Appendicitis

Appendicitis (Appendix) Symptoms, Diagnosis And Treatment

The appendix is attached to your intestines and protrudes out from the colon on the right side of the abdomen. The appendix is a narrow tube-shaped pouch has no real purpose within the human body, however it can cause severe problems when inflamed.

Although the appendix does not serve a purpose it does perform a function in the body, specifically it produces insignificant amounts of mucus that flow into the upper section of the colon, known as the cecum. The walls of the appendix have lymphatic tissue that helps make antibodies, which keep you healthy. But your immune system will not be compromised without an appendix.

Apendix-Location

At this photo so you can see exactly where the appendix is within the human body.

Appendix Symptoms

Appendicitis is a blockage of the appendix. This blockage can occur due to stool, cancer or some other foreign entity. This blockage is what causes appendicitis symptoms.

The symptoms of appendicitis typically begin mild and worsen as time passes. The main symptom is abdominal pain however the pain isn’t always located by the appendix. Because the pain is located in the lower right abdomen, many people dismiss the pain as general stomach discomfort. But when that pain is accompanied by other symptoms, it is a sign that you may have appendicitis.

Signs and symptoms of appendicitis are:

  • Loss of appetite
  • Inability to produce flatulence
  • Painful urination
  • Severe cramps and abdominal swelling
  • Constipation or diarrhea accompanied by gas
  • Vomiting
  • Fever in excess of 99° F.
  • Sharp abdominal pain (as blockage worsens).
  • Tenderness of the skin in the lower right abdominal region

The pain associated with appendicitis may begin in any part of the abdominal region. If you cannot pinpoint the source of the pain as in injury or stomach illness, make an appointment to see your physician.

Appendicitis Facts

Appendicitis is a fairly common health problem, but the more information you have the more effective your appendicitis treatment will be.

  • 8% of the worldwide population suffers from appendicitis
  • 250,000 appendicitis cases occur in the United States each year
  • Appendicitis most often affects teenagers and those in their early twenties
  • If left untreated, appendicitis can lead to an infection
  • Acute appendicitis may occur in children under 15 years old and adults over the age of 50
  • Surgery is the most common and best method to treat appendicitis

Causes

There can be many reasons why the appendix becomes inflamed and blocked (appendicitis) even though there is no direct causal link to one activity or incident. There are two main reasons that appendicitis can occur; infection and obstruction.

An infection of the gastrointestinal system may cause inflammation of the appendix. Whether it is an infection caused by fecal matter, viruses, parasites or fungi, these infections can cause appendicitis. The other major cause of appendicitis is an obstruction such as a fecal stone (hard portion of stool) or food waste. This obstruction blocks the opening that runs the length of the appendix.

The photo below is an example of an inflamed appendix.

Inflamed-Appendix

Inflamed Appendix

In either of these scenarios the bacteria can multiply, which causes major inflammation of the appendix. If left untreated, many complications can occur.

Complications

If a case of appendicitis is left untreated, the patient is at risk for various complications. Some complications may be due to the spread of the infection. The two most serious complications are:

  • Rupture. The appendix can continue to be inflamed as the bacteria grow within it, leaving you at risk for a ruptured appendix. If this happens you will experience severe pain, but also you are at risk for an even more problematic infection. A ruptured appendix puts you at risk of having your intestines leaking into your abdominal cavity which can lead to serious health complications.
  • Abscess. A ruptured appendix and the ensuing infection can also cause an abscess to from, which is a pocked of infected pus. If the abscess is perforated you could be at risk for the spread of infection throughout your entire abdominal cavity.

The major cause of both of these complications is delayed treatment. The only reason treatment is delayed is that many sufferers ignore the symptoms of appendicitis, which simply increases your risk for these complications.

Diagnosis          

Because the pain associated with appendicitis does not often occur in the lower right abdomen, it can be difficult for patients to realize they are experiencing appendicitis symptoms. Due to the ever-changing nature of the symptoms it can be difficult for self-diagnose appendicitis, which is why it is important to get an official diagnosis from your physician.

