Commonly asked questions about appendicitis

Oct 08, 2017 Dr Zulfikar Bux, Features / Columnists

By Dr Zulfikar Bux

Assistant Professor of Emergency Medicine

Appendicitis is the most common abdominal emergency found in children and young adults. One

Dr. Zulfikar Bux

person in 15 develops appendicitis in his or her lifetime. More males than females develop appendicitis between puberty and age 25. It is rare in infants and children under the age of two and the risk gradually decreases as one approach the 5^th decade of life. Today we will discuss some commonly asked questions about this common and potentially deadly illness.

WHAT IS THE APPENDIX?

The appendix is a long, thin pouch that is shaped like a finger. It hangs down from the large intestine, which is also called the colon. There are many theories around but the function of the appendix remains unknown.

WHAT IS APPENDICITIS?

Appendicitis is the name for when the appendix gets infected and inflamed. If that happens, it can swell and in some cases burst. That’s dangerous, because a burst appendix can cause infection in the belly.

WHAT ARE THE SYMPTOMS OF APPENDICITIS?

The usual symptoms include:

Severe pain in the lower part of the belly, on the right side. (For many people, the pain starts near the belly button and then moves to the lower right side.)
Loss of appetite
Nausea and vomiting
Fever

Some people can have different symptoms, such as:

Stomach upset
Having a lot of gas
Irregular bowel movements
Diarrhoea
Feeling ill

IS THERE A TEST FOR APPENDICITIS?

Your doctor can run tests that can help him or her find the cause of your symptoms. But if you do have appendicitis, he or she will probably be able to diagnose it just by doing an exam. Your doctor can learn a lot about your condition by pressing on your belly and talking with you about your symptoms.

SHOULD I SEE A DOCTOR?

Yes. Call your doctor right away if you have the symptoms listed above. The risk of your appendix bursting is much higher after the first 24 hours of symptoms. If the appendix bursts, the surgery to treat it will be more complicated.

HOW DEADLY IS APPENDICITIS?

The inflammation caused by appendicitis, when left untreated, can cause the appendix to burst. After an appendix bursts, infectious materials are spilled out into the abdominal cavity and can cause poisoning through sepsis. In extreme cases, appendicitis can lead to peritonitis, which is a much more severe version, and can cause death. To prevent such fatalities, surgeries are preformed to remove the appendix (appendectomy).Due to medical advances, people rarely die from appendicitis in developed countries today. Nonetheless, the disease does maintain a 1% death rate.

HOW IS APPENDICITIS TREATED?

The main treatment for appendicitis is surgery to remove the appendix. This surgery can be done in 2 ways:

Open surgery– During an open surgery, the surgeon makes a cut near the appendix that is big enough to pull the appendix through.
Laparoscopic surgery– During laparoscopic surgery, the surgeon makes a few cuts that are much smaller than those used in open surgery. Then he or she inserts long, thin tools into the belly. One of the tools has a camera (called a “laparoscope”) on the end, which sends pictures to a TV screen. The surgeon can look at the image on the screen to know where to cut and what to remove.

If your appendix has burst, your surgery will probably be more complicated than it would be if it had not burst. Your surgeon will need to wash away the material that spills out when an appendix bursts. As a result, your cuts might be larger or you might spend more time in surgery.

If it has been a few days since your appendix burst and you are not very sick, your doctor might decide not to do surgery at all. That’s because the body sometimes forms a wall inside the belly, to block off the area that became infected when the appendix burst. In a case like this, doctors usually give antibiotics and carefully watch the person. They might be able to avoid doing surgery right away, since it can be more difficult in people who fit this description. But many people will need surgery later to take out the appendix.

WHAT IF I AM PREGNANT?

If you are pregnant and think you have signs of appendicitis, make sure you tell your doctors that you are pregnant. They will still treat you like every other patient but will take steps to protect your unborn baby.

Remember that appendicitis lasts for a short time. If your belly pain has been occurring for weeks to months, chances are it’s not your appendix. By the way, patients ask this question about their chronic belly pain more often than any other.