Appendicitis: Symptoms, Causes, and Treatment

Causes

Although exact cause of appendicitis is yet unknown, experts believe that the primary reason is blockage of the appendix. When the appendix gets clogged/blocked, it can become inflamed, infected, or swollen, leading to appendicitis. When the appendix becomes sore and swollen, blood supply to the appendix gets reduced and this is when appendix starts decaying. If not treated, the appendix can rupture, leading to other complications. The appendix can get blocked due to many reasons, such as hardened stool, tumours, colitis, traumatic injury, enlarged lymphoid tissue in the appendix, and intestinal worms. Appendicitis can also be genetic.

Symptoms

• Abdominal pain is the most common symptom of appendicitis. This pain can start suddenly on the right side of your lower abdomen or begin around the navel area and move to the abdomen. It can worsen when you cough, sneeze, walk, and also when touched.

• Fever and chills

• Lack of appetite

• Diarrhoea

• Constipation

• Bloating of the abdomen

• Nausea and vomiting

• Indigestion

Appendicitis pain can become an emergency within a few hours. So, if you experience any of the above appendicitis symptoms, consult a doctor as soon as possible.

Diagnosis

If you are suspected of having appendicitis, your doctor will ask about the pain, other symptoms and medical history. The following tests will be done to arrive at a diagnosis of appendicitis —

• Physical examination:

Your doctor will first do a physical examination to look for swelling or tenderness of your abdomen (right-hand side of your lower abdomen).

• Blood tests:

A complete blood count (CBC) will show if you have any infection or inflammation, which will be indicated by a high white blood cell count. The C-reactive protein count test will help identify the infection.

• Urine tests:

Urine tests will ascertain whether you have UTI (i.e., urinary tract infection) because the symptoms are similar to appendicitis.

• Abdominal imaging tests:

These tests, such as ultrasound, CT scan, or MRI, are done to check if your appendix is swollen.

• Pregnancy test:

If doctor suspects that the symptoms could be due to ectopic pregnancy, you will have to undergo a pregnancy test. Ectopic pregnancy can be mistaken for appendicitis.

Treatment

In most cases, appendicitis is a medical emergency. So, the treatment involves surgery to remove your appendix, which is called appendectomy. An appendectomy can be done as an open surgery or laparoscopic, depending on an individual’s condition. In laparoscopic surgery, there’s less pain and faster healing, but it is generally not recommended if your appendix has burst and the infection has already spread to other parts of the body. Before surgery, you may have to take antibiotics to treat the infection.

If the condition is not severe and doesn’t require surgery, your doctor may prescribe only antibiotics. However, there is a high chance of recurrence of appendicitis if the appendix is not removed. In rare cases, people recover from appendicitis with antibiotics alone.

Complications

Ignoring appendicitis symptoms and leaving it untreated can rupture the appendix, leading to infection and complications which can be life-threatening. Some complications of untreated appendicitis are —

• Peritonitis:

When the bacterial infection enters your abdominal cavity after appendix ruptures, it can lead to peritonitis. The infection may be severe and even lead to death if not treated properly. Treatment includes surgery and antibiotics.

• Abscess:

After the appendix bursts, there will be pus formation around the burst appendix, called an abscess. The abscess must be drained, and the infection must be treated with antibiotics.

• Ischemia and necrosis:

When there’s severe swelling in your appendix, it can lead to ischemia, that is, reduced blood supply. Due to ischemia, the tissues can start decaying, a condition called necrosis.

• Gangrene:

If you develop necrosis, the infection will start spreading. It can spread slowly through internal gangrene or quickly when the appendix ruptures.

Recovery and Aftercare

Recovery depends on several factors, like your overall health condition, the type of surgery (open or laparoscopy), and if you have developed any complications during or after the surgery.

If you opt for laparoscopic surgery, you will be discharged from hospital the same day after surgery or the next day. If you have open surgery, you have to stay a few days in the hospital because it needs more follow-up care; in case of any complications, you will need to stay longer. Post-surgery, you will be prescribed antibiotics and pain-relieving medications for a few days to help with recovery. It generally takes a few weeks to recover from appendicitis completely. However, recovery can take longer if you develop any complications.

Prevention

As of now, there is no way you can prevent appendicitis. However, you can certainly decrease the risk of developing it by consuming a high-fibre diet. Some fibre-rich foods you can include in your diet are fruits, vegetables, whole grains, lentils, legumes, whole wheat, brown rice, etc.