Early warning signs of appendicitis, and treatment

What is the appendix?

The appendix is a 3.5 inch long, finger-like tube that sits at the junction of the small and large intestines. It’s present in the lower-right quadrant of the abdomen. The lower end of the appendix is closed, while the upper end is connected to the cecum, the beginning of the large intestine.

What is its purpose?

Atrophy is the law of nature. Organs or body parts that are not used get defunct with time. Appendix is one such vestige. It serves no clear purpose.

Some scientists believe the appendix stores good bacteria which helps to bring the digestive system to normal after a bout of illness or diarrhoea. There is no concrete data to prove this theory.

What is appendicitis and why does it occur?

The appendix generates mucous and fluid constantly which drain into the cecum eventually to be eliminated through the stools. Sometimes the appendix gets blocked by stools or some foreign body. Or it gets infected by bacteria and swells up in response to the infection, thereby blocking the outlet to the colon. This can cause 2 kinds of complications.

1. Rupture: The blocked appendix swells up over time, causing inflammation, reduced blood flow, and eventually ruptures. This causes an infection called as peritonitis of the peritoneum or the outer lining of the abdomen. Peritonitis can be dangerous and causes more complications of its own.
2. Abscess: The burst appendix forms one or more pockets of pus in the abdomen called as abscess. The pus will then have to be drained out by a doctor quickly before it creates other complications.

The contributing causes and resulting complications are collectively called appendicitis.

Signs and Symptoms

Appendicitis manifests as a pain in the navel area that gradually shifts to the right lower part of the abdomen. This abdomen or stomach pain is the most common symptom in children, adults and pregnant women, although there can be other conditions causing such pain. This is the earliest warning sign and must not be ignored.

Other symptoms include:

• Abdomen pain that worsens when you cough, walk or move quickly
• Nausea
• Vomiting before and during the abdomen pain
• Loss of appetite
• Low-grade fever that worsens as the condition progresses
• Constipation or diarrhoea
• Bloating or swelling of the abdomen
• Flatulence (gas)
• Inability to pass gas
• Wanting to pass stools to relieve discomfort

How is it diagnosed?

1. A doctor will check for visible signs such as abdomen pain (by gently applying pressure on different parts of your abdomen) and fever
2. Your medical history will be reviewed. If you have had any surgeries or medical conditions in the past; what medications or supplements you may be taking currently and whether you consume tobacco, alcohol or recreational drugs.
3. Physical examinations of the pelvic and rectal area will be done
4. The doctor will order a blood test to check for pregnancy, infection or any other medical condition
5. Finally, imaging tests such as ultrasound, CT or MRI are done to check for an enlarged appendix, an abscess, an inflammation of the appendix, a blockage inside or rupture of the appendix

How is it treated?

1. Mild appendicitis is treated successfully using intravenous fluids and antibiotics
2. In cases of acute appendicitis, surgery- an appendectomy- has to be performed. Surgery is of 2 types:
3. Laparoscopic: Small incisions are made on the right side of the abdomen, through which an endoscope with different tools attached at the end, is inserted. This helps to operate on and remove the appendix, and clean the wound as required. This is a minimally invasive procedure performed under local anaesthesia. Benefits are shorter recovery time and fewer chances of hospital infections.
4. Laparotomy; If the appendix has already ruptured, the laparoscopic method will not work. A proper surgery performed under general anaesthesia will be required. The doctor will make an incision on the right side of the abdomen, clean out the ruptured appendix and other debris, and suture the wound. This will require hospitalization and the patient is restricted to certain movements for 1 to 2 weeks.

Conclusion

 Appendicitis is easily and successfully curable when diagnosed early. Incidents of complications or fatality are extremely rare. If you or your dear ones are diagnosed with appendicitis, do not panic. Consult a reputed hospital when you notice those early warning signs. These hospitals have the best general surgeons in town who will decide the right course of treatment for quick recovery and rehabilitation.

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Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

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