Appendicitis — Know It All!

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All you need to know about Appendicitis.

Know your ailment well, so you can manage it better!!

Here we come with Appendicitis today!

What is Appendicitis?

The appendix is a narrow, worm-like, closed-ended conduit up to several inches long that connects to the cecum (the first part of the colon). (Vermiform appendix, the anatomical term for the appendix, means worm-like appendage.) The appendix’s inner lining contains a small volume of mucus that runs through the cecum and into the exposed central heart of the appendix. Lymphatic tissue that is part of the immune system is found in the wall of the appendix. The wall of the appendix also includes a layer of muscle like the rest of the colon, but the layer of muscle is poorly developed.

It is not known if, in older children and adults, the appendix has a significant role in the body. It may have an immune role in young kids. There are no substantial long-term health complications arising from the elimination of the appendix, although a small rise in certain ailments, such as Crohn’s disease, has been observed.

Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects to the lower right side of your abdomen from your colon as mentioned earlier

In the lower right belly, appendicitis induces discomfort. In most individuals, however, pain starts near the navel and then travels. When inflammation worsens, the pain of appendicitis usually increases and becomes severe gradually.

While appendicitis may be acquired by anyone, it most commonly happens in individuals between the ages of 10 and 30. Surgical removal of the appendix is the standard procedure.

What causes Appendicitis?

In many cases, the exact cause of appendicitis is unknown. Experts believe it develops when part of the appendix becomes obstructed, or blocked.

Many things can potentially block your appendix, including:

  • a buildup of hardened stool
  • enlarged lymphoid follicles
  • intestinal worms
  • traumatic injury
  • tumors

When your appendix becomes blocked, bacteria can multiply inside it. This can lead to the formation of pus and swelling, which can cause painful pressure in your abdomen.

What are the symptoms of Appendicitis?

There are also moderate early signs and symptoms of appendicitis, consisting only of a lack of appetite and/or nausea and a sensation of not feeling well. Abdominal pain does not even occur.

he classic symptoms of appendicitis include:

  • Pain in your lower right belly or pain near your navel that moves lower. This is usually the first sign.
  • Loss of appetite
  • Nausea and vomiting soon after belly pain begins
  • Swollen belly
  • Fever of 99–102 degrees
  • Can’t pass gas

Other less common symptoms of appendicitis include:

  • Dull or sharp pain anywhere in your upper or lower belly, back, or rear end
  • Painful or difficult peeing
  • Vomiting before your belly pain starts
  • Severe cramps
  • Constipation or diarrhoea with gas

Nevertheless, as the progression of appendicitis continues, stomach pain becomes the primary symptom.

The pain is diffuse and poorly localised at first, that is, not limited to one location. (Every time a condition is limited to the small intestine or colon, including the appendix, poorly localised pain is typical.)

The pain is so hard to recognise that most persons show the position of the pain with a circular gesture of their hand across the central part of their abdomen when prompted to point to the area of the pain.

The pain may be localised to the lower right abdomen over time, and the patient may be able to pinpoint the precise site of the pain.

The second symptom of appendicitis, if not already present, is lack of appetite, which can lead to nausea and even vomiting. Due to intestinal obstruction from the expanding inflammatory mass or abscess rather than from local inflammation, nausea and vomiting may occur later.

If the inflammation of the appendix rises, a thin membrane called the peritoneum may stretch through the appendix to its outer covering and then to the lining of the abdomen. The character of the pain varies as the peritoneum becomes inflamed and can then be distinctly localised to one specific area. This area is usually between the front of the right hip bone and the button of the abdomen. The precise point is named after the point given to Dr. Charles McBurney-McBurney. When the entire lining of the belly becomes inflamed, once the appendix ruptures and inflammation occurs across the abdomen, the pain becomes diffuse again.

What are the complications of Appendicitis?

Possible complications caused by appendicitis are provided below.

Peritonitis

The patient can contract peritonitis, which is an infection and inflammation of the peritoneum, if the appendix ruptures and releases the infection into the abdomen. The peritoneum is the membrane that lines and protects most of the abdominal organs in the abdominal cavity.

Peritonitis will cause bowel movements to avoid shutting down, and the bowel may be blocked. A fever can occur in the patient and could go into shock. Urgent therapy includes peritonitis.

Abscess

If the infection seeps out of the appendix and mixes with the contents of the intestines, an abscess may form. It can cause peritonitis if the abscess is not treated. Often, antibiotics treat abscesses. Sometimes, with the help of a tube that is inserted into the belly, they are surgically drained.

It may be life-threatening to have symptoms of appendicitis. For someone who may have appendicitis, it is necessary to seek medical attention.

How is Appendicitis diagnosed?

When the doctor suggests that you might have appendicitis, a physical examination may be carried out. In the lower right section of the abdomen for swelling or rigidity, they will scan for tenderness.

Your doctor might prescribe one or more tests to check for signs of appendicitis or rule out other possible causes of your symptoms, based on the results of your physical exam.

To diagnose appendicitis, there is no single test available. If no other causes of the symptoms can be found by your doctor, the cause can be diagnosed as appendicitis.

Complete blood count

Your doctor can prescribe a full blood count to check for signs of infection (CBC). They will take a sample of the blood to administer this procedure and send it for examination to a clinic.

