Appendicitis is an inflammation of the appendix. The appendix is a long tube of tissue that extends from the large intestine. The appendix may have some role in gut immunity, but nothing is definite, and we can live without it, without obvious consequences.
Appendicitis happens when the appendix becomes inflamed, and early symptoms can vary between age groups, and can also be confused with symptoms of other conditions.
Appendicitis is a medical emergency that almost always requires prompt surgery to remove the appendix, and if left untreated, an inflamed appendix will eventually rupture or perforate, spilling infectious materials into the abdominal cavity.
This can lead to peritonitis, a serious inflammation of the abdominal cavity’s lining that can be fatal unless it is treated quickly.
Fast Facts On Appendicitis
- An early sign of appendicitis includes a pain near the belly button that may shift toward the lower right-hand side of the abdomen.
- Many people with appendicitis will go directly to the emergency unit.
- Early treatment is usually successful, but when left untreated, appendicitis can lead to fatal complications.
- Appendicitis is usually suspected on the basis of a patient’s history and physical examination. A white blood cell count, urinalysis, abdominal X-ray, barium enema, ultrasonography, laparoscopy, and computerized tomography (CT) scan also may be helpful in diagnosis.
- It may be difficult to differentiate appendicitis from other abdominal and pelvic diseases or even during the onset of labor due to the varying size and location of the appendix and the proximity of other organs to the appendix.
- The treatment for appendicitis is antibiotics and appendectomy (surgery).
- Complications of appendectomy include wound infection and abscess.
- Other conditions that can copy appendicitis symptoms include pelvic inflammatory disease (PID), inflammatory diseases of the right upper abdomen (gallbladder disease, ectopic pregnancy, liver disease, or perforated duodenal ulcer), right-sided diverticulitis, kidney diseases, and Crohn’s disease (of the terminal ileum).
Signs and Symptoms
Severe and sudden abdominal pain is usually the first symptom of appendicitis, and the pain often begins near the belly button, and will likely shift to the lower right side of the abdomen as it worsens.
Other symptoms of appendicitis include:
- Dull pain around the navel or the upper abdomen that becomes sharp as it moves to the lower right abdomen.
- Loss of appetite, Nausea and/or vomiting soon after abdominal pain begins
- Abdominal swelling at some point, due to Inability to pass gas
- Dull or sharp pain anywhere in the upper or lower abdomen, back, or rectum
- Painful urination and Severe cramps
- Constipation or diarrhea with gas
Seek medical attention immediately, If you have any of the mentioned symptoms because timely diagnosis and treatment is very important, and do not eat, drink, or use any pain remedies, antacids, laxatives, or heating, etc. which can cause an inflamed appendix to rupture.
Abdominal pain at other times can be a symptom of other conditions that seem like appendicitis. Conditions like stomach lesions, constipation inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, and damage or injury to the abdomen.
What Causes Appendicitis?
Appendicitis occurs when the appendix becomes blocked, Blockage often occurs from a stool, a foreign body, or cancer, and may also occur from infection, since the appendix can swell in response to an infection in the body.
It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The stool hardens, becomes rock-like (fecalith), and blocks the opening.
At other times, it might be that the lymphatic tissue in the appendix swells and blocks the opening, and then bacteria which normally are found within the appendix begin to multiply and invade the wall of the appendix.
The body responds to the invasion by mounting an attack (inflammation) on the bacteria. If the symptoms are not recognized and the inflammation progresses, the appendix can rupture, followed by the spread of bacteria outside of the appendix.
After rupture, the infection can spread throughout the abdomen, forming a peri-appendiceal abscess.
Sometimes, the body is successful in containing appendicitis without surgical treatment if the infection and accompanying inflammation cause the appendix to rupture.
Treatment of Appendicitis
Some mild cases of appendicitis can be treated completely with fluids and antibiotics, but treatment normally begins with antibiotics and intravenous fluid.
The next option is surgery (appendectomy). Removing the appendix decreases the risk of it rupturing, and early treatment is important to reduce the risk of complications, which can be fatal.
Two types of surgery are possible, Laparoscopic surgery and Laparotomy surgery
In Laparoscopic surgery, surgeons make several small incisions and use special tools to remove the appendix through them. Its benefits include:
- a lower risk of complications,
- lower hospital-related infections
- shorter recovery time
However, in Laparotomy surgery, surgeons remove the appendix through a single incision made in the lower right area of the abdomen (necessary for a burst appendix).
This allows the surgeon to clean the inside of the abdomen to prevent infection, and patients usually limit their physical activity for the first 10 to 14 days after a laparotomy surgery.
Recovery from an appendectomy depends on the severity of the inflammation, and mild inflammation usually takes a few days to a week for recovery.
However, if there has been more extensive inflammation such as an abscess or localized perforation of the appendix, recovery might take several weeks, and rupture of the appendix into the peritoneal cavity (abdomen) may require even longer time.
With timely treatment, appendicitis is treatable, and recovery is normally fast and whole, and the mortality rate is under 1%. Without timely surgery or antibiotics, especially, in remote areas, the mortality rate can be over 50%.
If the appendix bursts, complications may arise, such as an abscess or peritonitis, and recovery may be lengthy too. Older people may also take a longer time to recover.
The appendix is often considered a nonfunctioning organ, unnecessary for survival, but believed to play a role in maintaining a healthy digestive and immune system.
On a final note, if you experience any of the mentioned symptoms, seek medical attention immediately, because timely diagnosis and treatment is very important, and do not eat, drink, or use any pain remedies, antacids, laxatives, or heating pads, which can cause an inflamed appendix to rupture.