Appendicitis

Appendicitis is inflammation of the appendix, a small pouch attached to the cecum, the beginning of the colon, on the lower right side of the abdomen. The appendix is not necessary for life, but it can become diseased. If untreated, an inflamed appendix can burst, causing infection and even death. Appendicitis can affect people at any age. It is most common in people ages 10 to 30.

The cause of appendicitis is usually unknown. It may occur after a viral infection in the digestive tract or when the opening connecting the large intestine and appendix is blocked. The inflammation can cause infection, a blood clot, or rupture of the appendix. Because of the risk of rupture, appendicitis is considered an emergency. Anyone with symptoms needs to see a doctor immediately.

Symptoms of Appendicitis

Symptoms include

• pain in the right side of the abdomen
• nausea
• vomiting
• constipation
• diarrhea
• inability to pass gas
• low fever that begins after other symptoms
• abdominal swelling
• anorexia

The pain usually begins near the navel and moves down and to the right. The pain becomes worse when moving, taking deep breaths, coughing, sneezing, and being touched in the area.

Not everyone has all the symptoms. People with symptoms of appendicitis should not take laxatives or enemas to relieve constipation because these medicines could cause the appendix to burst. Pain medicine can mask symptoms that the doctor needs to know about, so it should not be used before consulting a doctor when appendicitis is suspected.

Diagnosis of Appendicitis

The doctor bases an appendicitis diagnosis on symptoms, a physical exam, blood tests to check for signs of infection such as a high white blood cell count, and urine tests to rule out a urinary tract infection. Usually doctors use CT scan or ultrasound to see whether the appendix looks inflamed.

If the diagnosis of appendicitis is not certain, people with equivocal signs of appendicitis may be watched and sometimes treated with antibiotics. People with definite appendicitis have surgery to remove the appendix, which is called an appendectomy. Doctors may use laparoscopic surgery for appendectomy. This technique involves making several tiny cuts in the abdomen and inserting a miniature camera and surgical instruments. The surgeon then removes the appendix with the instruments, so there is usually no need to make a large incision in the abdomen. People can live a normal life without their appendix--changes in diet, exercise, or other lifestyle factors are not necessary.

^{reproduced from NIH Publication No. 03-4547}