Appendicitis: Symptoms, Diagnosis, and Treatment

Appendicitis, an inflammation of the appendix, causes sharp abdominal pain, nausea, and fever. Left untreated, it can lead to severe complications. Diagnosis involves physical exams, imaging, and blood tests, while treatment typically includes surgery or antibiotics.

Understanding Appendicitis

Appendicitis refers to inflammation of the appendix, a small pouch connected to the large intestine. While its exact function is unclear, the appendix can become blocked, leading to swelling and infection. This condition can affect individuals of any age, although it is more common in people between 10 and 30 years old.

Symptoms of Appendicitis

Abdominal Pain

The most notable symptom starts around the belly button and shifts to the lower right abdomen. The pain often worsens with movement, coughing, or deep breathing.

Other Symptoms

• Nausea and Vomiting

These symptoms often appear early, accompanying the onset of abdominal pain, as the body reacts to inflammation in the digestive system.

• Fever

A mild fever (around 37.2–38°C) is typical, signalling the body’s immune response to the infection. Severe cases may lead to higher fevers if the appendix ruptures.

• Loss of Appetite

The discomfort and inflammation can suppress hunger, making it challenging to eat or drink, which may worsen weakness and fatigue.

• Bloating

Inflammation and blockage can lead to gas build-up and swelling in the abdomen, causing additional discomfort.

• Constipation or Diarrhoea

Appendicitis may disrupt normal bowel movements, causing constipation from blockage or diarrhoea due to irritation in the digestive tract.

What Causes Appendicitis?

The reasons for appendicitis are primarily due to obstruction in the appendix, which can cause bacterial growth and infection. Common triggers include:

Faecal Blockages

Hardened stool, known as a faecalith, can obstruct the appendix, creating a blockage that traps bacteria and leads to inflammation.

Infections

Gastrointestinal infections or viral illnesses, such as gastroenteritis, can cause swelling in the lymphatic tissue of the appendix, contributing to obstruction and infection.

Foreign Bodies

Rarely, undigested materials like seeds, food particles, or other foreign objects may lodge in the appendix, initiating inflammation.

Diagnosis of Appendicitis

Physical Examination

The doctor assesses tenderness in the lower right abdomen, often focusing on McBurney’s point, a key indicator of appendicitis. Techniques like rebound tenderness are used to evaluate pain levels when pressure is released.

Imaging Tests

Ultrasound: A non-invasive option, commonly used to detect swelling, fluid build-up, or an enlarged appendix.

CT Scan: Provides detailed cross-sectional images, offering a clearer confirmation of appendicitis, especially in ambiguous cases.

Blood Tests

Elevated white blood cell counts often point to an infection or inflammation, aiding in diagnosis. Other markers of infection might also be evaluated.

Appendicitis Test

Additional tests like urinalysis help rule out conditions such as kidney stones or urinary tract infections. In some cases, a rectal examination might be performed to exclude other possible causes of abdominal pain.

Types of Appendicitis

• Acute Appendicitis: Develops suddenly, causing severe pain and requiring immediate treatment.
• Chronic Appendicitis: Symptoms are milder and recur over time but still require medical intervention.

Treatment for Appendicitis

Appendicitis Surgery

• Laparoscopic Appendectomy: This minimally invasive procedure involves small incisions and is often preferred due to its shorter recovery time and reduced post-operative discomfort.
• Open Appendectomy: Used in cases of a ruptured appendix or complications, this method involves a larger incision to thoroughly clean and address widespread infection.

Antibiotics

For mild or early cases of appendicitis, antibiotics may serve as a temporary or initial treatment to control infection. However, surgery is generally the definitive and long-term solution to prevent recurrence.

Complications of Appendicitis

• Ruptured Appendix: A delayed diagnosis or treatment can lead to a ruptured appendix, spreading infection within the abdominal cavity and causing peritonitis, a serious and potentially life-threatening condition.
• Abscess Formation: Infection can result in the development of pus-filled pockets around the appendix. These abscesses often require drainage through surgical or interventional radiology techniques.

When to See a Doctor?

Seek immediate medical attention if you or your child experience:

• Persistent or worsening abdominal pain.
• Fever combined with nausea and vomiting.
• Inability to pass gas or stool.

If you’re in Bangalore, consult some of the best gastroenterologists in Bangalore at your nearest SPARSH. They can help rule out conditions mimicking appendicitis, such as ovarian cysts or ectopic pregnancy.

Conclusion

Appendicitis is a medical emergency that requires prompt attention to prevent complications. Recognising symptoms early and seeking timely medical care can ensure effective treatment and a smooth recovery. Surgery remains the most common and successful treatment method.

Frequently Asked Questions

What causes appendicitis?

Appendicitis usually happens when the appendix becomes blocked, often by hardened stool, a foreign body, or an infection. This blockage creates a breeding ground for bacteria, leading to inflammation and swelling.

How can I recognise appendix pain?

Appendix pain often begins as a dull ache near the belly button before moving to the lower right abdomen. The pain intensifies over time and can worsen with coughing, walking, or other movements.

What are the treatment options for appendicitis?

Mild cases may respond to antibiotics to manage infection and inflammation. However, most cases require surgery—either laparoscopic or open—to remove the appendix and prevent complications.

Can an appendix be treated without surgery?

In specific cases, especially when the inflammation is mild, antibiotics alone may be sufficient. However, surgery is typically recommended for lasting resolution and to avoid recurrence.

Is appendix surgery painful?

Appendix surgery, particularly the minimally invasive laparoscopic method, is not overly painful. Patients usually experience mild post-operative discomfort, which is manageable with prescribed pain relief.