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Appendicitis

Topic Overview

What is appendicitis?

Appendicitis is one of the causes of serious belly pain. It happens when the appendix, a part of the large intestine, becomes infected and inflamed. Experts don't know what the appendix does in the body, but most of the time it doesn't cause problems.

Appendicitis is most common in people ages 10 to 30, but it can happen at any age. With treatment, most people recover quickly and don't have any further problems. But without treatment, the appendix may burst and cause infection throughout the belly. This can be very serious.

What causes appendicitis?

It's often not clear why someone gets appendicitis. In some cases, a small object (such as a hard piece of stool) blocks the opening to the appendix. Then bacteria can grow in the appendix and cause an infection.

What are the symptoms?

The main symptom of appendicitis is belly pain. Many people feel the first pain near the belly button. Then it moves to the lower right side of the belly. But the pain can be in different parts of your belly or even on your side or back. The pain may get worse if you move, walk, or cough.

You may also have a fever or feel sick to your stomach.

In some cases, appendicitis doesn't cause any symptoms except for belly pain. The pain in your belly may be different than any pain you have had before. It may be severe. Or it may not seem like a very strong pain, but you may have the feeling that something is wrong. If you have moderate belly pain that does not go away after 4 hours, call your doctor. If you have severe belly pain, call your doctor right away.

Sometimes the only symptom is a general feeling of not being well and a pain that is hard to describe. Trust your instincts. If you think you could have appendicitis, you need to see a doctor.

How is appendicitis diagnosed?

Appendicitis can be hard to diagnose. Your doctor will do a physical exam and ask you questions about what symptoms you have, when they started, and what was happening before the pain began. You also may have blood and urine tests to look for signs of infection. In some cases, you may need a CT scan or an ultrasound of your belly.

Even though tests can't always show for certain that you have appendicitis, your symptoms may lead your doctor to strongly suspect that you have it. In this case, your doctor probably will recommend that you have surgery to remove your appendix. Most of the time, the doctor is right and the appendix is infected. During surgery your doctor may find that your appendix is normal and that something else caused your pain. Your doctor will go ahead and remove your appendix. You can live just fine without it, and taking it out gets rid of any chance that it could cause problems later.

How is it treated?

The main treatment for appendicitis is surgery to remove the appendix (appendectomy). There are different types of surgery for appendicitis. Your surgeon may operate through a cut (incision) in your belly or use a tool called a laparoscope to remove your appendix through a few small incisions.

If you have appendicitis and aren't treated in time, your appendix can burst and cause serious problems. It's best to remove the appendix before it bursts.

If your appendix does burst, surgery may be more complicated. You also will need antibiotics and may need other treatment.

How long does it take to recover after surgery?

Most people leave the hospital 1 to 3 days after surgery. Some may even go home the same day. Depending on what type of surgery you have, it may take from 1 week to 1 month to get back to your normal activities.

If your appendix ruptures, or if there is infection in your belly or other problems, you may be in the hospital longer. And it may take longer to get better.

After surgery, be sure to follow your doctor's advice about what to watch for, such as fever, increasing belly pain, or problems with your incision.

References

Other Works Consulted

  • Ben-David K, Sarosi GA, Jr. (2010). Appendicitis. In M Feldman et al., eds., Sleisinger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., vol. 2, pp. 2059–2071. Philadelphia: Saunders.
  • D'Souza N, Nugent K (2014). Appendicitis. BMJ Clinical Evidence. http://clinicalevidence.bmj.com/x/systematic-review/0408/overview.html. Accessed January 14, 2015.
  • Sauerland S, et al. (2010). Laparoscopic versus open surgery for suspected appendicitis. Cochrane Database of Systematic Reviews (10).

Credits

ByHealthwise Staff
Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine
E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine

Current as ofMarch 28, 2018


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