Appendicitis is a condition that causes the inflammation of the appendix. The appendix is a tube around 3½ inch long and extends from the large intestine. It is said that the appendix has a role in gut immunity, but nothing as yet is definite with regard to its function. An individual can live without it without any implications on his life or any of his organs' ability to function.
Appendicitis is a very dangerous condition. If you don’t seek treatment immediately, your appendix can rupture, releasing bacteria into other parts of the body and leading to a life-threatening condition called peritonitis. Someone suffering from appendicitis often experiences immense pain in the lower right side of the abdomen, near the belly button, in addition to other symptoms like nausea, vomiting, and fever. Identifying the symptoms of appendicitis early is very important in order to get the appropriate treatment as soon as possible. Appendicitis is a medical emergency that requires prompt treatment. Removal of the appendix and cleaning of the abdominal cavity through surgery need to be performed right away.
In some cases, an abscess walled off from the rest of the abdomen forms around a burst appendix in the body's attempt to fight the infection. This abscess is filled with pus and occurs as a complication of a burst or perforated appendix. To prevent the infection from the burst appendix from spreading, scar tissue walls off the appendix from the abdomen. In most cases, the surgeon drains the abscess and uses antibiotics to clear the infection.
Most appendicitis cases are seen in children or teens in the 10 to 20 age group, but in rare cases, it also occurs in infants or even newborns. One should note that this medical condition is not contagious. Preventing appendicitis is not possible, but diagnosing it as soon as possible is very important. Many of the cases identified in time are treated without any complications. An infected appendix can burst anytime from 24 to 72 hours from the onset of symptoms. Symptoms of the appendix having burst are the pain spreading across the abdomen, and the fever possibly rising to 104 degrees Fahrenheit.
Let’s learn about these symptoms in detail.
The starting symptom of appendicitis is a pain in the middle of the abdomen that can gradually come and go.
Abdominal Pain: Since appendicitis occurs in the lower right side of the abdomen, the pain and discomfort usually occur near the belly button. The pain worsens if you walk, cough, or do other activities that involve a lot of abdominal movements. Some people develop appendicitis behind the colon. In this case, the person may experience lower back or pelvic pain.
Worsening pain: Once the pain reaches the lower abdomen it becomes very intense and severe. Once the severe level is reached, the pain can increase rapidly within a matter of a few hours.
Low-Grade Fever: A person with appendicitis usually has a mild fever between 99°F and 100.5°F. He or she may also have chills. The fever can rise above 101°F if the appendix ruptures.
Upset Stomach: Digestive upsets are common among people suffering from appendicitis. The person may experience nausea and vomiting, and mild diarrhea or constipation may also occur. If you are unable to pass gas, this can be due to the obstruction of your bowel and the underlying problem of appendicitis. This would usually happen after the abdominal pain. If the diarrhea is mild with lot of mucus, in addition to pain in the lower abdomen, then it is time to go to the hospital.
Tenderness: When one pushes on the lower right part of the abdomen, rebound tenderness may be felt. This means that one feels pain again as the pressure is released. In such cases, avoid touching that area again and again and talk to your doctor.
Below are some of the other symptoms that may be experienced:
- Loss of appetite
- Vomiting after the pain in the abdomen has started
- Severe cramps
- One may find it difficult to pass urine or feel excruciating pain during urination
One should note that it is important to seek immediate medical attention, since timely diagnosis will be most helpful in starting the treatment. One should not eat, drink, or use any kind of painkiller, laxative, and heating pad, which would worsen the inflamed appendix and cause its rupture.
Appendicitis Symptoms in Children
Children aren’t always able to clearly describe how they are feeling and the problems they are experiencing. Parents sometimes think that stomach pain may be an excuse given by the child to not go to school, or assume that it’s just a minor stomach upset. This negligence or heedlessness can lead to life-threatening conditions. The risk of death due to appendicitis is higher in infants and toddlers than in adults, who are able to seek the doctor’s help immediately when they feel that something is wrong. Symptoms of appendicitis vary from child to child. When it comes to kids who are 2 years of age, the common symptoms seen are the bloating and swelling of the abdomen, along with vomiting and pain.
