Healthy Living

Appendicitis and Appendectomy

Appendicitis and Appendectomy

Key Takeaways

  • Doctors usually do a physical examination for appendicitis by applying some pressure to feel the extent the abdomen has been affected.
  • Appendicitis is treated through an appendectomy, which is surgical removal of the appendix.
  • After an appendectomy, the patient has to watch out for infection of the wound, bleeding and swelling, scarring, pus (abscess), and hernia before they lead to a dangerous condition.

Health care personnel can identify many cases of appendicitis by checking the patient's medical history and then doing a physical examination of the individual.

The health care personnel will ask questions like:

  • when did the pain commence,
  • how severe was the pain when you first felt it,
  • do you have any other diseases,
  • and whether you are under the influence of alcohol.

Physical examination includes the health personnel applying some pressure to feel the extent the abdomen has been affected. A doctor will also perform laboratory and other tests to diagnose or rule out appendicitis. This is why it is important that when you seek medical attention for your severe pain, you explain the exact conditions of your pain, where it is originating from, and any other medical symptoms you may be facing very clearly to the doctor.

Diagnosing appendicitis is sometimes tricky because the signs and symptoms are similar to those of other diseases like Crohn’s disease, gallbladder infection, gastritis, and colitis. Even though the condition is critical, the symptoms are mostly unclear, since they could be caused by any of a number of things.

This is why your doctor may ask you detailed questions about your medical history, and other relevant information so as to get a proper diagnosis. It may be a good idea for you to make notes regarding your condition and the symptoms you face, that will help the doctor diagnose the condition accurately.

Physical Diagnosis of Appendicitis

Responses showing the presence of the disease include:

  • the psoas sign, where the muscle that is over the appendix becomes painful on stretching it or applying pressure on it;
  • the Rovsing's sign, where pain is felt in the lower right side of the abdomen when pressure is applied on and released from the lower right side of the abdomen;
  • and the obturator sign, where pain is felt when bending the left knee due to the flexing of the obturator muscle.

Abdominal guarding, where the abdominal walls tense up or tighten to protect the inflamed appendix, also occurs sometimes. Rebound tenderness, known as Blumberg's sign, is when pain is felt upon release or removal of pressure rather than upon application of pressure and indicative of peritonitis, the infection that results from the rupture of the appendix. 

These are some of the symptoms your doctor would be looking for, at the first physical examination post which he would recommend a series of tests and even hold further detailed discussions with you, asking you to explain the symptoms in detail.

Diagnostic Tests To Check For Appendicitis

Laboratory tests can also be used in checking for the disease and ruling out others. A blood test may indicate infection if a high number of white blood cells is seen. Urinalysis can also be used to check for a urinary tract infection or the possibility of kidney stones, either of which might be the cause of the pain the patient is experiencing. A pregnancy test could also be carried out.

An abdominal ultrasound may also be done with a transducer to detect inflammation or rupturing of the appendix. Imaging tests may also be used to detect appendix inflammation or rupture, or other sources of the pain. An ultrasound will involve the application of a gel on the skin over the abdomen and running the ultrasound machine over it. It is done mostly on children and women and shows the problem easily.

Magnetic resonance could also be used to show a diseased state of an organ through the application of dye and checking its reaction. Scanning for the disease may also be done using a CT scan or X-ray. 

So if a physical diagnosis does not make the condition clear to the doctor, he would then run a full battery of diagnostic tests to ensure that your condition is diagnosed accurately. These various tests should help the doctor to ensure that your condition is appendicitis and not a result of some other condition so that he can then recommend an effective course of treatment for the same on time.

Risks of Appendicitis

When the appendix bursts, it is a life-threatening medical emergency, and the person will probably feel very ill and experience nausea, vomiting, and fever. Bacteria is released by the infected appendix and can often result in a grave condition called peritonitis, which can result in death. 

Hence, people who think they have appendicitis should go to the E.R. immediately to get quickly diagnosed and treated, reducing the probability of the appendix bursting and the dangerous conditions it brings about. The organ does not perform any important function, and getting it removed does not pose any problems, but not getting appendicitis treated in time could lead to death. 

Leaving appendicitis untreated is dangerous and if you are not careful, you could end up collapsing. So if your abdominal pain has become severe and you are also experiencing severe nausea, then it means that your appendicitis has burst and you need to head over to the emergency room right away.

Treatment of Appendicitis

Appendicitis is treated through an appendectomy, that is, through surgical removal of the appendix. An antibiotic is prescribed before the surgery to reduce the infection of the abdominal cavity, and the operation is carried out under general anesthesia. 

You will be given general anesthesia and then taken to the operation room for the procedure. Then, your appendix will be removed, and you will be treated with various antibiotics to reduce the infection. You can ask your doctor any questions you may have regarding the procedure, how long it will take and what the post-operative care and the recuperation process is and the length of time.

