Appendicitis

What is appendicitis?

The appendix is a small tube of tissue located where the large bowels (or intestines) begin, and it is usually found at the lower right part of the abdomen. When the appendix becomes inflamed or infected, this condition is called Appendicitis.

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What causes it?

There is an increased likelihood of developing appendicitis if it happens to a first-degree relative. Diets low in fibre also increases the chances of developing this condition. Viral infection may cause the appendix to become inflamed and subsequently get infected by bacteria causing appendicitis. However, the most common cause is obstruction by partly digested food particles called faecoliths. This obstruction causes the appendix to become inflamed. Swallowed foreign bodies or worms may also cause obstruction.

What are the symptoms?

Pain is the first symptom. It starts around the umbilicus, and after a few hours, it migrates to the right lower. It may eventually become severe and occur all over the abdomen. The pain may be worse if you move, and it might get a little better if you draw your knees up.

You most probably won’t feel like eating, and you might throw up.

You may also have a slight fever.

Constipation is the usual feature but diarrhoea can occur in a few cases.

It’s very important to see a doctor urgently if you feel you have appendicitis. If you don’t get treatment early enough, your appendix can burst, and this could be fatal.

How do doctors diagnose it?

Where resources are limited, diagnosis is usually on clinical basis, with simple investigations like blood tests and ultrasound imaging to back it up. More advanced techniques such as CT (computed tomography) scan may be useful in situations where the diagnosis is difficult to make such as in the elderly.

 

What treatments work?

Surgery

Surgery is the definitive treatment for appendicitis. This surgery is called appendicectomy (“-ectomy” means “to cut off”). A burst appendix may be however first managed conservatively with intravenous fluids and antibiotics for a while before surgery is done.

There are two methods of appendicectomy. Both require being put to sleep during the operation, so that pain is not felt. In the open surgery the surgeon takes out the inflamed appendix through a cut in the abdomen. There’s a keyhole surgery, which is also called laparoscopic surgery, in which a camera is used to perform the operation through several small holes on the abdomen. There are less complications from this and the hospital stay is shorter, however, keyhole surgery is not available everywhere.

 

Treatment without surgery

Some recent research has suggested that, for some people with appendicitis, antibiotics might be the only treatment they need.

However, more research would need to show that this approach is safe before it could become standard practice.

 

What will happen to me?

The appendix is not vital to life, so you lose nothing by having it cut off. However, as with any type of operation, appendicectomy carries risks, such as an infection and bleeding from surgery site.

Most people recover very well and get discharged from the hospital within a few days. You should be able to start eating normally again a day or two after the operation.