticed in the medical world. Because it’s not well known, it’s often misdiagnosed and confused with other conditions that also cause severe stomach pain. Epiploic appendagitis is relatively understudied, and research is in early stages.
What Causes Epiploic Appendagitis?
Small sacks of fat sit above your colon and large intestine. Appendagitis happens when the blood flow to these sacks is cut off or restricted. This may happen if there is inflammation of the tissue around the sacks. It can also happen if the sacks get twisted around themselves.
These sacks, or epiploic appendages, are sensitive. When the blood that flows to them is restricted, they become inflamed. Not much is known about epiploic appendages or their function, which is another reason why epiploic appendagitis is still such a mystery. Researchers have not yet discovered a crucial function for these epiploic appendages.
The inflammation is what creates such an intense and painful feeling in your abdomen. But even if the inflammation is not treated, it may go away. It has been found that epiploic appendagitis will go away on its own within two weeks if untreated.
Research is unclear on why certain people experience this condition. One study reported that epiploic appendagitis is more common in people over 20 who are overweight. But more research needs to be done before definitive connections can be made about what causes it.
Symptoms of Epiploic Appendagitis
Abdominal pain. Epiploic appendagitis is characterized by pain in the abdomen. The majority of cases take place in the right side of the abdomen, but you may experience pain on the left side of your abdomen, as well. This pain may feel severe and be difficult to ignore.
In most cases, you will only feel abdominal pain. Other symptoms are rare, but may include:
- Back pain
- Fever
- Nausea
- Vomiting
Epiploic appendagitis may also cause leukocytosis, which is a blood response to the inflammation. Leukocytosis brings an influx of white blood cells to the affected area. This symptom is rare, and you’re not likely to know that it’s happening unless you have a blood test done.
Diagnosis of Epiploic Appendagitis
You are most likely to be diagnosed with epiploic appendagitis after seeing your doctor for severe abdominal pain. Your doctor will order a CT scan and be able to see the epiploic appendagitis while reviewing your scans. They will look for thickening of your mid-bowel wall along with other visual cues. It’s possible to see the effects of appendagitis on a CT scan or ultrasound, but the changes can be subtle. For this reason, it can be easy to misdiagnose epiploic appendagitis as something else. Your doctor or the radiologist examining your scans must know what to look for.
Only 1% of people with abdominal pain are diagnosed with appendagitis, so it’s unlikely that this is the cause of any abdominal pain you may have.
The symptoms of epiploic appendagitis are very similar to those of other conditions, including:
- Appendicitis, which happens when your appendix is inflamed
- Infections of the digestive tract
- Ruptured ovarian cysts
- Pelvic inflammatory disease
It’s often misdiagnosed or thought of as one of these conditions because the symptoms are similar. Some of these conditions require surgery, but epiploic appendagitis doesn't. Getting the right diagnosis is important so that you can be treated for the right problem.
If you are diagnosed with epiploic appendagitis, you will either be diagnosed with normal epiploic appendagitis or acute epiploic appendagitis. Normal epiploic appendagitis is when the tissue that surrounds the sacks of fat near the colon becomes inflamed. Acute epiploic appendagitis is when the sacks of fat either twist or their blood flow becomes limited.
Treatment for Epiploic Appendagitis
Treatments for both types of epiploic appendagitis are relatively unobtrusive.
You will be given anti-inflammatory medicine by your doctor, and your symptoms should go away within one to two weeks. Your symptoms may go away without medication.
If you have severe abdominal pain, talk to your doctor right away. If it isn’t appendagitis, it could be one of the conditions with symptoms that are similar. These conditions are treatable, but they need to be cared for to avoid serious problems.
