Little is known about the appendix. It’s a small tube hanging off your large intestine with no clear function. Some posit that it plays a role in inflammatory response. Others theorize that it houses good gut bacteria.
The rest of us are only aware of it for the one thing it’s known to do more than anything else: get infected.
“The appendix is basically a small tube off your colon. If that tube gets clogged, it can cause a backup of mucus, stool, and bacteria. And that’s what leads to infection,” says Christopher Bell, MD, a general surgeon at The Iowa Clinic.
This infection is called appendicitis. Since we don’t know how the appendix works or what it does, we also don’t know why it gets infected. When it does, watch out!
Appendicitis is not your average stomach ache.
An inflamed, infected appendix has a calling card — sudden, sharp pain on the lower right side of your abdomen. Initially, the pain may come and go. But over time, it’s constant and can be severe.
“Pain is the number one sign but there are three things the textbooks tell you to think of: right-sided lower abdominal pain, lack of appetite or hunger and nausea or vomiting,” says Dr. Bell. “Having those three symptoms together raises the suspicion for appendicitis, and that’s something that should be evaluated immediately.”
Because unlike stomach infections, appendicitis does not go away on its own. Left untreated, the pain — and your risks — only get worse.
Your appendix can burst days after your first symptoms.
Appendicitis comes on quickly. It takes less than 24 hours to start feeling the pain and other symptoms after the appendix becomes inflamed. The infection progresses quickly after that too, which is why your symptoms get worse.
In just a day or two more, the tiny tube is so full of pus, bacteria, and fecal matter that it can’t contain it any longer. It bursts.
“When your appendix ruptures, there’s essentially a hole in your GI tract. The bacteria and fecal matter can spill out into your abdomen, creating an infection of the entire intra-abdominal space,” Dr. Bell says. “That’s the type of thing that can cause you to get very sick, very quickly.”
Avoiding a rupture is the reason appendicitis is an emergency.
The good thing about a useless appendage is that it can be removed with no lasting effects on your health — other than the instant relief of your abdominal pain and stomach issues.
An appendectomy is a necessary surgery needed within hours of your diagnosis. The sicker you are, the more important it is to remove the appendix sooner. It likely means it’s already ruptured, so you’ll be rushed to the operating room.
“We do consider appendicitis a surgical emergency. However, that’s pretty scary sounding,” Dr. Bell says. “Most people with appendicitis can manage with medications until we do their surgery within 24 hours.”
Antibiotics help fight the infection while a general surgeon performs a laparoscopic appendectomy. A tiny camera is inserted to find the tiny appendix. Using equally small instruments, your appendix is cut off and sealed off in a bag to keep it from leaking bacteria as it’s pulled out. In just an hour, the surgery is over and you’re instantly better off.
“The majority of the time, the lower right abdominal pain and sick feeling goes away immediately,” Dr. Bell says. “The pain switches to discomfort from the incisions we created for the surgery, which takes about two weeks to fully recover from.”
Treat your abdominal pains urgently.
If you’re in sudden pain, the solution is simple. You need to be seen.
“If you’re very sick from appendicitis, having blood pressure issues or feeling pain all over your abdomen, that’s more of an emergency. You would probably have surgery right away,” Dr. Bell says.
But there’s no shame in showing up at the clinic with “just a stomach ache” either. Lesser degrees of abdominal pain may be more problematic than you think.
“Symptoms of complicated appendicitis, which is a ruptured appendix, are sometimes more delayed or not as bad,” Dr. Bell says. “Some people are lucky. They are able to wall off the infection and not get as sick. Instead, those people get an abscess and need to be treated with an IV of antibiotics and drainage of the infection.”
Most people with appendicitis wind up in the emergency room, but you can get an accurate diagnosis and quick path to surgery in an urgent care setting. The best test for appendicitis is an abdominal CT scan, which can be performed at The Iowa Clinic Urgent Care.
“If it’s complicated, we’ll do surgery within a few hours of finding out,” Dr. Bell says. “We take your appendix out and you live like a normal person with an appendix the rest of your life, with no loss of day-to-day function, no bowel issues and no other noticeable changes.”
ChristopherBell , MD
Christopher Bell, MD, joined the Iowa Clinic after his General Surgery residency at Iowa Methodist Medical Center where most of his attendings were Iowa Clinic surgeons. He recognized teamwork, talent, and dedication in these physicians and could not pass up an opportunity to join them.
Dr. Bell chose General Surgery due to the breadth of surgery that is practiced in this specialty. He is also drawn to the emphasis and prevalent use of minimally invasive techniques. The most rewarding part of his job is fixing a surgical problem and interacting with his patients.
When not working, Dr. Bell tries to stay active by riding his bike, playing tennis, and golfing. He also enjoys reading spy thrillers and watching crime documentaries.