Appendicitis

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Introduction

Your appendix is a small tube-like structure that extends off your large intestine.  While the appendix does not have a known function, if it becomes inflamed or infected the result is appendicitis.  Appendicitis can be quite dangerous as there is no way to medically treat it.  If it occurs, it is considered an emergency and requires surgery to remove.  Severe sharp pain in the right lower abdomen is the main symptom of appendicitis.  Prompt surgery is necessary to remove the appendix to avoid complications.  If there is a delay in treatment, the appendix can burst and cause life threatening complications.  Anyone can get appendicitis, but it most often occurs between 10 and 30.
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Anatomy

Your large intestine, also called the large bowel, is a tube that is about 5 feet long and 3 or 4 inches around.  The large intestine is divided into sections.  The appendix is located near the beginning of the large intestine in a section called the cecum.  The appendix is a finger-shaped pouch.  It does not serve any known purpose. 
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Causes

Appendicitis results when the appendix becomes infected, inflamed, or blocked.  A piece of stool or ingested material can block the appendix.  In some cases of appendicitis, the cause is not known.  Appendicitis is an emergency medical condition and needs immediate treatment.  An inflamed appendix may rupture.  A ruptured appendix can lead to a fatal infection or abscess if it is not treated immediately.

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Symptoms

Pain that gradually gets worse is a main symptom of appendicitis.  The pain usually starts at the belly button and then shifts to the lower right.  Appendicitis related pain typically intensifies over 6 to 12 hours and can become very severe and sharp.  The pain may increase when you gently press and release on the area.  You may experience a fever, chills, nausea, diarrhea, constipation, and vomiting.  You may not feel like eating.

If your appendix ruptures, you may actually feel better for a short time.  However, a ruptured appendix may lead to an infection called peritonitis.  The infection will make you feel very sick and your pain will feel worse.  Your abdomen may swell and feel hard.  You may not be able to pass gas.  You may feel thirsty and may only pass small amounts of urine.  Peritonitis is a medical emergency, and you should go to the emergency department of a hospital immediately if you experience symptoms.
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Diagnosis

You should be evaluated and treated by a doctor immediately if you suspect that you have appendicitis.  Appendicitis is an emergency medical condition.  Your doctor will conduct a physical examination and may order some tests.  Your doctor will examine your lower abdomen.  Your doctor may check a sample of your blood or urine for signs of infection to rule out other conditions with similar symptoms, such as kidney stones.

Imaging tests may be used to help confirm the diagnosis of appendicitis and rule out other conditions.  An abdominal X-ray, ultrasound, or computed tomography (CT) scan are commonly used.  A CT scan is used to check for an abscess from a ruptured appendix.
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Treatment

Some mild forms of appendicitis may be treated with antibiotics, but for most people, appendicitis is treated with surgery to remove the appendix.  You may receive traditional open surgery or laparoscopic surgery.  Open surgery uses a larger incision and usually requires a longer recovery time than laparoscopic surgery. 

Laparoscopic appendectomy is performed with a laparoscope.  A laparoscope is a thin viewing instrument with a miniature camera at the end.  The laparoscope is inserted through small incisions.  The camera transmits images to a video screen, which a surgeon uses to guide the surgery.  Thin surgical instruments are passed through the incisions to perform the procedure.  Because only small incisions are necessary for laparoscopic appendectomy, this procedure is associated with less pain, less bleeding, fewer complications, and a quicker recovery than traditional surgical methods.

Recovery time is faster for people that have their appendix removed before it ruptured.  A longer recovery time is associated with infections, abscesses, and ruptured appendices.  In some cases, doctors may treat an infection before removing the appendix.
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Prevention

You may prevent complications by contacting your doctor immediately if you experience the symptoms of appendicitis.

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Am I at Risk

Appendicitis can happen to anyone.  It occurs most frequently between the ages of 10 and 30.  A ruptured appendix is more common in children.

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Complications

In rare cases, a ruptured appendix can cause death.  A ruptured appendix can lead to infection and needs to be treated immediately in the emergency department of a hospital.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.