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Appendicitis

What is appendicitis?

An inflammation of the appendix, a finger-shaped organ projecting from the colon is known as appendicitis. Appendix is a vestigial tissue in humans and no known functions are ascribed to it.

The inflammation of the appendix occurs when the germs from the intestine infect it leading to swelling and pus formation. Abdominal pain is the primary complaint of individuals suffering from appendicitis. The appendix may burst (perforate) if timely treatment is not provided. This can lead to peritonitis or pus formation in the abdomen.

appendicitis

Causes and risk factors

Causes

Appendicitis is fairly common and can occur in individuals of any age. Owing to the dietary habits in Asian countries, the incidence of appendicitis are lower in comparison to the western countries.

Often the exact cause of appendicitis is not known in many cases. Most cases are attributed to blockages of the lumen by faecal matter and undigested food in the appendix. Usually, such matter will be repelled out by the walls of the appendix, however, if they remain for a long time, they lead to such blockages. This blockage of the appendicular lumen provides a haven for bacteria to thrive and multiply rapidly, causing the swelling and pus formation.

Symptoms and signs

The symptoms and signs of appendicitis include:

  • Pain in the abdomen – the key symptom of appendicitis. It manifests as a pain in the abdomen mainly in the right lower side of the abdomen, the place where the appendix is located.
  • Vomiting and nausea
  • Diarrhoea or constipation
  • Bloating of the abdomen
  • Loss of appetite
  • Fever
  • Painful urination
  • Difficulty to pass gas

apendicitis

Diagnosis

Diagnosis is made based on the symptoms and signs by the physician.  The tests may include:

  • Physical examination: Your physician may gently press the area which is painful. Worsening of pain on releasing the pressure indicates inflammation of the abdominal wall (peritonitis), probably due to appendicitis.
  • Urine test: Urine tests may be done to rule out kidney and urinary tract infection.
  • Blood test: A white blood cell count will point to an infection.
  • Imaging tests: Abdominal X-rays will help in diagnosing appendicoliths. A CT-scan or ultrasound may be performed for detecting any complications or an abscess.

 

 

Treatment and prevention

Treatment

The treatment includes the use of antibiotics, nil per oral status and a liquid diet, till the inflammation settles. Depending upon the case, surgical removal of the inflamed appendix, known as an appendicectomy might be required.

Appendicectomy can be done via an open or laparoscopic surgery. Open surgery will be done when the appendix has burst and the abdominal cavity requires cleaning. If an abscess is detected and the appendix has not burst, the doctor will drain the abscess and prescribe antibiotics for treating the infection.

Prevention

There are no sure ways to prevent appendicitis. However, appendicitis is less common in people who consume foods rich in high fibre like fruits and vegetables.

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Complications

An inflamed appendix can lead to:

  • Appendix rupture: A fatal condition can arise by the rupture of the appendix requiring surgery and clean up of the abdominal cavity.
  • Pus formation in the abdomen: An abscess with pus may form due to a burst appendix. The pus will be drained and antibiotics prescribed to treat the infection. Surgery is performed later to removed the appendix.

Red Flags

Rush to your doctor straight away if you notice any symptoms of appendicitis. Speedy medical attention is a must for severe pain in the abdomen.

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References

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  • Appendectomy: Surgical removal of the appendix. American College of Surgeons. https://www.facs.org/~/media/files/education/patient%20ed/app.ashx. Accessed 25 Apr. 16.
  • National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.nih.gov/ddiseases/pubs/appendicitis/. Accessed 25 Apr. 16.
  • Craig S, Inceu L, Taylor C. Appendicitis. Medscape 2014;17:773895.
  • Mike Hardin, Acute Appendicitis: Review and Update. Am Fam Physician. 1999 Nov 1;60(7):2027-2034.
  • Lohar HP. Epidemiological aspects of appendicitis in a rural setup. Med J DY Patil Univ 2014;7:753-7

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