Appendicitis is an inflammation of the appendix, a 3 1/2-inch-long tube of tissue that extends from the large intestine. One study suggests that the appendix may have some role in gut immunity, but nothing is definite. One thing we do know: We can live without it, without apparent consequences.
Appendicitis is a medical emergency that almost always requires prompt surgery to remove the appendix. Left untreated, an inflamed appendix will eventually burst, or perforate, spilling infectious materials into the abdominal cavity. This can lead to peritonitis, a serious inflammation of the abdominal cavity’s lining (the peritoneum) that can be fatal unless it is treated quickly with strong antibiotics.
Sometimes a pus-filled abscess (infection that is walled off from the rest of the body) forms outside the inflamed appendix. Scar tissue then “walls off” the appendix from the rest of the abdomen, preventing infection from spreading. An abscessed appendix can perforate or explode and cause peritonitis. For this reason, almost all cases of appendicitis are treated as emergencies, requiring surgery.
In the U.S., one in 20 people will get appendicitis. Although it can strike at any age, appendicitis is rare under age 2 and most common between ages 10 and 30.
Symptoms of appendicitis
Appendicitis typically starts with a pain in the middle of your tummy (abdomen) that may come and go.
Within hours, the pain travels to your lower right-hand side, where the appendix is usually located, and becomes constant and severe.
Pressing on this area, coughing, or walking may all make the pain worse.
If you have appendicitis, you may also have other symptoms, including:
- abdominal pain
- low fever
- loss of appetite
- difficulty passing gas
Not all people will have the same symptoms, but it’s crucial that you see a doctor as quickly as possible. According to Johns Hopkins Medicine, the appendix can rupture as quickly as 48 to 72 hours after the onset of symptoms. Go to the hospital immediately if you’re experiencing any of the following symptoms.
Appendicitis usually involves a gradual onset of dull, cramping, or aching pain throughout the abdomen. As the appendix becomes more swollen and inflamed, it will irritate the lining of the abdominal wall, known as the peritoneum. This causes localized, sharp pain in the right lower part of the abdomen. The pain tends to be more constant and severe than the dull, aching pain that occurs when symptoms start. However, some people may have an appendix that lies behind the colon. Appendicitis that occurs in these people can cause lower back pain or pelvic pain.
Appendicitis usually causes a fever between 99°F (37.2°C) and 100.5°F (38°C). You may also have the chills. If your appendix bursts, the resulting infection could cause your fever to rise. A fever greater than 101°F (38.3°) and an increase in heart rate may mean that the appendix has ruptured.
Appendicitis can cause nausea and vomiting. You may lose your appetite and feel like you can’t eat. You may also become constipated or develop severe diarrhea. If you’re having trouble passing gas, this may be a sign of a partial or total obstruction of your bowel. This may be related to underlying appendicitis.
Appendicitis means inflammation of the appendix. It is thought that appendicitis begins when the opening from the appendix into the cecum becomes blocked. The blockage may be due to a build-up of thick mucus within the appendix or to stool that enters the appendix from the cecum. The mucus or stool hardens, becomes rock-like, and blocks the opening. This rock is called a “fecalith” (literally, a rock of stool). At other times, it might be that the lymphatic tissue in the appendix swells and blocks the opening. After the blockage occurs, bacteria which normally are found within the appendix begin to multiply and invade (infect) the wall of the appendix. The body responds to the invasion by mounting an attack on the bacteria, an attack called inflammation. If the symptoms of appendicitis are not recognized and the inflammation progresses, the appendix can rupture, followed by spread of bacteria outside of the appendix. The cause of such a rupture is unclear, but it may relate to changes that occur in the lymphatic tissue that lines the wall of the appendix, for example, inflammation that causes swelling and buildup of pressure within the appendix that causes it to rupture.
After rupture, infection can spread throughout the abdomen; however, it usually is confined to a small area surrounding the appendix by the surrounding tissues, forming a peri-appendiceal abscess.
Sometimes, the body is successful in containing (“healing”) the appendicitis without surgical treatment if the infection and accompanying inflammation cause the appendix to rupture. The inflammation, pain, and symptoms also may disappear when antibiotics are used. This is particularly true in elderly patients. Patients then may come to the doctor long after the episode of appendicitis with a lump or a mass in the right lower abdomen that is due to the scarring that occurs during healing. This lump might raise the suspicion of cancer.
What is appendicitis?
A blockage, or obstruction, in the appendix can lead to appendicitis, which is an inflammation and infection of your appendix. The blockage may result from a buildup of mucus, parasites, or most commonly, fecal matter. When there’s an obstruction in the appendix, bacteria can multiply quickly inside the organ. This causes the appendix to become irritated and swollen, ultimately leading to appendicitis.
The appendix is in the lower right side of your abdomen. It’s a narrow, tube-shaped pouch protruding from your large intestine.
Although the appendix is a part of your gastrointestinal tract, it’s a vestigial organ. This means that it provides no vital function and that you may live a normal, healthy life without it. The purpose of the appendix is unknown. Some believe it contains tissue that helps your immune system process infections in your body.
If you don’t get treatment for an inflamed appendix quickly, it can rupture and release dangerous bacteria into your abdomen. The resulting infection is called peritonitis. This is a serious condition that requires immediate medical attention.
Having a ruptured appendix is a life-threatening situation. Rupture rarely happens within the first 24 hours of symptoms, but the risk of rupture rises dramatically after 48 hours of the onset of symptoms. It’s very important to recognize the early symptoms of appendicitis so that you can seek medical treatment immediately.
Risk factors and prevention
According to the National Institute of Diabetes and Digestive and Kidney Diseases, in the United States, appendicitis is the most common cause of abdominal pain that leads to surgery. About 5 percent of Americans experience appendicitis at some point in their lives.
Appendicitis can happen at any time, but it most often occurs between the ages of 10 and 30. It’s more common in men than in women.
You can’t prevent appendicitis, but there are steps you can take to lower your risk. Appendicitis seems less likely if you have a diet rich in fiber. You can increase your fiber intake by eating a healthy diet that contains lots of fresh fruits and vegetables.
Foods that are particularly high in fiber include:
- green peas
- black beans
- bran flakes
- whole wheat spaghetti
Increasing the amount of fiber in your diet can prevent constipation and subsequent stool buildup. Stool buildup is the most common cause of appendicitis. If you have any condition that causes inflammation or infection of the bowels, it’s important to work with your doctor to prevent appendicitis. Always seek medical attention immediately if you or someone you know has symptoms of appendicitis.