A person who has pain in their appendix might have a condition called appendicitis. This pain often begins around the belly button and then moves to the lower right side of the abdomen. Appendicitis happens when the appendix, a small, finger-like organ on the right of the abdomen and connected to the large intestine, becomes inflamed, swollen, and filled with a substance called pus. The exact purpose of the appendix is not clear, and people can live without it.
Appendicitis usually occurs because something blocks the inside of the appendix. This blockage can lead to problems with blood flow, cause inflammation and infection, and increase pressure inside the appendix. If not treated, the appendix can burst, which is very serious.
While appendicitis can happen to anyone, it is most common in teenagers and people in their 20s.
Signs and Symptoms
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the most usual sign of appendicitis is lower stomach pain that begins around the belly button and then moves to the lower right side of the abdomen. This pain can increase with movement, sneezing, coughing, or deep breaths and may become severe within a few hours.
Other symptoms of appendicitis include swelling of the abdomen, fever, loss of appetite, nausea, and vomiting. In children, appendicitis may not always present typical symptoms. Additionally, although rare, a person with appendicitis might feel a often and urgent require to urinate.
Anyone experiencing continuously worsening abdominal pain should seek treatment immediately. While other conditions, like urinary tract infections, can have similar symptoms, they also need immediate medical care.
Acute Appendicitis
Acute appendicitis is the most usual kind of appendicitis and typically develops quickly, usually within 24 hours. It is a medical emergency that requires prompt attention because the appendix can burst, especially if treatment is delayed for 2-3 days after symptoms begin.
Chronic Appendicitis
Chronic appendicitis is less usual and lasts a longer time than acute appendicitis. According to a 2015 article, chronic appendicitis causes a less severe but ongoing pain that can last for weeks, months, or even years. Unlike acute appendicitis, it is not considered a medical emergency.
To determine chronic appendicitis, doctors use a CT scan. Treatment typically involves surgery to remove the appendix.
Diagnosis
When diagnosing appendicitis, a healthcare provider will start by examining the patient and asking about their signs. They may press on the lower part of the abdomen to see if it makes the pain worse.
If the healthcare provider observes the typical symptoms and signs of appendicitis, they can diagnose it on the spot. If the symptoms aren’t clear, the doctor will order additional tests to make sure.
These tests might include:
- Blood tests
- Imaging tests
- Urine tests
Treatment
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the first step in treating appendicitis is usually prescribing antibiotics. In some events, antibiotics alone can effectively treat the condition, and surgery may not be needed. However, most patients will require surgery to remove the appendix.
Operative Options for Appendicitis
There are two main surgical options for removing the appendix: laparoscopy and open surgery.
Laparoscopy
Laparoscopy, also known as minimally invasive surgery (MIS), involves making a small cut and results in minimal blood loss. This procedure allows for a faster recovery time and less scarring compared to open surgery. During laparoscopy:
- The doctor inserts a thin tube called a laparoscope, which has a small video camera with light, into the lower stomach through a hollow device called as a cannula.
- The doctor views a magnified image of the inside of the lower stomach on a monitor.
- small instruments, controlled by the surgeon’s hand movements, are used to remove the appendix through small abdominal cuts.
Open Surgery
Open surgery involves making a larger cut in the abdomen. This method is used in specific cases, such as when:
- The appendix has burst, and the infection has extended.
- An abscess has formed due to the appendix.
- The tumors are present in the patient’s digestive system.
- The patient is in the late stages of pregnancy, specifically the third trimester.
- The patient has undergone several abdominal surgeries previously.
After open surgery, the patient will receive intravenous antibiotics to prevent or treat any infection.
Recovery Time
After keyhole (laparoscopic) surgery, most people can go home within 1 day. During the first several days, they might experience pain, constipation, and bruising. Some people also feel pain at the end of their shoulders. This happens because the doctor sends gas into the lower stomach during the surgery, which can irritate the phrenic nerve near the diaphragm, causing pain that is felt in the shoulder, known as referred pain.
Prescribed medicines can help manage this post-surgical pain.
If open surgery is required, or if there are complications like peritonitis, the hospital stay might extend up to a week.
After the laparoscopic procedure, it’s important to restrict physical activities for 3–5 days. Following a laparotomy (open surgery), physical activity should be avoided for 10–14 days. The doctor will provide specific advice on how much activity is appropriate at every stage of recovery.
Symptoms of Infection
It’s crucial to contact the doctor if there are signs of infection, such as:
- Swelling and worsening pain
- Persistent vomiting
- High fever
- The surgical site feels hot to the touch
- Pus or discharge from the surgical site
Prevention
Currently, there is no correct evidence to prevent appendicitis. However, being aware of the symptoms and signs and knowing when to contact a healthcare provider can be helpful in early detection and treatment.
Appendicitis in Pregnancy
Appendicitis is the most usual emergency surgery not related to pregnancy that occurs during pregnancy. Diagnosing appendicitis during pregnancy can be challenging because the typical symptoms may not always be present, and they can overlap with symptoms of pregnancy itself.
Symptoms of appendicitis in pregnancy include nausea, pain, loss of appetite, throw up, and high temperature. Atypical symptoms may include gas, heartburn, diarrhea, or constipation. Conducting a physical examination can be challenging depending on the pregnancy stage. Biochemical markers used in laboratory tests for appendicitis may not be reliable during pregnancy, so imaging tests might be necessary for diagnosis.
Like in non-pregnant individuals, appendicitis during pregnancy is commonly caused by a blockage that leads to infection and inflammation. The procedure to eliminate the appendix is often the recommended treatment.
Complications
Appendicitis can lead to several potential complications, including:
Peritonitis
If the appendix cuts and releases infection into the lower stomach, it can cause peritonitis. It is a serious condition characterized by inflammation and infection of the peritoneum, the membrane lining the abdominal cavity and covering most abdominal organs. Symptoms may include stopped bowel movements, bowel blockage, fever, and shock. Peritonitis needs urgent medical treatment.
Abscess
Sometimes, if the infection leaks from the appendix and combines with intestinal contents, it can form an abscess. Left untreated, an abscess can lead to peritonitis. In some cases, antibiotics may be sufficient to treat an abscess. However, often a healthcare provider will need to drain the abscess surgically using a tube inserted into the lower stomach.
Other Complications
Additional complications of appendicitis may include:
- Ileus is a condition caused when the bowel does not function properly.
- The fistula is an abnormal link between the intestine and stomach.
- Small bowel obstruction.
- Infection at the surgical place.
These complications can be life-threatening. Therefore, anyone who suspects they may have appendicitis must consult a doctor immediately.
When to Consult a doctor
If you have any symptoms of appendicitis, it’s important to contact a doctor or go to the emergency room right away. Appendicitis is a severe condition that needs immediate medical attention. Don’t wait if you experience symptoms like abdominal pain, nausea, vomiting, fever, or loss of appetite. Getting prompt treatment can help prevent complications and ensure your health and safety.
Summary
Appendicitis is a serious condition that requires prompt medical attention. Symptoms include abdominal pain, nausea, vomiting, fever, and loss of appetite. Diagnosis may involve physical examination, blood tests, and imaging tests. Treatment options include antibiotics and surgery, depending on the severity. Complications such as peritonitis and abscess formation can arise if left untreated. It’s crucial to contact a doctor immediately if appendicitis symptoms occur.