There are two kinds of surgeries for appendix removal:

  • Open Surgery - In this procedure, which is also called laparotomy, a large incision is made in the abdomen to get to the abdominal cavity to remove the appendix. A laparotomy is done when infection has spread in the inner lining of the abdomen, to allow the surgeon to clean out the abdominal cavity. It is done this way to remove the appendix as soon as possible.
  • Laparoscopic Surgery - Laparoscopic surgery is another method of surgery where several smaller incisions are made to remove the infected appendix.
    • A tube to inflate the abdomen with a gas is pumped. This helps the surgeon to have a clear picture of the appendix.
    • Another small tube (laparoscope) gives images of the inside on a monitor.
    • The appendix is then removed with the help of surgical tools.

But a laparoscopy is not recommended in all cases, such as in these:

  • The appendix has already burst, forming a lump (appendix mass). 
  • The surgeon is inexperienced in performing the procedure.  
  • The patient has had previous open surgery of the abdomen. 

In both surgical methods, the incisions are closed with either dissolvable or regular stitches. The latter stitches need to be removed a few weeks after the operation. The removing of the stitches should not take much time and is a simple procedure.

Recovering from Appendectomy

The main advantage of laparoscopy is that the recovery time is very short. Most patients are discharged from the hospital in 24 hours after the procedure. If there is any complication like peritonitis, recovery takes a few weeks. This is why it is important that you seek out a medical professional to get the help you need on time and ensure speedy treatment. Even a slight delay in getting to the hospital on time can cause your appendix to burst, causing you to collapse.

Pain and bruising after the surgery are treated with painkillers and improve with time. If a patient experiences pain at the tip of the shoulder for over a week, it is because of the gas that was pumped into the abdomen during the surgery to lift the abdominal wall and expose the internal organs. Patients also complain of short-term constipation, which does, however, goes away on its own. These are some of the initial side effects of having an appendectomy.

One needs to contact the doctor or surgeon in these cases:

  • Increased pain and swelling: if you are having increased pain and swelling post the operation, then you need to contact your doctor right away regarding this as it could be an indication that something is seriously wrong. So consult your doctor right away and he would in all probability ask you to undergo a complete checkup.
  • Repeated vomiting: if you have started experiencing repeated vomiting, then you must consult a doctor right away as it could be an indication of something serious. Your doctor can run a few tests and see if it is on account of the appendectomy.
  • High fevers: if you are experiencing high fever post the operation, then you need to make sure that you consult your doctor right away. Your doctor can carry out a few tests to help determine if your fever is a result of the surgery and the resulting infection.
  • Wound is hot to the touch and there is discharge coming from the wound: in this case, the wound is infected. You need to head over to the emergency room and consult the doctor and get it looked at right away.

Risks after an Appendectomy

After an appendectomy, the patient has to watch out for a few things. These are infection of the wound, bleeding and swelling, scarring, pus (abscess), and hernia that cause serious problems and should be treated by medical professionals before they lead to a dangerous condition. Doctors usually advise a post-operative patient on how to take care of the wound or wounds and what activities should be avoided, before discharge from the hospital. However, when nothing intervenes in healing and recovery, patients can return to their normal routines after a few weeks.

You must visit your doctor regularly and ensure that there is no infection in the wound. You need to get yourself checked out regularly by the doctor and make sure that you do not suffer from any surgery-related complications. Furthermore, if there are any complications or infections, your doctor would be able to spot the same right away. This is why it is essential that you visit your doctor on a regular basis post-surgery.

Home-Care Methods After an Appendectomy

Research has shown that the way people eat can be a major contributor to the disease. Once one has been treated, he or she will be on a soft food diet till the infection is over. Food like milk, eggs, soups, rice, meat, fish and baked potatoes are recommended for reducing the recovery period. You need to maintain a prudent diet and exercise discipline over what you eat.

Your doctor would make certain diet suggestions to enable faster healing. The diet would be nutrient rich and will provide your body with all the required proteins and nutrients for a healthy recovery from the appendectomy.

After the operation, the patient needs to keep the incision area clean so that there is no other infection and the wound heals fast.

Is There Any Way to Prevent Appendicitis?

Studies show that people who have diets high in fiber are less prone to appendicitis. This is why it might be a good idea to opt for food items rich in dietary fiber. For example, you could go with chia seeds and oats, both are rich in dietary fiber. The dietary fiber aids in effective digestion and nutrient absorption, as well as in the removal of unwanted toxins from the body. 

Along with that, you can also opt for food items which are rich in potassium, zinc, manganese, and iron. This should give your body all the nutrients it needs to fight off any infection. This is why you need to opt for a healthy diet, one that can go a long way to helping you stave off infections.