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Emergency Signs and Symptoms of Appendicitis

What is appendicitis?

Highlights

  1. Appendicitis is an inflammation of the appendix, a pouch-shaped organ connected to the large intestine. If you don’t get treatment for it, the appendix can rupture, which is a life-threatening situation. Always seek immediate medical attention if you think you have appendicitis.
  2. Your appendix is on the lower right-hand side of your abdomen, but pain from appendicitis may start in the middle of your abdomen.
  3. Treatment for appendicitis involves surgery to remove the appendix. After surgery, most people recover quickly and without complications.

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, but some believe it contains tissue responsible for helping 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 known as peritonitis, which 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

Symptoms

Appendicitis causes a variety of symptoms. 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:

Abdominal pain

Appendicitis typically 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.

Mild fever

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 elevation in heart rate may indicate that the appendix has ruptured.

Digestive upset

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 an indication of a partial or total obstruction of your bowel. This may be related to underlying appendicitis.

Symptoms of appendicitis in children

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).

However, 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:

  • vomiting
  • abdominal bloating or swelling
  • a tender abdomen

Older children and teenagers are more likely to experience:

  • nausea
  • vomiting
  • pain in the lower right side of the abdomen

Symptoms of appendicitis during pregnancy

pregnant women

Many appendicitis symptoms can mimic some of 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 appendix is pushed higher during pregnancy by the growing uterus, so the pain may occur in your upper abdomen instead of the lower right side of your abdomen. Pregnant women with appendicitis are also more likely to experience heartburn, gas, or alternating episodes of constipation and diarrhea.

How is appendicitis treated?

Treatment

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:

If your doctor diagnoses you with appendicitis, they’ll then determine 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.

Depending on the severity of your appendicitis, your surgeon may perform an open appendectomy or a laparoscopic appendectomy:

Open appendectomy

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 an abscess has formed.

Laparoscopic appendectomy

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 them 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 surgery

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 complication.

Risk factors and prevention

Prevention

According to the National Institute of Diabetes and Digestive and Kidney Diseases, 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 happen at any time, but it most often occurs between ages 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 reduce your risk. It seems less likely to happen 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:

  • raspberries
  • apples
  • pears
  • artichokes
  • green peas
  • broccoli
  • lentils
  • black beans
  • bran flakes
  • barley
  • oatmeal
  • whole wheat spaghetti

Increasing the amount of fiber in your diet can prevent constipation and subsequent stool buildup, which is the most common cause of appendicitis. Additionally, if you have any condition that causes inflammation or infection of the bowels, it’s important to create an effective plan with your doctor to prevent appendicitis. Always seek medical attention immediately if you or someone you know is experiencing the symptoms of appendicitis.

Dos and Don'ts

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  • Go to the hospital immediately if you or your child has the symptoms of appendicitis. There are no home remedies that can help.
thumbs down Avoid this
  • Don’t take over-the-counter medications for the symptoms of appendicitis. Enemas and laxatives can cause your appendix to rupture. Pain medications that mask symptoms may also make it harder for your doctor to make a quick diagnosis.

Read next

Appendectomy: Preparation, Procedure, Risks
What's Causing Your Abdominal Pain?
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