Epiploic Appendagitis

A sudden belly ache can sideline even the healthiest person. Abdominal pain is a common symptom of many different conditions from mild to life threatening. Epiploic appendagitis is a rare condition that can cause severe belly pain. It happens when blood flow is cut off from an area of the colon. You may hear the condition called primary epiploic appendagitis. It can be mistaken for appendicitis or diverticulitis.

Your healthcare provider can detect this condition with an ultrasound or CT scan. The condition usually goes away on its own.

About EA

Epiploic appendages are normal pouches of fat. They are found on the outside surface of the colon. Each pouch has its own blood supply that keeps it healthy. But these pouches can become twisted or blocked. This cuts off blood supply to the tissue. The result is pain, most commonly in the left lower abdomen. It can also cause tissue death (necrosis).

EA more often affects overweight men in their 40a and 50s. But can occur at any age and in women.

Symptoms of EA

Symptoms of EA are often vague and can be a sign of other conditions. They may include:

• Lower belly pain

• Feeling very full after eating

• Vomiting

• Bloating

• Diarrhea

• Low-grade fever

Your healthcare provider will ask you questions about your symptoms and will do a physical exam. They may order imaging tests like a CT scan or an ultrasound of your belly to help find the cause of your symptoms.

Treatment for EA

EA doesn't usually need to treatment other than over-the-counter pain medicines. If pain is severe, your provider may give you a limited prescription of opioids. Follow your provider's specific instructions. EA should go away on its own in a couple weeks.

Rarely, surgery may be needed to remove an inflamed fat pouch. Surgery is reserved for appendagitis when symptoms like fever, nausea and vomiting or pain do not resolve with conservative management. Some of rarer complications of appendagitis mentioned below may also require surgery.

Possible complications of EA

• One part of the intestine slides into the next, like a telescope. This is called intussusception.

• Bowel obstruction

When to call your healthcare provider

• Fever of 100.4°F (38.0°C) or higher, or as advised by your provider

• Chills

• Belly, pain, cramps, or tenderness that doesn’t get better with OTC medicines or seems to be getting worse

• Constipation, diarrhea, or changes in bowel habits

• Ongoing nausea and vomiting

• Bleeding from your rectum