What you should know about appendicitis

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Most of the time, pain in your abdomen is caused by minor issues such as gas, constipation, stress, or a muscle strain. However, if you experience persistent pain that continues to grow worse, moves to another location, or is accompanied by other symptoms, you should seek emergency medical care to rule out a life-threatening condition called appendicitis.

The appendix and appendicitis

Your appendix is a finger-shaped organ that branches off from a pouch located at the junction of your small and large intestines. It’s on the lower right side of your abdomen, near your right hip bone. The appendix ranges from 2 to 14 inches long, but its average length is 3.5 inches.

The role the appendix plays in your body isn’t completely understood. One theory is that it helps your gut keep bad bacteria in check by serving as a haven for good bacteria. Another is that it’s a part of your immune system that may help prevent diseases in your large intestine. Regardless of its purpose, having your appendix removed won’t cause any health problems.

Appendicitis is a condition in which your appendix becomes inflamed, causing it to swell. When that happens, it can burst, which can cause severe problems.

If your appendix bursts, it can spread bacteria from your bowels throughout your abdominal cavity and cause peritonitis. That’s inflammation in your peritoneum, which is the tissue that lines your abdominal cavity.

The bacteria also can spread to your bloodstream, leading to sepsis. That’s a potentially life-threatening condition that can happen when your immune system has a dangerous reaction to an infection.

There are two types of appendicitis:

• Acute appendicitis begins suddenly and worsens quickly. One in 1,000 people living in the U.S. are affected by acute appendicitis, typically between the ages of 10 and 30.

• Chronic appendicitis is a condition that may be caused by something intermittently irritating your appendix over a long period. This condition is rare, accounting for less than two percent of appendicitis cases.

While it’s not clear what causes appendicitis, some doctors believe it may happen due to:

• Hardened stool or growths blocking the appendix’s opening
• Enlarged tissue in the appendix’s wall due to infection
• Inflammatory bowel disease

Symptoms

The first and most common appendicitis symptom is pain in your abdomen. It usually begins near your belly button and moves lower and to the right over 12 to 24 hours, eventually becoming focused at a spot above your appendix. Sometimes, however, the pain may start at that spot.

Other common symptoms of appendicitis include:

• A loss of appetite
• Nausea and vomiting
• A swollen belly
• A fever of 99 to 102 degrees   
• An inability to pass gas

Pain from appendicitis often gets worse over time. It also may feel worse when you move, take deep breaths, inhale, cough, sneeze, or your abdomen is touched. If your appendix bursts, you may feel pain all over your belly.

Less common symptoms of appendicitis include:

• Pain anywhere in your upper or lower belly, back, or rear end
• Pain or difficulty urinating
• Vomiting that begins before you experience abdominal pain
• Severe cramps
• Constipation or diarrhea with gas

If you think you might have appendicitis, you should see a medical professional immediately. Avoid using any pain medications, antacids, laxatives, or heating pads until you see a doctor.

Diagnosis

Diagnosing appendicitis can be difficult because its symptoms can be unclear or may resemble the symptoms of other conditions and diseases.

Your doctor likely will start by giving you a physical exam. If you have appendicitis, your pain will likely increase when they press your lower right belly area. If your appendix has ruptured, you may feel a lot of pain and may tighten your muscles when they touch your belly. A rectal exam may find tenderness on the right side of your rectum.

Other tests your medical professional may give you include:

• A blood test to see if you have a high white blood cell count, which is a sign of infection
• A urine test to see if you have a urinary tract infection
• An abdominal CT scan and/or an abdominal ultrasound

Treatment

Due to the health risks of a burst appendix, your medical provider will recommend having your appendix removed quickly if you have appendicitis. The procedure of removing your appendix is called an appendectomy, which can be performed by traditional open surgery or by laparoscopy.

Recovery

If you have an appendectomy before your appendix bursts, you likely will spend one or two days in the hospital recovering. Usually, people who have the surgery can resume their normal activities within a few weeks. If your appendix did burst before the surgery, your recovery will take longer and may be more complicated.

Appendicitis is often a life-threatening condition. That’s why you should be aware of its common symptoms and see a doctor immediately if you suspect appendicitis could be the cause of your pain.