Overview
Appendicitis is a medical condition caused due to an inflamed appendix.
An appendix is a small 5-10 cm thin tube-like structure that extends from the lower quadrant of the larger intestine. The appendix does not have any vital function apart from storing helpful gut bacteria that protect our immune system.
The appendix can get inflamed due to blockage and in severe cases burst or rupture spilling the content into the abdominal cavity. This is a serious life-threatening condition and needs immediate surgery, also known as appendectomy.
What are the main causes of appendicitis?
In many cases, it is not always clear what has caused appendicitis. Medical professionals believe that appendicitis mainly occurs due to a blockage in the form of hardened stool or other growths or due to some gastrointestinal infection.
The hardened stool can get stuck in the opening of the appendix and cause bacterial growth, infection, and inflammation.
Sources of appendiceal luminal blockage include:
- Enlarged lymph tissue in the appendix wall
- Appendicoliths or buildup of hardened, calcified stool deposits (appendix stones)
- A traumatic abdominal injury
- Foreign objects like stones or bullets
- Intestinal parasites like pinworms
- Other growths
- Tumor formation
Sources of gastrointestinal bacteria or infection include:
- Fungal infections that may weaken the immune system
- Foodborne bacteria that cause diarrhea, vomiting, and other gastrointestinal complications
Other risk factors:
Family history
A family history of appendicitis may increase the risk of getting the condition.
Age
Appendicitis is more common in children, teenagers, and young people in their 20s. However, the medical condition can occur at any age.
Being male
Research shows that appendicitis is more common in males than their females. However, appendicitis can occur at any age, even in older adults, irrespective of their gender or age.
Pollution
Exposure to air pollutants like high ozone levels also increases the risk of developing appendicitis.
Foods
Certain foods like processed or fried foods, and high-fat foods like fatty meats or cheese can cause digestive issues leading to bowel irregularities. They can trigger inflammation and cause infection in the appendix.
Medical conditions that can cause appendicitis:
- Lymphoid hyperplasia – This can cause acute appendicitis. The lymphatic system releases white blood cells in the lymphoid tissues to fight bacterial infections. The swollen lymphoid tissues can obstruct the appendix and cause inflammation
- Ulcerative colitis – Research studies show that appendicitis is correlated to patients suffering from ulcerative colitis
- Appendix tumors – Carcinoid or benign tumors can develop in the appendix and cause blockage leading to appendicitis
Is surgery needed to treat appendicitis?
Once you are diagnosed with appendicitis, it is quite likely that your appendix may rupture within 36 hours. Your surgeon will perform an emergency surgery called appendectomy within the next 24 hours.
In mild cases, your healthcare provider may prescribe some medications and antibiotics to manage the symptoms. You will be asked to follow the wait-and-watch approach and keep a close eye on your symptoms.
Sometimes, during the surgery, your surgeon may find a normal appendix and may decide to remove it to prevent the occurrence of appendicitis in the future.
Surgery may be delayed based on your symptoms, overall health, and age, but surgery remains the standard treatment for appendicitis.
Surgery
Appendectomy is a surgery to remove your appendix.
Before an appendectomy, as part of the diagnosis, your doctor will perform several other tests.
These tests include:
Physical exam
Your doctor will examine your abdominal pain and symptoms. The doctor will apply gentle pressure on the area where you are experiencing pain and discomfort. If you have pain, the pressure will feel worse.
During this examination, the doctor will diagnose abdominal stiffness and tenderness.
Rectal exam
A digital rectal exam may be performed to rule out other symptoms and medical conditions.
Abdominal ultrasound
An abdominal ultrasound helps the doctor to check the internal organs and blood vessels.
Other imaging tests
This includes a CT scan and an MRI to confirm appendicitis.
Blood tests
Blood tests confirm infection such as a high count of white blood cells.
Urinalysis
A urine test will indicate whether you have a urinary tract infection (UTI), red blood cells, infections, or other urinary tract problems.
There are mainly two surgical techniques for appendectomy:
Open appendectomy
A large incision is made in the lower right abdomen. The surgeon ties off the appendix, stitches, it, and then detaches it from the intestine.
In case of a ruptured appendix, the surgeon drains the abscess and fluids from the abdominal cavity before performing the surgery. The abdominal cavity is then rinsed with saline solution.
Laparoscopic appendectomy
In a laparoscopic procedure, instead of a large big incision, the surgeon makes tiny 1-3 incisions.
Through one of the incisions, the surgeon inserts a cannula (a thin tube) and inflates the abdominal cavity with gas. This provides space and allows the surgeon to see images of the abdominal cavity.
The cannula is removed. A laparoscope with an attached tiny light and a camera is inserted. Other instruments are inserted through the incisions. The camera guides the surgeon to locate the appendix and view the complications by projecting images on the video screen.
The appendix is then removed.
Open appendectomy needs a hospital stay for a few days. A laparoscopic surgery is a non-invasive procedure and you may go home after some rest.
Stop your suffering NOW
Don't just jump into a surgery because your doctor is advising you to go for it. Consult our doctors to know if you need a surgery at all. Rest assured, we WON'T recommend you surgery unless it's the last resort.
