Appendicitis

________________________________________________________________________

KEY POINTS

• Appendicitis is swelling and irritation of the appendix. The appendix is a small, finger-shaped pouch where the large and small intestines join.
• Appendicitis is usually treated with surgery to remove the appendix.
• Ask your provider how to take care of yourself at home, what symptoms or problems you should watch for, and what to do if you have them.

________________________________________________________________________

What is appendicitis?

Appendicitis is swelling and irritation of the appendix. The appendix is a small, finger-shaped pouch where the large and small intestines join. Scientists are not sure what the appendix does, but when it is inflamed, it gets swollen and painful and can cause serious problems.

It is important to get treatment for appendicitis before the appendix ruptures. A rupture is a break or tear in the appendix. If an infected appendix breaks open, it can cause a life-threatening infection of the belly.

Because of the risk of rupture, appendicitis is considered an emergency.

What is the cause?

In most cases appendicitis is caused by a blockage of the opening of the appendix by a piece of bowel movement. Sometimes it is caused by infection in the digestive tract.

What are the symptoms?

The symptoms can differ from person to person. They may include:

• Pain, usually starting near the bellybutton, then moving to the right lower side of the belly. The pain starts suddenly and worsens in just hours, especially with moving around.
• Loss of appetite
• Nausea and vomiting
• Constipation or diarrhea
• Trouble passing gas
• Fever, usually not very high
• Swollen, tight, or hard belly

Children under 10 and adults over 50, as well as pregnant women, are less likely to have the usual symptoms of appendicitis. Because of this, they may not get treatment right away, which makes it more likely that the appendix will rupture. They should be especially careful to report symptoms that could be early signs of appendicitis. Appendicitis is most common between the ages of 10 and 30. If you think you may have appendicitis and are about to see your healthcare provider, do not eat or drink anything before you are examined.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. You may have the following tests:

• Blood tests
• Urine tests
• An ultrasound, which uses sound waves to show pictures of the belly
• MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the belly
• CT scan, which uses X-rays and a computer to show detailed pictures of the belly

If the diagnosis is not clear, you may be watched closely in the emergency room or hospital for 12 to 24 hours to see if surgery is needed.

If your provider does not hospitalize you and sends you home without surgery, your provider will probably ask you to:

• Not use any pain medicine. Taking pain medicine could make it hard for you to know if the pain gets better or worse.
• Not use any enemas or laxatives. These medicines increase the risk that the appendix will rupture if it is inflamed.
• Not take any antibiotics.
• Take and write down your temperature every 2 to 4 hours.
• Contact your provider if any of your symptoms get worse over the next few hours.

How is it treated?

Appendicitis is usually treated with surgery to remove the appendix. It is important to have surgery quickly, before the appendix ruptures. People can live a normal life without an appendix.

Surgery to remove the appendix is done under general anesthesia, through either one cut in the lower right area of the belly or several small cuts. If your appendix is removed before it ruptures, you will usually feel much better in a couple of days.

If the appendix has ruptured, infection can spread through your belly, which is dangerous. Your healthcare provider may put a drainage tube in your belly to help the infection drain. You will stay in the hospital for several days after surgery to receive IV antibiotics and may need more than 1 surgery.

Treatment without surgery includes taking antibiotics to treat the infection. This treatment may be used if you are not well enough for surgery or surgery is not available. Without treatment, appendicitis can be fatal.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. If an antibiotic has been prescribed, take all of it according to your provider’s instructions.

Ask your provider:

• How and when you will get your test results
• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.