Appendicitis: Things you need to know

Appendicitis happens when it inflames the appendix. Early symptoms can differ across age groups, and may be confused with other conditions.

When left untreated, the symptoms can be unpleasant, painful, and potentially life-threatening, so it’s important that you know them.

Sudden appendicitis is the most common cause of acute abdominal pain requiring surgery in the United States (United States), with at some point more than 5 percent of the population contracting appendicitis.

This occurs most frequently between the teen years and the 20s but it can grow at any age.

Fast facts on appendicitis:

Here are some key points about appendicitis. More detail is in the main article.

  • Early symptoms include a pain near the belly button that may shift toward the lower right-hand side of the abdomen.
  • If treatment for gas does not solve the problem, prompt medical attention should be sought.
  • Many people with suspected appendicitis will go directly to the emergency department.
  • Early treatment is usually successful, but untreated appendicitis can lead to fatal complications.

Symptoms

Appendicitis can cause pain in the lower, right-hand side of the abdomen.
Appendicitis can cause pain in the lower, right-hand side of the abdomen.

The appendix is about 4 inches long, and is found on the lower right side of the abdomen. It is a tubular piece of tissue which is closed at one end. A pouch-like part of the colon, or large intestine, is attached to the cecum.

Severe and sudden abdominal pain typically is the first symptom of Appendicitis.

The pain also happens near to the stomach button. It will probably shift to the lower right side of the abdomen as it worsens.

Within the next few hours the sensation can become more powerful and be intensified by jumping about, taking deep breaths, coughing or sneezing.

Other popular Appendicitis signs include:

  • nausea
  • vomiting
  • loss of appetite
  • constipation or diarrhea
  • inability to pass gas
  • low-grade fever and chills
  • a temperature between 99° and 102° Fahrenheit
  • stomach swelling
  • wanting to have a bowel

In only 50 percent of cases, however, these symptoms appear.

Many patients can experience very mild, or not at all, symptoms such as stomach pain. Others might experience less common symptoms.

Symptoms in children and infants

In a given area, children and infants may not experience pain. The whole body may have tenderness, or there may be no pain.

Children and infants may have movements of the intestines less frequent or no. This can be a symptom of another illness if diarrhea occurs.

While children and infants may not experience accurate pain as the older patients do, research suggests that abdominal pain is still the most common symptom for this age group of appendicitis symptoms.

Symptoms in older adults and during pregnancy

Older adults and women who are pregnant may have different symptoms too. The pain in the stomach can be less serious and less specific. Symptoms may include nausea, vomiting and fever.

During pregnancy, after the first trimester, the pain may shift upwards towards the upper right quadrant. There may be some back pain or flank pain too.

This may result from another condition when there is stomach pain.

Other conditions with similar symptoms

Abdominal pain may be a symptom of other disorders, which tend to be appendicitis.

Examples include:

  • stomach lesions
  • constipation
  • inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis
  • stool, parasites, or growths that clog the inside of the appendix
  • damage or injury to the abdomen

When to see a doctor

Appendicitis can be life-threatening, and needs immediate medical attention. The longer it is left untreated, the more likely it will worsen. Initial symptoms may resemble gas.

If over- the-counter (OTC) medicines do not relieve the gas, or if severe and worsening pain occurs, the individual should see a doctor immediately. Going straight into the emergency room may be advisable.

Treating appendicitis will prevent it from worsening as soon as symptoms appear and will cause further complications.

Diagnosis

Normally a health care provider can treat appendicitis by doing the following:

Reviewing the symptoms

The patient will be asked to give specifics of what symptoms they encounter, how serious, and how long.

Reviewing the patient’s medical history

The doctor will want to know details of the patient’s medical history to rule out other potential health problems.

These include:

  • any other medical conditions or surgeries the patient has or has had in the past
  • whether the patient takes any medications or supplements
  • whether the patient drinks alcohol or takes any recreational drugs

Doing a physical exam

The doctor will do a physical examination to find out more about stomach pain in the patient. They will exert pressure on or touch certain abdominal areas. It may also be used for pelvic and rectal examinations.

Ordering laboratory tests

Blood and urine tests can help confirm a diagnosis of appendicitis or identify symptoms of other health problems. A doctor may also order samples of blood or urine for pregnancy checkups.

The doctor may also prescribe medical tests, such as an abdominal ultrasound, MRI examination or CT scan, if appropriate.

These imaging tests can show:

  • an enlarged or burst appendix
  • inflammation
  • a blockage inside the appendix
  • an abscess

Treatment

Treatment normally starts with intravenous fluid and antibiotics. Some mild appendicitis cases can be treated with fluids and antibiotics to the full.

The next most common step is surgery, which is known as appendectomy. Removing the appendix reduces the risk of it breaking down. Early treatment is important in reducing the risk of complications that can result in death.

There are two types of surgery that can:

Laparoscopic surgery

Surgeons make several small incisions and use special tools through them to cut the appendix.

Benefits of laparoscopic surgery include:

  • a lower risk of complications, such as hospital-related infections
  • shorter recovery time

Patients should be limiting their physical exercise for the first 3 to 5 days following surgery.

Laparotomy surgery

Surgeons remove the appendix by a single incision that is made in the lower right abdomen area. That may be necessary for an appendix to burst.

It helps the surgeon to cleanse the abdomen inside to prevent infection.

For the first 10 to 14 days after a laparotomy surgery patients will limit their physical activity.

Complications

Treatment delays can significantly increase the risk of complications.

Inflammation can cause rupture of the appendix, sometimes as soon as 48 to 72 hours after symptoms start.

A rupture may cause bacteria, stool, and air to leak into the abdomen, resulting in infection and additional complications, which can be fatal.

Infections that may result from a burst appendix include peritonitis, abdomen lining inflammation or an abscess.

Taking medicine for pain can potentially mask the symptoms and delay treatment.

Recovery

Appendicitis is treatable with timely care, and recovery is generally swift and complete. The mortality rate is below 1 percent with early surgery.

For example, in remote areas, the mortality rate can be 50 percent or higher without surgery or antibiotics.

This may lead to complications, such as an abscess or peritonitis, if the appendix bursts. In these cases recovery can be lengthy. Older people also make recovery time take longer.

The appendix is often considered a non-functioning organ, unnecessary for survival, but some scientists suggest it may play a role in keeping a healthy immune system intact.

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