Appendicitis - An Overview

What Is an Appendix?

The appendix is a four-inch-long finger-shaped pouch located 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 the appendix harbors good bacteria, which helps to reboot the digestive system after diarrhea. Some believe it to be a vestigial organ (organs that do not have any apparent function). However, surgical removal of the appendix does not cause any noticeable health problems.

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 a 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, are:

• Acute Appendicitis - The common form of appendicitis 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. The associated symptoms are milder or recurrent. It is a rare condition. The diagnosis and treatment of chronic appendicitis is challenging.

Depending on the complications, appendicitis is classified into the following types:

• Simple Appendicitis - The type with no complications.

• Complex Appendicitis - Cases that involve complications like appendix rupture or abscess. The diagnosis and treatment are challenging in this type of appendicitis.

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 or bacterial infection.

• Blockage of the appendix by foreign material, or fecal material can lead to inflammation.

• An injury to the abdomen

What Are the Risk Factors for Appendicitis?

Some of the risk factors include:

• People between the ages of 15 and 30 years.

• More common in males.

• Family history.

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:

• The pain worsens and moves to the lower right side of the abdomen.

• Pain increases in coughing, walking, and making sudden movements.

• Nausea.

• Vomiting.

• The fever might go up.

• Constipation or diarrhea.

• The stomach gets bloated.

• Inability to pass gas.

• Painful urination.

• Loss of appetite.

How Is Appendicitis Diagnosed?

If the doctor suspects that the symptoms of patients are caused by appendicitis, he or she will check for tenderness or swelling and rigidity in the lower right side of the abdomen. To rule out conditions like gastroenteritis (digestive system inflammation), urinary tract infections, ectopic pregnancy (egg is fertilized and grown in the outer environment), Crohn’s disease (inflammatory bowel disease), and kidney stones, the doctor might suggest getting the following tests:

• Complete Blood Count (CBC) - CBC is done to look for signs of infection. Bacterial infections 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 are 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 two to four inches long.

• Laparoscopic Surgery - Surgery is done after placing a few small abdominal incisions with the help of special surgical tools and a 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 the 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 one to three weeks to recover from laparoscopic surgery and two to four weeks for open surgery. If the appendix bursts, then the patient 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 the abdomen and apply pressure before they laugh, cough, and change position.

• Tell the doctor if they experience pain even after taking painkillers.

• Take rest when they feel tired.

What Are the Complications of Appendicitis?

The complications of appendicitis are as follows:

• Abscess - Collection of pus in the appendix can lead to the formation of an appendix.

• Ruptured Appendix - It spills fecal matter 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.

Conclusion

As of now, there is no sure way to prevent appendicitis, as the cause still needs to be clarified. However, its prevalence is less common in people who eat a fiber-rich diet. So, consuming foods rich in fiber like fruits, vegetables, lentils, and whole wheat might help prevent inflammation of the appendix. After an appendectomy, if they 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.