Appendicitis is generally an inflammation of the appendix, resulting from an infection, blockage, or for other reasons. The appendix is a small organ that is attached to the large intestine and has long been a mystery regarding its function in the human body. While its exact function within the human body may not be fully clear, we do know that when appendicitis does occur, immediate treatment and care are quite necessary. The main treatment for appendicitis is the surgical removal of the appendix, also known as an appendectomy. If left untreated, appendicitis can lead to serious complications; thus, it is important to understand the condition in its entirety.
What is Appendicitis?
Appendicitis is a disease that involves the inflammation of the appendix, a small organ at the junction between the small and large intestines. The appendix is usually small, about the size of a finger, and its function is not well known. However, the appendix is believed to play a part in the body's immune system, especially during childhood, since it produces antibodies. Nevertheless, people can have a very healthy life without their appendix since this organ is not considered very important in general functioning.
Acute inflammation of the appendix leads to sharp pain in the lower right abdomen, also known as acute appendicitis. Appendicitis is a serious medical condition, primarily because an untreated appendix could rupture, releasing an infection throughout the abdomen. Such an infection may be life-threatening by causing sepsis; thus, appendicitis is an emergency condition.
What is Acute Appendicitis vs. Chronic Appendicitis?
Appendicitis usually presents itself in two forms: the acute and chronic. The acute is by far the most common, with a sudden onset of symptoms that rapidly worsen. It usually is diagnosed by clinical manifestations such as abdominal pain, nausea, vomiting, and fever.
Chronic appendicitis, on the other hand, is a much rarer condition. The symptoms presented are much milder and may persist for a longer period. Consequently, chronic appendicitis may be difficult to detect since the symptoms are not as vivid, and the ailment may persist for some time unknowingly. Even then, it is highly advisable to consult a doctor in cases of chronic appendicitis, as the ailments can degrade into an acute form at any moment in time.
Epidemiology of Appendicitis
Appendicitis is common, especially in the 10-30 year age group. It is the most common indication for emergency abdominal surgery. Acute appendicitis will affect about 5% of the population during their lifetime. Although the commonest diagnosis of acute appendicitis is made in teenagers/young adults, it also occurs in younger children and older adults but often with atypical presentation.
Chronic appendicitis is much rarer, occurring in only about 1% of the population, and is harder to diagnose because the symptoms are so nonspecific.
Appendicitis Symptoms
The classic symptoms of most cases of appendicitis include abdominal pain, nausea, vomiting, and a loss of appetite. These can vary greatly from person to person, and not everyone will have their typical presentation.
Typical Symptoms
Appendicitis usually starts with pain at the navel, with such pain usually being gradual, dull, and waxing and waning. It shifts to the right lower abdomen, which is where the appendix is located, and, as the condition progresses, this pain may worsen and often comes with nausea and vomiting. The pain may worsen as the appendix increases its inflammation.
Other Symptoms
Aside from the classical symptoms outlined above, other signs may include:
- Fever: The condition occurs in roughly 40 % of the patients. The presence of fever reflects that the body's immunological response is underway in response to the infection, and it may be a harbinger of more severe illness.
- Malaise: It is a general feeling of unwellness and is often coupled with a lack of energy and tiredness.
- Abdominal swelling: The abdomen may appear swollen or bloated as the disease progresses, especially in cases of a ruptured appendix.
- Urinary symptoms: Appendicitis can irritate the bladder and cause frequent urination or give a feeling of urgency.
- Bowel changes: Constipation or diarrhoea can occur, depending on how the appendix presses on the surrounding intestines.
How to Check for Appendicitis
If you suspect that you or someone you know has appendicitis, you need to seek immediate medical help. The health professional may diagnose the condition based on a physical examination; they may also conduct specific tests that may help in the diagnosis of appendicitis.
The most common is the physical examination of McBurney's point, which is the anatomical position of the appendix. A healthcare provider may apply light pressure to the area to see if it is tender. Other diagnostic signs include:
- Blumberg's sign: There is pain upon release of the tension from the abdomen.
- Dunphy's sign: Pain increases upon coughing.
- Rovsing's sign: Tenderness on the left side of the abdomen elicits pain on the right side.
- Psoas sign: Extension of the right hip may produce pain if the appendix is retrocecal.
Possible Complications of Appendicitis
If appendicitis is not treated, it may lead to some serious complications. As the appendix becomes more inflamed, the risk of rupture increases and may result in:
- Perforation: When an appendix ruptures, bacteria spill into the abdominal cavity and cause an infection of the lining of the abdomen, called peritonitis. This can spread quickly and cause life-threatening complications.
- Abscess formation: Sometimes an abscess pouch or pocket of pus- may form around the infected appendix. This can sometimes contain the infection for a while but may break if not treated appropriately.
- Sepsis: If the infection spreads to the bloodstream, it results in sepsis which can cause organ failure and death.
Diagnosis of Appendicitis
The diagnosis of appendicitis is usually done by a physical examination, blood tests, and diagnostic imaging together. Blood tests can indicate that an infection is present, such as by an elevated white blood cell count. Imaging studies, such as an abdominal ultrasound or a computed tomography scan, may help confirm the diagnosis by visualizing the inflamed appendix and ruling out other causes for symptoms.
Where the diagnosis is not overt, other tests may be conducted to confirm the presence of appendicitis or rule out other conditions that could explain the symptoms.
Treatment of Appendicitis
Appendicitis is usually treated as an emergency. The standard management for the condition is surgical removal of the appendix-commonly referred to as appendectomy. The earlier appendicitis is treated, the lower the risk for complications.
Surgical Treatment
Appendectomy is one of the most common surgeries performed around the world. It can be done in a minimally invasive way in many instances, such as laparoscopic surgery, using small incisions with faster recovery times. However, open surgery may be required if complications such as rupture or abscess formation are present.
Non-Surgical Treatment
In rare cases, if the condition is diagnosed much earlier, doctors may just use medications for the treatment. But this is less because usually, appendicitis, when left untreated, often has recurrences or worsening symptoms.
Post-Operative Recovery
Recovery times certainly vary depending on the individual case after an appendectomy. Most individuals who have undergone laparoscopic surgery can return home the same day. Patients who develop complications, or those who have had open surgery, may need more time to recover. Full recovery is usually complete within six weeks after surgery.
Outlook and Prognosis
With prompt treatment, the outlook for appendicitis is usually very good. Most individuals with appendicitis have an excellent prognosis and can anticipate a complete recovery without further complications if treated in time. Those patients who have complicated appendicitis may need further treatments or a longer time to recover. If left untreated, the mortality rate for appendicitis is high, especially once the appendix ruptures and infection spreads.
When to Seek Medical Attention
Appendicitis is a medical emergency. In the presence of symptoms, which include abdominal pain, nausea, fever, or tenderness in the lower right abdomen, seek immediate medical attention. The complications may be avoided, and there is a chance of quicker recovery.
Finally, appendicitis is one condition that needs to be treated as soon as possible to prevent serious health complications. Although the appendix may not be as crucial as far as human survival is concerned, removal of the inflamed appendix in time saves lives and enables individuals to resume their usual activities without further complications.
