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What Is Appendicitis?

To understand Appendicitis, one needs to understand an organ called ‘appendix’. The appendix is a small, tube-like structure attached to the first part of the large intestine, also called the colon. The appendix is located in the lower right portion of the abdomen. It has no known function. Removal of the appendix appears to cause no change in digestive function. Appendicitis is an inflammation of the appendix. Once it starts, there is no effective medical therapy, so appendicitis is considered a medical emergency. When treated promptly, most patients recover without difficulty. If treatment is delayed, the appendix can burst, causing infection and even death. Appendicitis is the most common acute surgical emergency of the abdomen. In the U.S., 1 in 15 people will get appendicitis. Anyone can get appendicitis, but it occurs most often between the ages of 10 and 30. Appendicitis occurs when the appendix becomes blocked, often by stool, a foreign body, or cancer. Blockage may also occur from infection, since the appendix swells in response to any infection in the body.

Symptoms

The classic symptoms of appendicitis include:

• Dull pain near the navel or the upper abdomen that becomes sharp as it moves to the lower right abdomen. This is usually the first sign.
• Loss of appetite
• Nausea and/or vomiting soon after abdominal pain begins
• Abdominal swelling
• Fever of 99° F to 102° F
• Inability to pass gas

Almost half the time, other symptoms appear, including:

• Dull or sharp pain anywhere in the upper or lower abdomen, back or rectum
• Painful urination
• Vomiting that precedes the abdominal pain
• Severe cramps
• Constipation or diarrhea with gas

Treatment

Surgery to remove the appendix, which is called an appendectomy, is the standard treatment for appendicitis. If appendicitis is even suspected, doctors tend to err on the side of safety and quickly remove the appendix to avoid its rupture. If the appendix has formed an abscess, you may have two procedures: one to drain the abscess of pus and fluid, and a later one to remove the appendix. Antibiotics are given before an appendectomy to fight possible peritonitis. General anesthesia is usually given, and the appendix is removed through a 4-inch incision or by laparoscopy. If you have peritonitis, the abdomen is also irrigated and drained of pus. Within 12 hours of surgery you may get up and move around. You can usually return to normal activities in 2 to 3 weeks. If surgery is done with a laparoscope (a thin telescope-like instrument for viewing inside the abdomen), the incision is smaller and recovery is faster.