Published on May 08, 2019 and last reviewed on Oct 05, 2023 - 5 min read
Abstract
Inflammation or infection of the appendix is called appendicitis. It is one of the most common causes of abdominal pain.
The appendix is a 4 inches long finger-shaped pouch present at the junction of the small and large intestine. It is normally present in the lower right abdomen.
The exact function of the appendix is unknown. Some believe it harbors good bacteria, which helps to reboot the digestive system after diarrhea. And some believe it to be a vestigial organ (organs which do not have any apparent function). But surgical removal of the appendix does not cause any noticeable health problem.
Inflammation or infection of the appendix is called appendicitis. It is one of the most common causes of abdominal pain. The pain is accompanied by nausea and vomiting. The pain becomes worse as the inflammation increases and the appendix ruptures. Anyone can get appendicitis, but it is more common in people between 10 and 30 years of age. It is usually caused either by stomach infection moving to the appendix or when stool gets trapped in the appendix.
The two types of appendicitis depending on the onset, which are:
Acute Appendicitis - It develops very fast within a few days to hours, and requires prompt medical treatment or surgery.
Chronic Appendicitis - Here, the inflammation lasts for a long time. It is a rare condition.
And depending on the complications:
Simple Appendicitis - Cases with no complications.
Complex Appendicitis - Cases that involve complications like appendix rupture or abscess.
Appendicitis causes pain around the belly button and mild fever during the initial stages. As the condition progresses, the signs and symptoms seen are:
The pain worsens and moves to the lower right side of the abdomen.
Pain increases on coughing, walking, and making sudden movements.
Vomiting.
The fever might go up.
Constipation or diarrhea.
Stomach gets bloated.
Inability to pass gas.
When the lining of the appendix gets blocked, it results in an infection causing appendicitis. Things that can cause this blockage are:
Hard stools.
Swollen lymph nodes in the intestine.
Some of the risk factors include:
People between ages 15 and 30 years.
More common in males.
Family history.
If the doctor suspects that your symptoms are caused by appendicitis, he or she will check for tenderness or swelling and rigidity in the lower right side of your abdomen. To rule out conditions like gastroenteritis, urinary tract infections, ectopic pregnancy, Crohn’s disease, and kidney stones, the doctor might suggest you get the following tests:
Complete Blood Count (CBC) - CBC is done to look for signs of infection. Bacterial infection of the urinary tract and abdominal organs also cause similar symptoms.
Urine Test - Urinalysis is done to rule out urinary tract infection and kidney stones.
Pregnancy Test - To rule out an ectopic pregnancy.
Pelvic Exam - For females, a pelvic exam is done to rule out conditions affecting the reproductive organs like pelvic inflammatory disease.
Imaging Tests - To rule out abdominal abscess or fecal impaction, imaging tests like an abdominal ultrasound, X-ray, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan is done.
Chest Imaging - Chest imaging like a chest X-ray or CT scan is done to check for pneumonia
Usually, surgical removal of the appendix (appendectomy) is done to remove the inflamed appendix. To prevent the spread of infection, antibiotics are given before the surgery.
1) Surgery:
Appendectomy can be performed by:
Laparotomy - Open surgery is done after placing an incision about 2 to 4 inches long.
Laparoscopic - Surgery is done after placing a few small abdominal incisions with the help of special surgical tools and camera.
2) Draining the Abscess Before Surgery:
In case the appendix has burst and an abscess has formed around it, the abscess is drained before appendectomy. The abscess is drained by placing a tube through the skin.
The recovery time depends on the type of surgery and appendicitis. It usually takes 1 to 3 weeks to recover from laparoscopic surgery and 2 to 4 weeks for open surgery. If the appendix burst, then you would have to wait for the pus and infection to be drained out first, which will take a longer time. Some tips for recovering fast after surgery are:
Avoid strenuous activity for the first couple of weeks.
To reduce pain, place a pillow on your abdomen and apply pressure before you laugh, cough, and change position.
Tell your doctor if you experience pain even after taking painkillers.
Take rest when you feel tired.
The complications are:
Abscess - Collection of pus in the appendix.
Ruptured Appendix - It spills fecal matters and bacteria in the abdominal cavity.
