Mayuri Bhakta, FNP-BC
Did you know appendicitis is one of the most common causes of abdominal pain leading to emergency surgery in adults? It’s also the most common reason for emergency abdominal surgery in children. People can have appendicitis at any age, but it is more common in teenagers and adults in their 20s. Males of all ages are more likely to develop appendicitis than females. Let’s take a closer look at what appendicitis is and what it means for those affected by it.
What is the appendix?
Your appendix is a small, tube-like pouch that hangs off the large intestine (also known as your colon). It is usually found on the right lower side of the colon. Interestingly, the function of the appendix is still unknown.
What is appendicitis?
Appendicitis occurs when the appendix becomes inflamed. Inflammation can be caused when the appendix becomes blocked with bacteria, stool, or masses. Inflammation of the appendix can lead to infection, and in some cases, rupture of the appendix. A ruptured (burst) appendix can lead to a life-threatening infection in your abdominal cavity.
What are the signs and symptoms of appendicitis?
Signs of appendicitis usually include one or more of the following symptoms:
- Nausea, vomiting, and/or diarrhea
- Gas and bloating
- Loss of appetite
- Pain around the belly button
- Pain in the right lower side of the abdomen
- Pain with sudden or jarring movement
- Pain with change of position
- Pain when pushing on the abdomen
How is appendicitis diagnosed?
If you suspect that you have signs or symptoms of appendicitis, call your healthcare provider right away or seek treatment in an emergency room. Your provider will need to talk to you about your symptoms and will need to examine you and your abdomen. This examination often includes listening to your heart, lungs, and abdomen and then examining your abdomen by looking, listening, and pressing on your abdomen. If your provider suspects appendicitis based on your signs, symptoms and physical exam, your provider may order tests. These tests may include blood tests, urine tests, and imaging tests such as a CT scan and/or an ultrasound. Your provider may order an IV line (intravenous line) so that you can be given fluids, medications, or IV dye for testing. Based on the results of your examination and testing your provider may consult with a general surgeon to evaluate you and decide the best treatment options for you.
What is the treatment for appendicitis?
Appendectomy is the term used to describe a surgery to remove the appendix. Most cases of appendicitis require antibiotics and surgery. In some cases where the appendix has not ruptured, providers may order antibiotics and observation in the hospital to see if symptoms improve before deciding to perform an appendectomy. For those who are treated with only antibiotics, there is a chance that they can develop appendicitis again or that they may need to have an appendectomy in future.
Patients who have an abscess (a walled-off area of infection) around the appendix may need to have the area of infection drained by their surgeon before having an appendectomy.
There are two types of surgery to remove the appendix: open surgery and laparoscopic surgery. A patient’s surgeon will determine which type of surgery is best based many factors.
During an open surgery, surgeons make a cut in the area of the appendix big enough to remove the appendix and to clean any areas inside the abdomen if the appendix has ruptured.
During laparoscopic surgery, surgeons make several small cuts in the abdomen so that they can insert tools, including a camera (laparoscope), to help remove the appendix. Patients who have undergone laparoscopic surgery usually have a quicker recovery.
What happens after an appendectomy?
Most people recovering from appendectomy have no long-term side effects. It usually takes a few weeks to recover after a laparoscopic appendectomy, and longer after an open surgery. Patients who have had appendectomies are advised to slowly increase activity and to avoid strenuous activity. Healthcare providers will guide patients on return to work or school and advise on restrictions following surgery. As with any surgery, there could be scarring and a risk of post-operative infection.
Healthcare providers will discuss post-appendectomy care with patients as well as abnormal signs or symptoms following an appendectomy.
David E Wesson and Mary L Brandt, “Acute appendicitis in children: Clinical manifestations and diagnosis,” UptoDate, updated November 14, 2018.
David E Wesson and Mary L Brandt, “Acute appendicitis in children: Management,” UptoDate, updated April 4, 2019.
Ronald F Martin, “Acute appendicitis in adults: Clinical manifestations and differential diagnosis,” UptoDate, updated April 27, 2018.
Sandy Craig, “Appendicitis,” Medscape, https://emedicine.medscape.com/article/773895-overview
Douglas Smink and David I Soybel, “Management of acute appendicitis in adults,” UptoDate, updated April 1, 2019.