What is it?

‘Appendicitis’ refers to the painful inflammation of the ‘Appendix’, which is a small, slender finger-like pouch that is attached to the large intestine, usually on the lower right side of the abdomen. It typically measuring between 5 to 10 cm (2 to 4 inches) in length. Though the exact function of the appendix remains unclear, its removal is not known to be harmful.

What causes it?

Though the exact cause of appendicitis remains uncertain, it is believed that in many cases it is caused by something blocking the entrance of the appendix. This blockage can be caused by several factors such as by a small hard piece of feces or by swelling of the lymph node in the bowel wall triggered by an upper respiratory tract infection, among others. As a result of this obstruction, bacteria from the gut begin to multiply in the appendix, causing it to fill up with pus and swell. This inflammation and swelling may result in increased pressure inside the appendix which in turn can potentially lead to its rupture. Since the exact causes of appendicitis remain elusive, there are no proven methods for its prevention. 

What to watch out for?

Appendicitis typically causes pain in the lower right abdomen, where the appendix usually lies. However, in most people, the pain begins around the belly button and over the next few hours migrates to the lower right side of the abdomen. The pain may start as intermittent, where it comes and goes, and may later become severe and constant as the inflammation worsens. 

Symptoms of appendicitis can include:

• Sudden onset of pain in the lower right abdomen

• Sudden pain that starts around the belly button and, often shifts to the lower right-side of abdomen

• Pain that worsens with sudden movements including with coughing, sneezing and even walking. Pressing on this area may also elicits pain

• Mild fever that may rise as the disease progresses

• Nausea and vomiting

• Loss of appetite

• Changes in bowel habits, such as constipation or diarrhea

• Abdominal bloating and gas

  
  

How is it diagnosed?

Diagnosing appendicitis involves taking a detailed history of your symptoms and a physical examination focused on the abdomen. During the physical examinations, your surgeon will gently press on the painful region. Upon releasing suddenly the pain worsens. This occurs because of inflammation of the abdominal cavity lining, known as the peritoneum. Your surgeon will also look for signs of abdominal stiffness known as guarding. 

Blood tests will also be ordered and you may also be asked to take a urine test for urinalysis. To help confirm the diagnosis you will undergo imaging tests including an ultrasound and/or a CT scan of the abdomen. If your symptoms are not typical, additional tests may be needed to confirm the diagnosis and rule out other conditions.

What are the treatment options?