Appendicitis -- symptoms, diagnosis, treatment and prevention

Could your recurring stomach pain be due to appendicitis? Here are the symptoms, diagnosis and treatment.

Ajay, a 17 year old boy, often complained about pain in the right side of the stomach. Initially the pain was mild but it would start abruptly at any time of the day without any specific trigger. For about a month, the pain kept recurring and was localized to the same area. When his parents took him to a local health clinic, he was prescribed antibiotics which did not provide him any relief. His blood and urine tests were normal. Finally after taking an X-ray of the abdomen he was diagnosed with appendicitis.

Over years, the appendix was thought to be a vestigial organ in the body. And in most cases of appendicitis, surgical removal of the appendix is considered. But questions like what exactly causes appendicitis, what are its complications and whether it can be prevented still prevail among the general population. In this article, we address such common queries about appendicitis with inputs from our expert Dr Ajit Kukreja, Laproscopic GI and Colorectal Surgeon.

What is appendicitis? What causes it?

Appendicitis the inflammation and swelling of the appendix, a small tube like structure protruding from the large intestine. It occurs when the appendix gets blocked with stool or foreign particles passing through the intestine. Blockage may cause infection which results in painful swelling of the appendix. 'If left alone, the appendix does not cause any problems,' says Dr Kukreja.

There's a common belief that appendix is of no use in the body. Is that true?

'The discussion on this issue in itself can be taken as a separate topic. For years, the appendix was credited with very little function. But now there is adequate evidence that the appendix serves an important role in the fetus and in young adults', says Dr Kukreja.

'Specific cells which appear in the appendix of the human fetus at around the 11th week of the developmental stage have been shown to produce various essential compounds that control biological mechanisms in the developing baby. Among adult humans also, the appendix is now thought to be involved in some immune functions,' he adds further.

What are the symptoms of appendicitis?

The initial symptom of appendicitis is pain in the lower abdominal region on the right hand side. The pain is sharp and intense. It originates from the navel (middle of the abdomen) and gradually starts worsening over 6-24 hours. Other symptoms include:

• Vomiting
• Nausea
• Loss of appetite
• Change in bowel movements (constipation or diarrhoea)
• Abdominal swelling
• Stomach cramps

Who is likely to suffer from appendicitis?

Anyone can suffer from appendicitis. 'The highest incidence of appendicitis is found in individuals aged 10-19 years. Also, males have more likely to suffer than females for all age groups (overall rate ratio, 1.4:1),' says Dr Kukreja.

Why is the diagnosis of appendicitis difficult?

Most of the initial symptoms of appendicitis overlap with the symptoms of other gastrointestinal problems. Moreover there is no definitive or test that can confirm appendicitis. The doctor first does a physical examination to assess pain. A blood test that shows increased count of white blood cells (WBCs) may indicate infection. The doctor may also recommend a CT scan or an X-ray to confirm appendicitis. Read more about ultrasound safer than CT scans or X-rays to confirm or rule out appendicitis.

What are the complications of appendicitis? Is it life-threatening?

If diagnosis of appendicitis takes a longer time, the pain may become severe as the infection spreads. If not treated at the right time, the appendix may burst to release the pus to surrounding areas, which can be life-threatening. Sometimes, a tender mass of pus (abscess) may form around the burst appendix.

Is removal of appendix (appendectomy) the only solution to appendicitis?

'Appendectomy remains the only curative treatment of appendicitis but antibiotics do play an important role in the treatment of patients with this acute appendicitis. The duration of the administration of antibiotics is closely related to the stage of appendicitis at the time of the diagnosis,' says Dr Kukreja.

Can appendicitis be prevented? How?

'Not exactly but studies have shown that the incidence of appendicitis is a lot lower in countries where a high-fiber diet is common.' Here are 10 reasons you should eat fibre-rich foods.

Read more about causes, symptoms, diagnosis and treatment of appendicitis.

Also read:

• Could your frequent stomach upsets be Irritable Bowel Syndrome?
  
• Could your child's frequent stomach upsets be 'stomach migraine'?
• Could your stomach ache indicate a heart problem?
• 10 reasons for bloating or abdominal gas you didn't know about

For more articles on diseases & conditions , visit our diseases & conditions section. Follow us on Facebook and Twitter for all the latest updates! For daily free health tips, sign up for our newsletter. And to join discussions on health topics of your choice, visit our forum.