What is appendicitis?
A blockage, or obstruction, in the appendix can lead to appendicitis, which is an inflammation and infection of your appendix. The blockage may result from a buildup of mucus, parasites, or most commonly, fecal matter. When there’s an obstruction in the appendix, bacteria can multiply quickly inside the organ. This causes the appendix to become irritated and swollen, ultimately leading to appendicitis.
The appendix is in the lower right side of your abdomen. It’s a narrow, tube-shaped pouch protruding from your large intestine. Although the appendix is a part of your gastrointestinal tract, it’s a vestigial organ. This means that it provides no vital function and that you may live a normal, healthy life without it.
The purpose of the appendix is unknown. Some believe it contains tissue that helps your immune system process infections in your body. If you don’t get treatment for an inflamed appendix quickly, it can rupture and release dangerous bacteria into your abdomen. The resulting infection is called peritonitis. This is a serious condition that requires immediate medical attention.
Having a ruptured appendix is a life-threatening situation. Rupture rarely happens within the first 24 hours of symptoms, but the risk of rupture rises dramatically after 48 hours of the onset of symptoms. It’s very important to recognize the early symptoms of appendicitis so that you can seek medical treatment immediately.
Symptoms of appendicitis
Appendicitis causes a variety of symptoms, including:
- abdominal pain
- low fever
- loss of appetite
- difficulty passing gas
Not all people will have the same symptoms, but it’s crucial that you see a doctor as quickly as possible. According to Johns Hopkins Medicine, the appendix can rupture as quickly as 48 to 72 hours after the onset of symptoms.
Go to the hospital immediately if you’re experiencing any of the following symptoms.
Appendicitis usually involves a gradual onset of dull, cramping, or aching pain throughout the abdomen. As the appendix becomes more swollen and inflamed, it will irritate the lining of the abdominal wall, known as the peritoneum.
This causes localized, sharp pain in the right lower part of the abdomen. The pain tends to be more constant and severe than the dull, aching pain that occurs when symptoms start. However, some people may have an appendix that lies behind the colon. Appendicitis that occurs in these people can cause lower back pain or pelvic pain.
Appendicitis usually causes a fever between 99°F (37.2°C) and 100.5°F (38°C). You may also have the chills. If your appendix bursts, the resulting infection could cause your fever to rise. A fever greater than 101°F (38.3°) and an increase in heart rate may mean that the appendix has ruptured.
Appendicitis can cause nausea and vomiting. You may lose your appetite and feel like you can’t eat. You may also become constipated or develop severe diarrhea. If you’re having trouble passing gas, this may be a sign of a partial or total obstruction of your bowel. This may be related to underlying appendicitis.
Symptoms of appendicitis in children
Always take your child to the hospital if you suspect they have appendicitis. Children aren’t always able to describe how they’re feeling. They also may have a difficult time pinpointing the pain, and they may say that the pain is in their entire abdomen. This can make it difficult to determine that appendicitis is the cause.
Parents can easily mistake appendicitis for a stomach bug or urinary tract infection (UTI). It’s always better to be cautious when it comes to appendicitis. A ruptured appendix can be dangerous for anyone, but the risk of death is highest in infants and toddlers.
Children ages 2 and younger often show the following symptoms of appendicitis:
- abdominal bloating or swelling
- a tender abdomen
Older children and teenagers are more likely to experience:
- pain in the lower right side of the abdomen
Symptoms of appendicitis during pregnancy
Many appendicitis symptoms are similar to the discomforts of pregnancy. These include stomach cramping, nausea, and vomiting. However, pregnant women may not always have the classic symptoms of appendicitis, especially late in pregnancy. The growing uterus pushes the appendix higher during pregnancy. This means pain may occur in the upper abdomen instead of the lower right side of the abdomen.
Pregnant women with appendicitis are also more likely to experience heartburn, gas, or alternating episodes of constipation and diarrhea.
How is appendicitis treated?
When you meet with the doctor, they’ll perform a physical exam and ask you questions about your symptoms. They’ll also order certain tests to help them determine if you have appendicitis. These may include:
- blood tests to look for signs of an infection
- urine tests to check for signs of a UTI or a kidney stone
- an abdominal ultrasound or CT scan to see if the appendix is inflamed
If your doctor diagnoses you with appendicitis, they’ll then decide whether or not you need immediate surgery. You’ll likely receive antibiotics before surgery. The medications will help prevent an infection from developing after surgery. Your surgeon will then perform surgery to remove your appendix. This is called an appendectomy.
Your surgeon may perform an open appendectomy or a laparoscopic appendectomy. This depends on the severity of your appendicitis.
During an open appendectomy, your surgeon makes one incision in the lower right side of your abdomen. They remove your appendix and close the wound with stitches. This procedure allows your doctor to clean the abdominal cavity if your appendix has burst or if you have an abscess.
During a laparoscopic appendectomy, your surgeon will make a few small incisions in your abdomen. They’ll then insert a laparoscope into the incisions. A laparoscope is a long, thin tube with a light and camera at the front. The camera will display the images on a screen, allowing your doctor to see inside your abdomen and guide the instruments.
When they find your appendix, they’ll tie it off with stitches and remove it. They’ll then clean, close, and dress the small incisions.
After the surgery, your doctor may want you to stay in the hospital until your pain is under control and you’re able to consume liquids. If you developed an abscess or if a complication occurs, your doctor may want you to stay on antibiotics for another day or two. It’s important to remember that while it’s possible for problems to arise, most people make a full recovery without complications.
Risk factors and prevention
According to the National Institute of Diabetes and Digestive and Kidney Diseases, in the United States, appendicitis is the most common cause of abdominal pain that leads to surgery. About 5 percent of Americans experience appendicitis at some point in their lives.
Appendicitis can happen at any time, but it most often occurs between the ages of 10 and 30. It’s more common in men than in women. You can’t prevent appendicitis, but there are steps you can take to lower your risk.
Appendicitis seems less likely if you have a diet rich in fiber. You can increase your fiber intake by eating a healthy diet that contains lots of fresh fruits and vegetables. Foods that are particularly high in fiber include:
- green peas
- black beans
- bran flakes
- whole-wheat spaghetti
Increasing the amount of fiber in your diet can prevent constipation and subsequent stool buildup. Stool buildup is the most common cause of appendicitis. If you have any condition that causes inflammation or infection of the bowels, it’s important to work with your doctor to prevent appendicitis. Always seek medical attention immediately if you or someone you know has symptoms of appendicitis.