Appendicitis is a common condition in which your appendix—a small finger-like organ attached to your bowel—gets inflamed and infected. It can affect anyone but is most common in people between 10 to 30 years of age.
If left untreated, appendicitis can be dangerous. The inflamed appendix can burst leading to serious complications. That’s why it’s considered a medical emergency that requires urgent treatment.
What is Appendicitis?
Appendicitis means inflammation of the appendix which is a small finger-like pouch attached to the lower right end of your large intestine. It causes sudden and severe pain in the lower right part of your tummy.
The appendix can become blocked or infected leading to inflammation. Due to inflammation the appendix swells and can even burst, if not treated. And the burst appendix is a medical emergency.
When the appendix bursts, the bacteria from your intestines can spill into the abdominal cavity and cause a serious infection called peritonitis.
What are the Symptoms of Appendicitis?
The common symptoms of appendicitis include:
- Abdominal pain—that starts around the belly button and then shifts to the lower right side
- Nausea and vomiting
- Loss of appetite
- Fever
- Abdominal swelling
- Pain that gets worse with movement, coughing, or sneezing and gets slightly better when your move your knees towards your chest
- Constipation or diarrhoea
- Peeing more often than usual
- Rebound tenderness—it’s a sign often checked by the doctor during physical examination. It occurs when pain increases when pressure is suddenly released from the abdomen.
Some people don’t have the usual pain symptoms of appendicitis. They may have less severe pain that develops slowly and in a different place. This can be more common in pregnant women, young children, and older people.
Symptoms of Appendicitis in Pregnant Women
It can be difficult to detect appendicitis during pregnancy as many symptoms can overlap with normal pregnancy discomfort like nausea, vomiting, and mild tummy ache.
However, it’s very important to recognise early signs of appendicitis in pregnant women. Because delay in proper treatment can increase risk of complications for both mother and the baby.
Key symptoms of appendicitis in pregnant women are:
- Pain location changes— As the pregnancy progresses, the growing uterus causes the appendix to shift upwards. Due to this the pain may be felt higher in the abdomen rather than at the typical lower right side.
- Persistent abdominal pain—unlike round ligament pain which is common in pregnancy, appendicitis pain doesn’t come and go. It stays and often gets worse with time.
- Nausea and vomiting (more severe than usual morning sickness)
- Fever
- Loss of appetite
- Constipation or diarrhoea
- Fatigue
If you’re pregnant and feeling unusual or severe abdominal pain, seek medical care right away to rule out appendicitis or other complications.
What Causes Appendicitis?
The exact cause of appendicitis can vary but generally it happens when the appendix is blocked by small pieces of undigested food or hard poo (fecalith).
Other things that can cause blockage in the appendix include:
- Lymphopid hyperplasia—lymphoid tissues in your appendix swell in response to infection which is even anywhere else in your body
- Inflammation of colon due to an infection or inflammatory bowel disease
- Tumors
- Parasites
Once the appendix is blocked, bacteria inside it multiply quickly and cause inflammation and infection.
How is Appendicitis Diagnosed?
Doctors usually use a combination of tests to diagnose appendicitis. These include:
- Physical examination in which the doctor checks for tenderness, rebound tenderness, and guarding in the abdomen.
- Blood tests to look for infection (high white blood cell count)
- Urine test to rule out urinary tract infections
- Imaging tests such as ultrasound, CT scan or MRI to check for swelling in the appendix. (MRI is preferred during pregnancy to avoid radiation exposure)
- Pregnancy test to check if you’re pregnant
There isn’t a single test that always confirms appendicitis. Diagnosis can be tricky as symptoms of appendicitis can look similar to those of other conditions.
In some cases, doctors may keep you under observation to see how your symptoms progress in the hospital.
If the symptoms strongly suggest appendicitis or if it looks as if the appendix has ruptured, your doctor may recommend moving ahead with surgery rather than waiting for more tests.
How is Appendicitis Treated?
The standard treatment of appendicitis is appendectomy—surgical removal of the appendix. It’s not harmful to remove your appendix as you don’t need it.
You’ll be given general anesthesia for the surgery and the surgery can be done in two ways:
Laparoscopic surgery: It’s a minimally invasive procedure with small incision and faster recovery.
Open surgery: It’s usually done when the appendix has ruptured or there are complications.
In some cases, antibiotics may be recommended, in case infection has not spread or surgery is high risk for you. But usually surgery is recommended to prevent recurrence.
In rare cases there can be complications during or after the appendectomy. These complications can include:
- Wound infection
- Bleeding
- Formation of scar tissue (adhesions)
- Abscess (painful build-up of pus) formation at the site where appendix was removed
- Recurrence of appendicitis in the small portion of appendix that may have been left behind—known as stump appendicitis
Recovering from Appendectomy
Most people recover from appendectomy quickly, especially after laparoscopic surgery. It usually takes 1 to 3 weeks to return to work (depending upon the nature of your work) or school, or longer if you had an open surgery. Full recovery usually takes about 6 weeks.
Doctors usually recommend:
- Doing light activities for the first few days and usual activities when you feel ready
- Pain killers for pain management
- If you’re prescribed antibiotics then complete the whole course of treatment
- Following your doctor’s advice regarding caring for your wound
- Avoiding heavy lifting until cleared by your doctor
- Eating a healthy and fiber rich diet to avoid constipation
Risks of a Burst Appendix
A burst appendix also known as ruptured or perforated appendix can be serious and cause complications like:
- Infection of the lining inside your abdomen (peritonitis)
- A severe, life-threatening reaction to the infection (sepsis)
- A blockage in the intestines
- A painful build-up of pus called an abscess
- Complications during pregnancy
Final Thoughts
Appendicitis is a common condition but can become serious, if not treated quickly. Its symptoms can mimic other abdominal issues so it’s important to pay attention to persistent or severe abdominal pain, especially if it moves to the lower right side of your belly.
Having an early diagnosis and treatment can prevent complications and help you recover fast.
