<s>[INST] I m concerned that I have appendicitis. My symptoms are excruciating cramps in the middle of my lower abdomen. The pain is in my lower back as well. I have nausea that comes and goes, I have not thrown up, but I feel as though i could. I m on the fourth day of my period with an extremely light flow, and my periods usually last no more than 5 days. I have never had cramps this late in my period. I took Aleve about an hour ago. The pain has subsided now for the first time in 3 hours. Can you advise on whether or not emergency care is necessary? [/INST] HI, thanks for using Chat Doctor Appendicitis would normally present with pain in the right lower abdomen. It would be associated with fever, loss of appetite, vomiting. The diagnosis of appendicitis would require examination of your abdomen looking for certain signs of this infection. The fact your pains are in the middle of your local abdomen, and you are present having your period would more likely point to this being a cause of your pain. If you remain unsure, you can visit your doctor for an evaluation. I hope this helps </s>