|
What is appendicitis?
Appendicitis is an inflammation of the appendix, a small,
finger-like tube located where the large and small intestine join. The appendix
has no known function.
It is not known
why the appendix becomes inflamed in some people. However, when the appendix
becomes inflamed, it requires immediate medical attention.
Who is at risk for appendicitis?
Appendicitis is the most common reason for abdominal surgery in children. About
four of every 1,000 children under the age of 14 will undergo surgery called
an appendectomy to remove
their appendix. Appendicitis rarely occurs in children under the age of two, and
mostly occurs in people between the ages of 15 and 30. Appendicitis is more
common in males than females.
What are the symptoms of appendicitis?
Symptoms include:
- Nausea
- Vomiting
- Pain when touched on the lower right side of the abdomen
- Abdominal pain or tenderness, usually in the center of the abdomen above
the belly button, then shifting to the lower right side of the abdomen. The
pain increases when moving, taking deep breaths, coughing, or sneezing.
- Fever, usually low-grade (under 100 degrees)
- Inability to pass gas
- Diarrhea
- Constipation
- Abdominal swelling
- Lack of appetite
Note: Not everyone will have all of the symptoms.
If you have symptoms of appendicitis, it
is important that that you do not take
laxatives or enemas to relieve constipation. These medications could cause your
appendix to burst. You should also avoid taking pain medications that could mask
the symptoms the doctor would need to know about to diagnose the condition.
How is appendicitis diagnosed?
Appendicitis
is diagnosed based upon the patient's symptoms, a physical examination (including
a rectal examination), blood tests to check for signs of infection (such as a
high white blood cell count), and a urine test to rule out a urinary tract
infection. Some doctors may conduct chest X-rays, because pneumonia in the lower
right lung can cause pain similar to appendicitis. Additionally, an ultrasound
may be performed to determine if the appendix appears to be inflamed.
How is appendicitis treated?
After you
are diagnosed with appendicitis, the doctor will decide whether to hospitalize
you for further observation or send you home.
If you are hospitalized:
You will be closely observed for 12 to 24 hours to determine whether surgery
is necessary. If your symptoms are extremely severe, your appendix may be
removed immediately with an appendectomy.
An appendectomy can also be done as a laparoscopic or "minimally
invasive" procedure. During laparoscopic surgery, five or six small (5 to
10 millimeter) incisions are made in the abdomen. The laparoscope and surgical
instruments are inserted through these incisions. The surgeon is guided by the
laparoscope, which transmits a picture of the internal organs on a monitor. The
advantages of laparoscopic surgery include smaller incisions, less risk of
infection, less pain and scarring, and a more rapid recovery.
It is crucial to remove an infected appendix before it ruptures. If an
infected appendix ruptures, the infection may move to the abdomen, causing
peritonitis (an inflammation of the lining of the abdomen). The rupture may also
cause an abscess (infected area) near the place where the appendix ruptured. If
the appendix does rupture, the doctor will leave a drainage tube in the abdomen
for a few days after surgery to remove fluid.
After surgery, your doctor will prescribe antibiotics. You may need to take
them for 24 hours or more, depending on whether your appendix ruptured and which
areas were affected.
Usually for the first day or so after surgery, you will not be given anything
to eat or drink. Then your doctor will allow you to have small amounts of water,
then clear liquids, and then some solid foods until you are able to digest foods
normally.
If you are sent home:
- Do not use pain medication. Taking pain medication could make it difficult
for you to know if the pain from appendicitis gets better or worse.
- Do not use enemas or laxatives--they increase the risk of a ruptured
appendix.
- Take your temperature every 2 hours and keep a record. Bring it with you
when you return to see the doctor.
- Do not take antibiotics, unless prescribed by your doctor.
- Contact your doctor if you notice any change in your condition over the
next 6-12 hours.
- You may be asked to bring a urine sample with you when you return in 24
hours for another exam.
- If you are returning for another exam, do not eat or drink anything on the
day of the exam.
Call your physician immediately if:
- You have uncontrolled vomiting.
- You have increased pain in your abdomen.
- You are dizzy or faint.
- There is blood in your vomit or urine.
How can I prevent appendicitis?
There
is no way to prevent appendicitis. However, appendicitis is less common in
people who eat foods high in fiber, such as fresh vegetables and fruits.
If you think that you might have appendicitis, call your doctor immediately
so that he or she can assess your condition and prescribe the proper treatment.
|