Some of the common signs and symptoms of appendicitis in children are the following:
- A tender abdomen
- Abdominal bloating or swelling
- Pain in the lower right side of the stomach
Appendicitis Symptoms During Pregnancy
During pregnancy, women experience several abdominal discomforts such as nausea and stomach cramping. Hence, identifying the symptoms of appendicitis can be difficult for them. What complicates the situation further is that pregnant women don’t always experience the usual signs and symptoms of appendicitis. During pregnancy, the growing uterus pushes the appendix higher, so the woman may experience pain in the upper side of the abdomen instead of the lower. Pregnant women are also more likely to have gas, heartburn, or irregular episodes of diarrhea and constipation as a consequence of pregnancy.
Call your doctor immediately if you experience any of the above mentioned symptoms. If the appendix ruptures, prompt surgery is required.
Causes of Appendicitis
The occurrence of appendicitis happens when the appendix is blocked due to a foreign body, cancer, or stool. This blockage at times can also occur due to a persisting infection in the body, since the appendix may swell in response to any infection prevalent in the body.
Diagnosis of Appendicitis
For doctors, it can be very tricky to diagnose appendicitis. The symptoms of this medical condition are very vague and at times similar to other kinds of medical conditions such as urinary tract infection, Crohn’s disease, gallbladder problems, intestinal infection, and other problems. Below are a few of the tests that help a medical doctor make the diagnosis:
- Examination of the rectum
- Blood test to identify if the body is able to fight off the infection
- Ultrasound or CT scan
- Examination of the abdomen to detect the inflammation
- Urine test to avoid confusion with urinary tract infection
Treatment of Appendicitis
The standard treatment for appendicitis is removal of the appendix, also known as an appendectomy. The doctor quickly removes the appendix before it ruptures or explodes and spreads the infection to other parts of the body. For those individuals in whom an abscess has formed, there would be two procedures: one to drain the pus or fluid from the abscess, and the other to remove the appendix. There are now studies that indicate that for those people with acute appendicitis, surgery can be eliminated and the appendicitis can instead be treated through antibiotics.
Appendectomy: Usually, the doctor will provide antibiotics before the appendectomy to fight off the possibility of peritonitis. After that, the doctor gives the patient general anesthesia and removes the appendix through an incision of about four inches or using laparoscopy. If a laparoscope is used for the surgery, the incision will be shorter, and the healing process will be faster. If one has peritonitis, then the abdomen would have to first be drained of the pus, and the surgery is performed later. The patient is able to get up and carefully move about 12 hours after the surgery. Within two to three weeks, one may return to normal activity. Following the appendectomy, one should inform the doctor if they experience any of the below:
- Wound containing or oozing pus
- Vomiting that is uncontrolled
- Sudden fever
- Severe pain in the abdomen
- Pain and redness in the incision area
- Specks of blood in urine or vomit
Prevention of appendicitis is not possible. However, it can be less common in those individuals who have a high intake of foods rich in fiber, such as fruits and vegetables.
Risks and Complications
Non-treatment or untimely treatment of appendicitis can lead to rupture and then cause a life-threatening infection.
If the pain in the abdomen suddenly worsens and spreads across the abdomen, then it is best to call the doctor and rush to the hospital, as it could be a sign that the appendicitis has burst.
Peritonitis: An appendix that bursts releases bacteria into other parts of the body, and this can lead to a condition called peritonitis. In this case, the infection spreads to the peritoneum, which is a thin layer of tissue that forms a lining on the inside of the abdomen. These are some of the symptoms of peritonitis:
- Feeling sick
- Sudden high temperature
- Irregular and/or fast heartbeat
- Swelling or bloating in the abdomen
- Continuous pain in the abdomen
- Rapid breathing or irregular breaths
Non-timely treatment of peritonitis can lead to long-term problems or be fatal. The treatment carried out for peritonitis is antibiotics and the surgical removal of the appendix.
Abscesses: The formation of an abscess usually happens around an appendix that has burst. The abscess is an attempt of the body to fight against infection. An abscess can also occur as a complication of the surgery to remove the appendix. However, this is a rare occurrence. Treatment of the abscess is through antibiotics, and in most cases, the pus also needs to be drained from the abscess to avoid any complications of the infection.