Overview
Appendicitis is the inflammation of the appendix. Sudden and intense abdominal pain is usually the first symptom of appendicitis.
An appendix is a small, pouch-like organ on the lower-right side of the abdomen. It is a vestigial organ that does not perform any function and you can live without it.
The appendicitis pain generally starts as a sudden pain in the navel area and gradually radiates to the lower-right side of the abdomen.
Hardened stool can block the appendix causing infection and inflammation. This is a serious complication that can obstruct the blood flow, cause swelling or pus, and the appendix can burst.
A burst appendix is a life-threatening medical emergency. If the bacteria spreads inside the abdominal cavity and to the bloodstream, it can cause sepsis. This needs immediate surgery (appendectomy), the only curative treatment that involves the removal of the appendix.
What are the stages of appendicitis?
Appendicitis or the progression of the disease can be broadly classified into four main stages:
Normal appendix
The appendix is a small, tubular structure that resembles a hollow finger attached to the large intestine.
The appendix is filled with a clear liquid called lymph consisting of white blood cells that help to fight infections.
Though the appendix is considered an evolutionary remnant, a non-functional feature without any specific purpose, recent studies show that it helps support immune health and is a reservoir for healthy gut bacteria.
Uncomplicated appendicitis
Also known as early-stage appendicitis, it occurs due to the inflammation of the appendix.
The inflammation occurs at the appendiceal lumen (inner area of the appendix). The blockage is caused by stool, bacterial growth, swollen lymph nodes, and in some cases a foreign object.
The appendiceal lumen is filled with pus and the blockage causes a pressure buildup. You can experience achy pain, vomiting, nausea, or a loss of appetite. Early detection and prompt treatment can manage the symptoms successfully.
Complicated or acute appendicitis
Acute or complicated appendicitis is a surgical emergency and has a lifetime risk of 7-8 percent.
In complicated appendicitis, the inflammation progresses and spreads to the adjacent tissues. You can feel severe pain in the right lower part of the abdomen along with fever and chills.
As the appendix is engorged with fluid and is infected, it may obstruct the blood flow causing appendix tissue death. This is known as gangrenous appendicitis.
Other complications include bowel obstruction and possible sepsis. Acute appendicitis (AA) treatment involves an appendix removal surgery or appendectomy.
Perforated appendicitis
Perforated or ruptured appendicitis is the final stage when the engorged appendix bursts and spills the contents into the abdominal cavity. This is a life-threatening condition and can lead to severe complications like sepsis, abscess formation, peritonitis, etc.
Treatment included emergency appendectomy and antibiotic medication for managing the symptoms and infection.
When is appendicitis serious?
An appendicitis pain is a red flag and develops suddenly and warrants immediate medical treatment.
If you ignore the symptoms of appendicitis, it can lead to rupture or perforated appendicitis and is a life-threatening condition.
Appendicitis needs prompt treatment. Here are a few early signs and symptoms of appendicitis:
Acute abdominal pain
This is the first sign and most common sign of appendicitis. The pain first starts with mild cramping in the navel area and then gradually spreads to the lower quadrant of your abdomen.
The pain is:
- Sudden and intense
- Gets worse while coughing or sneezing
- Difficult to manage
- Continues for several hours
Loss of appetite
You may have indigestion, feel bloated, and have no urge to eat. You will consume small portions of food.
Fever with chills
You may experience low-grade fever with chills. This shows that your body’s immune system is fighting the infection.
Nausea and vomiting
There can be mild to severe indigestion, vomiting, and nausea.
Swollen lymph nodes
Sometimes, a perforated appendix can cause inflammation or swelling of the lymph nodes. The swelling of the lymph nodes is called mesenteric lymphadenitis.
Bowel problems
You may experience bowel problems such as:
- Constipation
- Diarrhea
- Inability to pass gas
- A desire for frequent bowel movements
Rebound tenderness
Rebound tenderness helps to diagnose acute abdominal pain. When you apply pressure to your abdomen followed by a quick release, you may experience pain. This is rebound tenderness.
Urinary problems
Urinary symptoms include:
- Pain during urination
- Frequent urge for urination
- Bladder inflammation (advanced stage)
General discomfort
You will feel unwell and fatigued. There is a general lack of energy. You may have severe constipation due to the inflamed appendix. The inflammation can also cause rectal pain and discomfort.
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