Document your symptoms over time including how long they last, when the pain worsens and what you are doing when the pain increases. Give this information to your physician and he or she will perform one of several tests to get an accurate appendicitis diagnosis.

You will undergo one of the following to diagnose appendicitis:

  • Physical exam will include the application of pressure to the area where you experience pain. The doctor will check for tenderness and inflammation. If the pain is worse when the pressure is relieved, your peritoneum may also be inflamed, which will help the doctor give you an accurate diagnosis.
  • Urinalysis is another diagnostic test that examines your urine for red and white blood cells as well as any bacteria found in the urine. If you have appendicitis there will be an abnormal results due to the proximity of the appendix to the bladder and ureter.
  • X-rays are performed on the abdomen to search for hardened stool stones that may be blocking the opening of the appendix. Since blockages are a common cause of appendicitis, this is an effective test.
  • A blood test is a practice method to test for appendicitis because your white blood cell count will increase if you have an infection. This test isn’t fail-safe as any infection will elevate the white cell count, which is why it is often accompanied by another test or procedure.
  • Imaging confirmation is often done using barium x-rays, CT scans or ultra sounds. This will allow the doctor to view the inflammation of the appendix or pinpoint other causes for abdominal pain.

The earlier your identify your symptoms and seek a diagnosis, the more likely it is that your doctor will use a less invasive diagnosis method.

Treatment

There is just one treatment for appendicitis; surgery. There are no home remedies or drugs that patients can take to treat appendicitis or the symptoms of appendicitis. The risk of rupture increases from the moment the symptoms begin.

Once you have received your diagnosis your physician will likely schedule surgery immediately to remove the appendix, known as an appendectomy.

How Is An Appendectomy Done?

Although appendectomies are often emergency surgeries they are rather routine and the risk of complications from surgery are quite low. There are two dominant methods of removing an appendix, and the choice usually depends on the patient and the doctor’s recommendation.

The traditional appendectomy (open appendectomy) requires a small incision—of 2 to 3 inches—in the abdominal wall just above the appendix. Once the surgeon confirms that there are no other serious problems in the region, he will remove the appendix. Removing it requires releasing the appendix from the attachment to the abdomen and colon. Any abscesses present will be drained before the incision is closed.


More surgeons are relying on a laparoscopic appendectomy because it scars less thanks to the tiny keyhole incision and allows patients a faster recovery time. This method is best for cases of appendicitis caught early enough that rupturing isn’t a concern. An open appendectomy may be required if your appendix has already ruptured or if your infection has spread.

Recovery time for an appendectomy is usually 1 to 3 days, depending on the patient.

What Are The Complications Of Appendectomy?

As with type of surgery, there is the risk of complications after an appendectomy. First is the risk of infection to the incision. The infection can range from mild to severe and usually requires antibiotics to treat. If the infection is noticeable before the appendectomy is over, the surgeon may opt to leave the scar open to begin treatment immediately.

The best way to prevent an infection is to take proper after-care as directed by the surgeon and keep the incision clean and dry.

There is also a risk of abscess as a result of an appendectomy. These abscesses may be removed through an additional surgery but it may also be drained using a tube to avoid surgery.

Can Appendicitis Be Prevented?

There are no real indicators to predict who will suffer from appendicitis and who will not. There are no risk factors proven to cause an appendicitis and since it is not contagious or hereditary there is very little that can be done to prevent appendicitis.

The best bet to prevent it is a healthy diet without a lot of sugar. If you are prone to infections a healthy diet with lots of vitamins and nutrients can help reduce your risk of infections, however not your risk of appendicitis. If you’re interested in helping treat and researching preventative methods for appendicitis, considering earning an online ms in nursing.

Written By Miranda Stephens

Miranda Stephens, MD is certified by the American Board of Family Medicine. Dr. Stephens earned her undergraduate degree from the University of Colorado.She completed a residency in Family Medicine at the University of Michigan at Ann Arbor. In 2006 Dr. Stephens was chosen for Alpha Omega Alpha Honor Medical Society.

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