Bacterial infection is also preceded by appendicitis. Symptoms similar to those of appendicitis can also be caused by an inflammation of the urinary tract or other abdominal organs.

Urine tests

Your doctor can use urinalysis to rule out urinary tract infection or kidney stones as a prospective cause of your symptoms. It is regarded as a urine test as well.

Your doctor will obtain a urine sample that will be analysed in a laboratory.

Pregnancy test

For appendicitis, ectopic pregnancy may be confused. It develops when a fertilised embryo, rather than the uterus, inserts itself in a fallopian tube. That might be a medical emergency.

A paternity test can be done if your doctor believes that you may have an ectopic pregnancy. They will collect a sample of your urine or blood to administer this examination. In order to discover where the fertilised egg has been inserted, they can even use transvaginal ultrasound.

Pelvic exam

Your symptoms can be triggered by pelvic inflammatory disorder, ovarian cysts, or other disorders impacting your reproductive organs if you are female.

Your doctor can conduct a pelvic exam in order to examine your reproductive organs.

They will physically inspect the vagina, vulva, and cervix during this test. They will even check the uterus and ovaries manually. For research, they can gather a sample of tissue.

Abdominal imaging tests

Your doctor can order imaging tests on your abdomen to check for appendix inflammation. This will also help them determine other likely triggers, such as an abdominal abscess or faecal effect, of the symptoms.

One or more of the following imagery assessments can be prescribed by the doctor:

abdominal ultrasound

abdominal X-ray

abdominal CT scan

abdominal MRI scan

In certain situations, for a period of time before the examination, you would need to avoid eating food. You will be helped by the doctor to learn how to train for it.

Chest imaging tests

Related to appendicitis, pneumonia in the lower right lobe of the lungs may also cause symptoms.

When the doctor suspects you may have pneumonia, a chest X-ray would usually be required. To generate accurate pictures of the lungs, they can even prescribe a CT scan.

They can prescribe an abdominal scan if your doctor thinks that you may have appendicitis. This imaging test will allow them to examine the appendix for signs of infection, abscess, or other complications.

Your doctor can order other tests for imagery as well. They can order a CT scan, for instance. In order to make pictures of the organs, an ultrasound uses high frequency sound waves, while a CT scan uses radiation.

A CT scan produces more accurate pictures of the organs compared to an ultrasound. There are some health hazards involved with exposure to radiation from a CT scan, though. Your doctor will be able to help you consider the possible advantages and disadvantages of multiple imaging tests.

What is the treatment for Appendicitis?

Treatment for appendicitis normally requires surgery to extract the inflamed appendix. A dose of antibiotics to cure the infection may be given before surgery.

Appendectomy — Surgery to remove the appendix

Appendectomy may be done as open surgery with one abdominal incision about 5 to 10 centimetres (2 to 4 inches) deep (laparotomy). Or it is possible to do the surgery with a few minor abdominal incisions (laparoscopic surgery). The surgeon implants advanced surgical instruments and a film camera into your abdomen after a laparoscopic appendectomy to remove your appendix.

Laparoscopic surgery, in general, helps you to recover more easily and heal with less discomfort and scarring. For older people and persons with obesity, it could be safer.

But for all, laparoscopic surgery isn’t ideal. You will require an open appendectomy that helps the surgeon to clean the abdominal cavity if the appendix has ruptured and the infection has spread past the appendix or you have an abscess.

During the appendectomy, plan to spend one or two days in the hospital.

Draining an abscess before surgery on the appendix

The abscess may be drained by inserting a tube through your skin into the abscess if your appendix has burst and an abscess has grown around it. Since containing the inflammation, an appendectomy should be carried out several weeks back.

Home remedies and lifestyle modifications for Appendicitis?

Expect a few weeks of appendectomy healing, or longer if the appendix has broken. To help restore the body:

  • Stop strenuous exercise initially. If you have undergone a laparoscopic appendectomy, limit your activity to three to five days. When an open appendectomy has been performed, limit the activity to 10 to 14 days. Often ask the doctor if your function is limited and when you will restart regular operations following surgery.
  • When you cough, help the belly. Before you cough, chuckle or move to help relieve discomfort, put a pillow over your abdomen and apply pressure.
  • If your painkillers don’t work, call your doctor. Being in pain places more burden on the body which delays the progress of recovery. If, after the pain killers, you’re really in pain, call the doctor.
  • When you’re prepared, get up and walk. Start slowly and, when you feel up to it, increase your operation. Start by taking short walks.
  • When sleepy, sleep. You can find that you feel sleepier than normal when your body recovers. When you need to, take it easy and relax.

Discuss making the doctor coming back to work or school. When you feel up to it, you will return to functioning. Less than a week after surgery, children will be able to return to kindergarten. In order to resume strenuous practises, such as gym lessons or athletics, they can wait two to four weeks.

References:

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https://www.mayoclinic.org/diseases-conditions/appendicitis/symptoms-causes/syc-20369543

https://www.medicalnewstoday.com/articles/158806

https://www.webmd.com/digestive-disorders/digestive-diseases-appendicitis#1

https://www.medicinenet.com/appendicitis/article.htm

https://www.healthline.com/health/appendicitis