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Appendicitis

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Appendicitis

Introduction:

The finger-shaped appendix is attached to the colon and lies in the lower right quadrant of your abdomen. Its function is not known. However, at times it gets inflamed and infected, resulting in appendicitis. The painful condition is serious and life-threatening because if it is not surgically removed, it can rupture. Its infected contents spill out in the abdomen (peritonitis) or get into the bloodstream. Generally, surgery removes the problem, and you heal completely after the operation.
Causes of the appendix (In Adults/ Babies/ Pregnant Women):
In Adults:

The exact cause of appendicitis or the function of the appendix is yet unknown. A blockage in the appendix lining leading to its infection is generally the likely cause. The infections cause swelling and pus to accumulate within the appendix, which may rupture within the abdomen, causing severe complications. 1 in 1,000 people have appendicitis. It can come to any person irrespective of gender, age or ethnicity. But, note that it generally occurs in the 10 to 30 age group. It also runs in certain families.

In Babies and young children:
Appendicitis in children happens when there is blockage leading to bowel infections. The blockage could be mucus, parasites, stools, mouth and nose fluids. Parasites, stool infections, a twist or bend in the appendix and cystic fibrosis can also lead to appendicitis.
In Pregnant Women:

Appendicitis may get inflamed due to the expanding uterus and ligament stretching. It is difficult to diagnose as the symptoms of vomiting, nausea, and abdominal pain are common in pregnancy and other bowel diseases too.

Symptoms of appendix pain:

The classic symptoms are
● Pain in the right lower quadrant below your navel. This is generally the first sign.
● Vomiting and nausea with belly pain
● Loss of appetite.
● Fever.
● Swollen belly and can’t pass stools/gas.
● Severe pain when coughing, sneezing etc.
● Behaviour changes.
Other symptoms may include
● Painful passing of urine
● A sharp/dull pain in the back, belly, etc.
● Cramps and vomiting just before the pain start.
● Diarrhoea, constipation, frequent passing of gas.
Timely diagnosis is crucial. So, if you have any appendicitis symptoms, meet your doctor immediately. Don’t drink, eat, use painkillers, laxatives, antacids or heating pads that can cause severe complications.
How is Appendicitis Diagnosed?
Appendicitis diagnosing is tricky as other abdominal diseases like Crohn’s disease, urinary tract infections, gastritis, gallbladder issues, bladder problems etc., also present the same symptoms. Treatment of appendicitis depends on the diagnosis, general health and age of the patient and is considered a medical emergency.
The tests usually ordered by the doctor may include:
Physical exam:
This covers medical history, genetic predisposition, and gently pressing just above the appendix to check for inflammation and pain.
Image tests:
● Ultrasound scanning of the abdomen using sound waves of high-frequency to produce images of the tissues, organs and blood vessels.
● PET or CT scan uses computer technology and x-rays to study the internal organs, fat, muscles, etc.
Blood tests:
Tests like blood count, haemoglobin levels, proteins, enzymes, white blood cells etc., are checked for inflammation and infection of the abdominal organs, pancreas, liver etc.
Urine test:
This test is for the kidneys, bladder infections and appendicitis.
Appendicitis treatment:

Since most of the symptoms are also exhibited by other diseases, an accurate diagnosis is required urgently. If confirmed, it requires immediate appendix operation surgery. The patients may be maintained on an IV and fluids with antibiotics before surgery.
The operation maybe
● Traditional/Open surgery under general anaesthesia where a small cut is made in the abdomen’s right lower quadrant and the appendix removed.
● Shunting may be required to drain out the fluids and pus through a small tube when the appendix ruptures. The infection is treated and the shunt removed after a few days.
● Laparoscopic surgery also uses anaesthesia and a laparoscope that makes very tiny ½ inch incisions through which the appendix surgery is performed and is used only if the appendix has not yet ruptured.
● Interval appendectomy in children and adults is used where the appendix has ruptured, but the patient is stable and waits till the infection is cleared before the appendix is removed. This treatment can last for up to 14 days when antibiotics are inserted through a PICC (peripherally inserted central catheter) line. Routine appendectomy follows in 6-8 weeks to remove the appendix.
● Post-surgery, adequate rest is needed. Follow your doctors’ instructions regarding the diet, care of the wound, medications, and follow-up appointments.

Note: Never use painkillers, self-diagnosis, laxatives, antacids etc., without a doctor’s prescription if you have bowel or appendix pains. Midas hospitals recommend immediate hospitalisation and a doctor’s opinion.

Warning Signs:
An inflamed and infected appendix can rupture and could be fatal. If you have any of these symptoms before/ after surgery, call your doctor or rush to a hospital urgently.

● Belly pain, cramps, abdominal swelling.
● Fever, chills, or vomiting
● Constant cough, trouble breathing or shortness of breath.
● No appetite, bowel movements or passing of gas for two days after the surgery.
● Watery diarrhoea continues beyond three days.
● The wounds from surgery smell, bleed or look bad.
● Pain around the wound worsens.
Note: Midas Hospitals recommends you consult a doctor if you suspect appendicitis or show bowel disease symptoms.

Conclusion
If you are experiencing the symptoms mentioned, get in touch with Midas Hospitals for evaluation. Since it’s problematic to assess the severity of these symptoms, a diagnosis is advised against any self-help decisions.

FAQs
What happens when pregnant women develop appendicitis?

Pregnant women with appendicitis have an increased risk of ruptures, morbidity and complications compared to others. It also leads to fetal loss, preterm delivery, and most times, require swift surgery.

What are appendicitis symptoms when pregnant?

Pregnancy may cause the appendix to be pushed upwards by the growing uterus during pregnancy. Symptoms of appendicitis may include severe anorexia, vomiting, nausea, tachycardia, pyrexia and right flank or right quadrant pain.

What options help deal with appendix surgery when pregnant?
In the first six months of pregnancy, the appendix can be removed by laparoscopic surgery. If it occurs later, it may be fatal for both mother and child.
When must I rush to the ER for abdominal pains?

If you have a high fever, severe right lower belly pain, cramps, vomit blood or pass blackish stools, rush to the ER as the situation is extremely serious and needs surgery right away.

Does appendicitis fade away on its own?

Appendicitis can become chronic and acute when it is left untreated. It is possible that in the stage of chronic appendicitis, the pain comes and goes. Eventually, the chronic stage leads to surgery and complications from other organs getting infected. It can stay undiagnosed for months, weeks or even years.

Reference:
https://docs.google.com/spreadsheets/d/1kblLjTTnmPbcJFuZQ0piYRbs3sBKCxWw/edit#gid=1586350786
https://www.webmd.com/digestive-disorders/digestive-diseases-appendicitis
https://www.webmd.com/digestive-disorders/ss/slideshow-guide-appendicitis
https://www.stlouischildrens.org/conditions-treatments/appendicitis