What is appendicitis?
Appendicitis is a medical condition characterized by inflammation of the appendix. 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 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.
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. However, this condition requires prompt medical attention as untreated appendicitis can lead to serious complications such as a burst appendix and abdominal infection.
A burst appendix is considered a medical emergency as it can spread bacteria throughout your abdominal cavity. If the infection spreads to your bloodstream, it can cause sepsis which could lead to life-threatening complications.
What is the difference between acute appendicitis and chronic appendicitis?
Acute appendicitis and chronic appendicitis are two distinct conditions involving inflammation of the appendix, but they differ in terms of their onset, duration, and symptoms.
Acute appendicitis is characterized by sudden onset of severe symptoms and rapid progression, while chronic appendicitis involves recurrent or persistent episodes of milder symptoms over a longer period.
Prompt medical evaluation and treatment are essential for acute appendicitis to prevent complications, while the diagnosis and management of chronic appendicitis may require careful consideration and ongoing monitoring of symptoms.
What causes appendicitis?
The exact cause of appendicitis is often unknown, but it is believed to occur when the appendix becomes blocked by stool, foreign objects, infection, or inflammation. The blockage leads to bacterial overgrowth, swelling, and eventual inflammation of the appendix.
Risk factors for appendicitis include a family history of appendicitis, age (most commonly affects individuals between the ages of 10 and 30), and certain medical conditions such as inflammatory bowel disease (IBD).
What are the symptoms of appendicitis?
Appendicitis is not your average stomachache. 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. 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.
Appendicitis symptoms can vary from person to person but often include:
- Abdominal pain: The most common appendicitis symptom is sudden and severe pain that starts around the navel and then moves to the lower right abdomen. The pain may worsen with movement, coughing, or deep breathing.
- Nausea: Individuals with appendicitis may experience a loss of appetite or nausea.
- Vomiting: Some individuals may experience vomiting, especially as the pain worsens.
- Fever: Appendicitis may cause a low-grade fever, usually less than 100.4°F (38°C).
Changes in bowel habits: Some individuals may experience constipation or diarrhea. - Urinary sensations: You may feel like you need to urinate urgently and/or more often. This can happen if the infection irritates the nerves connected to your bladder.
- Stomach bloating: Often an indication your appendix has ruptured, your stomach may appear swollen and/or feel bloated.
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. That’s the type of thing that can cause you to get very sick, very quickly.
How is appendicitis diagnosed?
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 need to have surgery right away.
But there’s no shame in showing up at the clinic with “just a stomachache” 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. Some people are lucky. They can 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, The Iowa Clinic surgeons will perform surgery within a few hours of finding out. They will take your appendix out and you will 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.
What is the treatment for appendicitis?
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.
At The Iowa Clinic, we do consider appendicitis a surgical emergency. However, that’s pretty scary sounding. 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 pain switches to discomfort from the incisions we created for the surgery, which takes about two weeks to fully recover from.