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Appendicitis

What is appendicitis?

Highlights

  1. Appendicitis occurs most often between the ages of 10 and 30.
  2. Symptoms include pain around the bellybutton, loss of appetite, nausea, abdominal swelling, and low grade fever.
  3. One possible cause of appendicitis is an obstruction in the appendix. Obstruction can lead to bacteria multiplying inside the organ and the formation of pus.

Appendicitis is inflammation of the appendix. It may be acute or chronic.

The National Institute of Diabetes and Digestive and Kidney Diseases states that appendicitis is the most common cause of abdominal pain resulting in surgery in the United States. About 5 percent of the American population experiences appendicitis at some point in their lives.

Appendicitis can occur at any time, but it occurs most often between the ages of 10 and 30. It’s more common in men than in women. Complications from appendicitis can be serious and even fatal.

What causes appendicitis?

Causes

In many cases, the cause for appendicitis is unknown. There can also be multiple causes for any one case of appendicitis. Doctors believe that one cause of this condition an obstruction in the appendix. Obstruction may be either partial or complete. Complete obstruction is a cause for emergency surgery.

Obstruction is often due to an accumulation of fecal matter. It can also be the result of:

  • enlarged lymphoid follicles
  • worms
  • trauma
  • tumors

When there’s an obstruction in your appendix, bacteria can multiply inside the organ. This leads to the formation of pus. The increased pressure can be painful. It can also compress local blood vessels. A lack of blood flow to the appendix may cause gangrene.

If the appendix ruptures, fecal matter can fill the abdomen. This is a medical emergency.

Peritonitis is one possible consequence of a ruptured appendix. It’s an inflammation of the tissue that lines the abdominal wall. Other organs can also become inflamed after a rupture. Affected organs may include the cecum, bladder, and sigmoid colon.

If the infected appendix leaks instead of ruptures, it can form an abscess. This confines the infection to a small walled off area. However, an abscess can still be dangerous.

What are the symptoms of appendicitis?

Symptoms

Symptoms of appendicitis include:

  • pain around the bellybutton
  • lower right side abdominal pain
  • loss of appetite
  • nausea
  • vomiting
  • diarrhea
  • constipation
  • inability to pass gas
  • abdominal swelling
  • low grade fever
  • a sense you might feel better after passing stool

You may experience one or more of these symptoms.

Appendicitis pain may start off as mild cramping. It often becomes more steady and severe with time. You won’t necessarily notice changes in your bowel habits. However, sometimes appendicitis can affect urination.

If you suspect you may have appendicitis, you should avoid taking laxatives or having an enema. The Cleveland Clinic notes that these treatments can cause your appendix to burst if you’re experiencing appendicitis.

If you have right side tenderness along with any of these other symptoms, talk to a doctor. Appendicitis can quickly become a medical emergency. Rupture rarely happens within the first 24 hours of symptoms.

A perforated appendix can be fatal. The risk of death is highest in infants and the elderly.

How is appendicitis diagnosed?

Diagnosis

Your doctor will begin by performing a physical exam. A physical exam for appendicitis looks for tenderness in the lower right quadrant of your abdomen. If you’re pregnant, the pain may be higher. If perforation occurs, your stomach may become hard and swollen.

A swollen, rigid belly is a symptom that should be discussed with a doctor right away.

In addition to looking for tenderness, your doctor will perform several tests for appendicitis:

  • Urinalysis can rule out a urinary tract infection or kidney stone.
  • Pelvic exams can make certain that women don’t have reproductive problems. They can also rule out other pelvic infections.
  • Pregnancy tests can rule out a suspected ectopic pregnancy.
  • Abdominal imaging can determine if you have an abscess or other complications. This may be done with an X-ray, ultrasound, or CT scan.
  • Chest X-ray can rule out right lower lobe pneumonia. This sometimes has symptoms similar to appendicitis.

What are the treatment options for appendicitis?

Treatment

Treatment for appendicitis varies.

In rare cases, appendicitis may get better without surgery. Treatment might involve only antibiotics and a liquid diet.

In most cases, however, surgery will be necessary. The type of surgery will depend on the details of your case.

If you have an abscess that hasn’t ruptured, you may receive antibiotics first. Your doctor will then drain your abscess using a tube placed through your skin. Surgery will remove your appendix after you’ve received treatment for the infection.

If you have a ruptured abscess or appendix, surgery may be necessary right away. Surgery to remove the appendix is known as an appendectomy.

A doctor can perform this procedure as open surgery or through a laparoscopy. Laparoscopy is less invasive, making the recovery time shorter. However, open surgery may be necessary if you have an abscess or peritonitis.

How can I prevent appendicitis?

Prevention

You can’t prevent appendicitis, but there are steps you can take to lower your risk. It’s less common in people who have diets high in fiber. Eating a healthy diet that contains lots of fresh fruits and vegetables increases your fiber intake.

Seek medical attention immediately if you think you have appendicitis. Untreated appendicitis can become a medical emergency.

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