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Appendicitis is a common disease at any age. It can occur in people between the ages of 10 and 30. In a case of appendicitis, a person may downplay the pain until it becomes very severe. Appendicitis is often the leading cause of critical patient admissions to the hospital.

In this article we will discuss what appendicitis is, its symptoms, the steps to reach a correct diagnosis and the most effective treatment depending on the case.

What is appendicitis?

Appendicitis is inflammation of the appendix. The appendix is a small tube-shaped sac, about the size of a finger, which is located at the end of the large intestine in the lower right side of the abdomen.

Appendicitis is identified by pain in the lower right side of the abdomen that increases to become very severe. The most common treatment is removal of the appendix. The appendix has no known major function, so removal does not compromise other organs or overall health.

Appendicitis is caused by a blockage of the appendix, which causes it to fill with pus, increasing its size and creating pressure inside. When not treated in time, the appendix can rupture and spread infection and stool into the abdominal area. This problem is called peritonitis and is highly dangerous to health.

Symptoms of appendicitis

One of the most prominent symptoms of appendicitis is sudden pain that occurs in the navel, and then spreads to the lower right area of the abdomen. This pain usually increases with increasing inflammation.

The area of pain may change depending on the age and position of the appendix. For example, in pregnant women the pain may be located in the upper abdomen, because during pregnancy the appendix is located in a higher position than usual.

The pain intensifies when any force or sudden movement such as running or coughing is performed. In some cases the inflammation is so severe that even walking can be quite painful.

Loss of appetite, vomiting and nausea are common due to severe pain in the abdominal area. This pain causes discomfort in the stomach, which in turn causes these discomforts.

Abdominal bloating is accompanied by constipation problems, or in some cases, diarrhea. At the onset of the disease, fever may be present and may increase as the days go by. The maximum pain concentrated in the upper part of the appendix occurs 12 to 14 hours after the onset of the disease.

Causes and diagnosis of appendicitis

Generally, appendicitis is due to an obstruction in the lining of the appendix, it can be caused by feces, a tumor, foreign agents, or in some cases by a parasite. This produces an infection that increases rapidly, causing inflammation and the accumulation of pus inside the appendix.

This infection spreads rapidly, causing pain and fever to increase as the infection progresses. When the pressure inside the appendix threatens to rupture the appendix, and progresses to peritonitis, the case becomes a life-threatening emergency.

To diagnose appendicitis, there are several steps to follow, the first being the performance of the following procedures.

Physical examination

The physical examination helps to locate the pain and to identify in most cases its origin. In women, pain in the lower abdomen may represent a gynecological problem. For this reason, not only symptoms related to pain are sought, but also abdominal rigidity, which is caused as a response of the abdominal muscles to the pressure that inflammation exerts on them.

Blood tests
A blood test may show an increase in white blood cells, which usually represents an infection.

Urinalysis
A urinalysis can rule out two possible causes of abdominal pain, such as kidney stones or urinary tract infection. Knowing that it is not one of them, then it can be established that the patient suffers from appendicitis.

Abdominal X-ray or ultrasound
This is one of the quickest methods to recognize the origin of the pain, allowing to discard any suspicion of other possible causes of abdominal pain.

Treatment for appendicitis
Treatment for appendicitis can be carried out in different ways. Among the most common are the following.

Medications
Treatment by physicians begins with recommending antibiotics to control the infection as much as possible.

Surgical intervention
Laparoscopic appendectomy allows the use of smaller incisions, making it possible to perform the removal by means of video cameras that allow the appendix to be located and removed. This surgery allows a faster recovery, less pain and less postoperative scarring.

Appendectomy with open abdomen is a common emergency surgery, in which a 5 to 10 cm incision is made to remove the appendix. There are cases in which it is necessary to do it with this method to clean the area, especially when the appendix is very sensitive and prone to burst.

In some cases, the infectious fluid can be drained gradually from the abscess. This is done by waiting for the infection and inflammation to subside before proceeding to remove the appendix. Whatever the procedure to be followed, antibiotics will be a necessary aid after the operation.

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