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Appendicitis: A Familiar Medical Emergency

Appendicitis is the most prevalent abdominal surgical urgency globally. Occurring at a rate of 233 cases per 100,000 individuals every year.

The appendix is the tiny finger-shaped pouch nestled in the lower-right side of your belly. Interestingly, with no real function, it holds little to no significance in our lives. Until it decides to rebel and cause us a lot of discomfort in the form of Appendicitis. The condition leads to abdominal pain and an overall weakening of the body. In most cases, the problem is short-term. But if ignored can lead to sepsis (infection) which can even get life-threatening.

So, while Appendicitis is not always fatal, being proactive helps avoid unnecessary complications. Here’s a detailed guide on the subject that can be of great help to you or someone experiencing the condition.


Appendicitis Definition

Appendicitis is a medical situation where the appendix gets inflamed. This is most likely a result of a blockage in it. Leading to bacteria multiplying inside it which further causes a buildup of pus. A yellow/green fluid in infected tissue along with consequent swelling. Then you feel a certain pressure in your abdomen that gets more and more painful with each passing hour, or day.


The majority of people suffer from Acute Appendicitis. This is a serious case where Appendicitis pain develops all of a sudden and worsens at a fast pace. It is a common condition, more frequent between the ages of 10 to 30 years. Especially in males. The situation demands quick medical treatment. If the appendix ruptures, the bacteria can spread in the abdominal cavity which can be fatal.


Chronic Appendicitis is the rare and the milder kind. It may remain unrecognized for a long time because the signs do not escalate as in the case of the acute type. But the issue may get dangerous at any time. So, if you feel any pain, it's best to consult a doctor as early as possible.

Here are some Appendicitis complications that may occur if left untreated for long.

  • Ischemia (Appendix swells extremely)

  • Necrosis (Decaying of the tissues)

  • Perforation (Appendix rupture)

  • Peritonitis (Swelling/infection in the membrane that lines the abdomen, mostly after a burst appendix)

  • Abscesses (Swollen area in your belly full of pus)

  • Sepsis (Severe infection in the bloodstream)

Appendicitis Symptoms

The most obvious symptom of Appendicitis is abdominal pain. It begins with mild cramps in the belly button area (upper abdomen). Then it goes to the lower right of your belly. The discomfort can:

  • Be a sudden one

  • Intensify with cough and movement

  • Be extremely severe and cause sleeping difficulties

  • Worsen within a couple of hours

Appendicitis pain can also be accompanied by:

  • Nausea

  • Vomiting

  • Loss of appetite

  • Indigestion

  • Swollen belly

  • Fever

  • Need to pee frequently

  • Diarrhea

  • Constipation

What Causes Appendicitis?

The position and the size of the appendix make it prone to being clogged, blocked, swollen, or infected.

Some of the possible Appendicitis causes include:

  • Hardened stools

  • Lymphoid Hyperplasia (enlarged lymphoid tissues that otherwise help with adaptive immune responses)

  • Colitis (inflammation in the colon)

  • Tumors

  • Intestinal worms

  • Cystic fibrosis (a genetic illness affecting the lungs, pancreas, and many other organs)

You are also more at risk if:

  • In your teens/20s

  • A male

  • Have a family history of the disease

Appendicitis Diagnosis

The diagnosis of Appendicitis is not always simple. That’s because Appendicitis signs are similar to those of many other health issues. Like:

  • Endometriosis (In this the tissues like the uterine lining grow outside the womb)

  • Ovarian cyst

  • Kidney stone

  • Urinary tract infection

  • Gallbladder issues

  • Gastritis (irritation on the lining of the stomach)

So, before confirming the condition, the doctor is likely to study the signs carefully. Followed by a thorough examination of your abdomen. And also some other parts to rule out conditions with similar signs.

Appendicitis tests may include:

  1. Complete blood count (CBC) - This is done to detect the symptoms of bacterial infection.

  2. Urine test- Urinalysis helps dismiss kidney stones and urinary tract infection chances.

  3. Pregnancy test - This helps figure out whether you are having the signs due to Ectopic Pregnancy. In this, the implantation of a fertilized egg happens outside the uterus.

  4. Pelvic exam - Here, your vagina, vulva, and cervix are inspected. This answers the possibility of pelvic inflammatory disease or ovarian cysts.

  5. Imaging tests - This helps track the signs of swelling, abscess, and other abdominal issues. The list may include:

  • Abdominal ultrasound

  • Abdominal X-ray

  • Abdominal CT scan

  • Abdominal MRI scan

  1. Chest imaging tests - Doctors suggest this if they suspect Pneumonia (in the lower right part of the lung).

Appendicitis Treatment

The process of treating Appendicitis requires surgery. But your doctor may put you on antibiotics before that to combat the infection.


Appendectomy

This is the surgical method to remove the appendix. But there are two techniques to get it done. The first is an open surgery involving one abdominal cut (2-3 inches). This is known as Laparotomy. The other process is Laparoscopic surgery which requires a few small cuts. In general, the latter is less painful and usually has a faster recovery rate. It is great for aged adults and those who are overweight. However, not all sufferers will benefit from this procedure. For eg, if the appendix has burst and the infection has escalated beyond the appendix. Or if you have developed an abscess, then Laparotomy may be a better option. Plus, an open surgery ensures a proper clean-up of your abdominal cavity too.

Appendicitis treatment can also involve:

  • Draining the abscess using needle drainage/ surgery before Appendectomy.

  • Pain relievers

  • Liquid-based diet

  • IV fluids (liquids injected to prevent dehydration)

You also need to be quite disciplined post the surgery to allow your body to heal fast. So, besides taking the recommended Appendicitis medication, try to:

  • Get enough rest

  • Stay hydrated

  • Go for gentle walks daily

  • Avoid doing strenuous work unless your physician gives the green signal

  • Ensure the areas surrounding the operation are clean and dry.


Can Appendicitis Be Cured Without Surgery?

Most patients will require Appendicitis surgery treatment. But in some rare scenarios, the condition may be very mild and can ease with antibiotics alone.


Final Thoughts

Appendicitis should be treated as an emergency. But being a common medical condition there is no significant ‘fear of the unknown’ in it. You just have to consult a doctor at your earliest and get started with the treatment. Fast recovery is also possible with simple laparoscopic surgery and no additional issues. However, complications intensify the matter and prolong the recovery period. As for preventing Appendicitis, there is no defined way to avoid the problem. Following a fiber-rich diet might help though. So, try to include lots of fruits, vegetables, and whole grains in your dietary plan.

 

The Author : Dr. Sunil Khattri

sunilkhattri@gmail.com

+91 9811618704


Dr. Sunil Khattri MBBS, MS(General Surgery), LLB, is a Medical doctor and is a practicing Advocate in the Supreme Court of India and National Consumer Disputes Redressal Commission, New Delhi.

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