Peritonitis - Bacteria can cause inflammation of the abdominal lining, which can be fatal.
Spread of Infection - The infection can travel through the bloodstream and infect other organs.
As of now, there is no sure way to prevent appendicitis, as the cause is still not clear. But its prevalence is less common in people who eat a fiber-rich diet. So there is a chance that consuming foods rich in fiber like fruits, vegetables, lentils, and whole wheat, might help prevent inflammation of the appendix.
After an appendectomy, if you have uncontrolled vomiting, severe abdominal pain, dizziness, pus in the wound, and fever, get immediate medical attention, as it can be a sign of infection.
Appendicitis can be ruled out by using brief case history, physical examinations, computed tomography scan, urine analysis, ultrasound abdomen, anal examinations, an x-ray of the abdomen, and blood examination.
The duration taken for bursting depends on the type of appendicitis. In the case of chronic appendicitis, it lasts for a long period, whereas in the case of acute conditions, symptoms will appear suddenly and immediate surgery is needed.
Appendicitis pain might be mild or severe. There will be fever, abdominal pain, navel pain, difficulty in moving around, loss of appetite, and anal pain in some cases. There may also be vomiting, diarrhea, and nausea.
There will be sharp pricking pain in the abdomen and the pain worsens by pressing the painful area, moving around. Sometimes, even coughing, and sneezing worsens the pain. There will be difficulty in sitting in a particular place for a long time. There will also be difficulty in passing urine.
There are no standard methods for the examination of appendicitis at home, but we can check for any swelling in the abdominal area. If we have basic knowledge and ideas about appendicitis we can palpate the abdomen and rule out in some cases.
Any blockages in the lining of the appendix lead to appendicitis. This is mainly due to the food items we consume and seeds of fruits that block the passage. It may lead to infection and rupture in the appendix region and sometimes pus discharges also.
Appendicitis treated at an early time is easily curable but in cases where it is left untreated leads to fatal conditions. So, it is necessary to start the treatment faster. This will make the condition simple.
The pain usually comes and goes for a short period of time in the belly and navel region. It starts with pain around the navel region which makes it difficult in sitting and moving. If you are feeling too much pain, you should consult your doctor immediately.
Usually, it takes around one to three days for recovery for laparoscopy. It usually takes two to four weeks after surgery to return to our routine life. Depending on the severity of the surgery, and the patient the recovery time may be extended. You should ask your doctor for instructions that are to be followed.
Appendicitis comes so quickly that symptoms appear within the first 24 hours. Later on, any disturbance and food items lead to further signs and rupture. Any disturbance to the regions leads to further signs.
The patient stays in the hospital just for three days. The patient is admitted to the hospital one day before the surgery. This is done so that the patient can adapt to the environment before the surgery. The next day surgery is performed. The patient is asked to stay in the hospital for another day and then they can be discharged if the doctor advises them to do so.
The degree of pain and the duration it takes to show the symptoms might vary. Appendicitis usually develops in teenagers, the symptoms appear very early in addition some food items lead to rupture of the appendix. Symptoms and signs appear in an early stage. However, you should consult your doctor if you experience pain for more than one day.
Initially, the pain starts near the belly and in the navel region, and later on the pain travels to the abdominal region, mainly to the right abdomen. There will be swelling in the stomach region which can be identified by palpation by the doctors. Palpation is the procedure of investigation done by touching and pressing.
For severe cases of appendicitis, appendectomy is done. It is the surgical removal of the appendix. This is usually done by open surgery. Nowadays, it is done using a laser. The surgery that is done using a laser is known as laparoscopy. In which three holes are made and the further procedure is carried out.
Undigested food makes the condition of the appendix to worsen. Seeds of fruits and vegetables are also harmful. Medications that are taken to relieve pain leads to the rupture of the appendix. This makes the condition even worsen. Some doctors say that spicy food items also worsen the condition of appendicitis.
The signs and symptoms of appendicitis are:
- Nausea.
- Vomiting.
- Loss of appetite.
- Sudden and severe pain in the right side of the lower abdomen.
- The pain begins in the navel that shifts to the right side of the abdomen.
- Severe pain will be experienced while walking, coughing, and movements.
Last reviewed at:
05 Oct 2023 - 5 min read
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Surgical Gastroenterology
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