Gastro Health

Appendicitis

Written by
Dr. Sneha Kannan
and medically reviewed by Dr. Datta Ram Udayagiri

Published on May 08, 2019 and last reviewed on Oct 10, 2019   -  4 min read

Abstract

Abstract

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.

Appendicitis

What Is an Appendix?

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.

What Is Appendicitis?

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.

What Are the Types of Appendicitis?

The two types of appendicitis depending on the onset, which are:

  1. Acute Appendicitis - It develops very fast within a few days to hours, and requires prompt medical treatment or surgery.

  2. Chronic Appendicitis - Here, the inflammation lasts for a long time. It is a rare condition.

And depending on the complications:

  1. Simple Appendicitis - Cases with no complications.

  2. Complex Appendicitis - Cases that involve complications like appendix rupture or abscess.

What Are the Signs and Symptoms of Appendicitis?

Appendicitis causes pain around the belly button and mild fever during the initial stages. As the condition progresses, the signs and symptoms seen are:

What Are the Causes of Appendicitis?

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.

  • Parasitic infection.

What Are the Risk Factors for Appendicitis?

Some of the risk factors include:

  • People between ages 15 and 30 years.

  • More common in males.

  • Family history.

How Is Appendicitis Diagnosed?

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 scan, or MRI scan is done.

  • Chest Imaging - Chest imaging like a chest X-ray or CT scan is done to check for pneumonia

What Are the Treatment Options for Appendicitis?

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.

What Is the Recovery Time for Appendectomy?

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.

What Are the Complications of Appendicitis?

The complications are:

  • Abscess - a 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.

Can Appendicitis Be Prevented?

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.

Last reviewed at:
10 Oct 2019  -  4 min read

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Related Questions & Answers


Could CT scan miss appendicitis?

Query: Hi doctor, I was in an emergency last night because of 48 hours of pain that moved to my right lower abdomen. Also, I am not eating, and I have severe diarrhea if I do. They said my white blood cells were a bit elevated. The CT scan without contrast did not show an inflamed appendix. Now it is the...  Read Full >>


Dr. Salah Saad Shoman
Internal Medicine Physician

Answer: Hi,Welcome to icliniq.com.CT scan could not miss a case of appendicitis unless the medical personnel who viewed the CT scan were not qualified enough for correct interpretation of the scan.However, the other causes of right lower abdomen pain may be any one of the following. It could be due to irrit...  Read Full

USG shows appendicitis. Do I need surgery?

Query: Hello doctor, I am a 28 year old female. Whenever I have indigestion and gas formation in my stomach, I feel pain in the right side of my stomach. So, I did a whole abdomen USG. It shows appendicitis. I did blood ESR test also. Attached are the reports. As per my doctor's suggestion, I am having be...  Read Full >>


Dr. Parth R Goswami
Family Physician, General Practitioner, Hematologist, Pathologist

Answer: Hi, Welcome to icliniq.com. I had seen your report (attachment removed to protect patient identity) and CBC (complete blood count) is not showing any shift to the left or high total count. You have mild appendicitis infection. For that, medical management will be beneficial. You have been prescribed...  Read Full

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