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Appendicitis: Signs & Symptoms of Appendix Pain

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Once thought to be useless, the appendix could be used to help battle diseases.

Appendicitis is inflammation of the appendix. Acute appendicitis requires the appendix to be surgically removed. If an inflamed appendix is not removed, it is likely to rupture, leading to greater complications and pain. Appendicitis is a serious illness and can be life threatening if not treated in time.

According to the NIH, appendicitis is the leading cause of emergency abdominal operations in the United States. Anyone can suffer from it, though the majority of people who get it are 10-30 years old. It is rare in children under the age of 2, and it affects 1 in 15 Americans.

The Appendix

The appendix is an abdominal organ that is often called “useless” — though its actual function or lack thereof is still up for debate among scientists. The appendix is a thin tube, about four inches long, which lies at the junction of the small intestine and the large intestine on the right side of the abdomen. The appendix produces mucus that travels into the large intestine.

Appendix function

There are multiple theories about the appendix’s function. Many scientists contend that it has no practical function in contemporary human life, but is a vestigial organ from a different stage in our evolution. Others, however, assert that it plays a role today. It may be a storage unit for good bacteria, which can help reboot the digestive system after a diarrheal illness. Another theory is that the appendix helps the development of fetuses and young adults. It produces endocrine cells in fetuses, which produce good bacteria, and helps suppress potentially destructive antibodies and promotes immunity in young adults.

Appendix pain

Sudden abdominal pain is the classic symptom of acute appendicitis. It is usually the first sign, and often wakes the patient at night. The pain is distinctive and usually begins near the belly button then moves lower and to the right. It worsens quickly, usually within a matter of hours, and seems to get worse if the patient moves around, takes deep breaths, coughs, or sneezes.

Other symptoms of appendicitis include:

  • loss of appetite
  • nausea or vomiting
  • constipation or diarrhea
  • inability to pass gas
  • a low-grade fever that follows other symptoms
  • abdominal swelling

In addition to those above, nearly half of sufferers also experience one or all of the following symptoms: 

  • Pain anywhere in the abdomen, back, or rectum
  • Painful urination
  • Severe cramps
  • Vomiting before pain begins

A person suffering from these symptoms must not eat, drink, use pain medicines, antacids, laxatives, or heating pads, as they can lead to rupturing of the appendix.

What causes appendicitis?

Appendicitis is caused by a blockage in the inside of the appendix. When it is blocked, mucus may back up inside it, causing the appendix’s normal bacteria to multiply to a dangerous level. As a result, the appendix swells and becomes infected.

The blockage can be caused by:

  • a stool, parasites, or growths
  • enlarged lymph tissue on the appendiceal wall, caused by infection
  • inflammatory bowel diseases like Crohn’s disease and ulcerative colitis
  • trauma to the abdomen
  • cancer

Ruptured appendix

If an inflamed appendix isn’t removed quickly, it can rupture. While rupturing may cause less pain for a short time, it will soon become worse than before and likely cause sickness. When an appendix ruptures, it spills infection throughout the abdomen. This condition is called peritonitis and is potentially quite dangerous.

When peritonitis occurs, the lining of the abdominal cavity becomes inflamed and infected. People with peritonitis may be come very sick, experiencing nausea, vomiting, fever and severe soreness in the abdomen.

Peritonitis requires immediate surgery to remove the appendix. This is usually done through a laparotomy (a single incision). When the infection and inflammation are under control (usually after about six to eight weeks), surgeons remove what is left of the burst appendix.

In some cases, an abscess forms around the burst appendix. Surgeons typically drain the pus from the abscess before surgery using a tube placed through the abdominal wall. After surgery, the drainage tube is left in for around two weeks, while the patient takes antibiotics.

Chronic appendicitis

There are two types of appendicitis: acute and chronic. Acute is what is typically thought of as appendicitis, and is described above.

Chronic appendicitis is a far more rare condition than acute appendicitis. It is also significantly milder, develops more slowly, has less-obvious symptoms, and does not necessarily require surgery.

Symptoms are usually not especially pronounced and may include recurring bouts of abdominal pain in the right side of the body for an extended amount of time. For others, it presents itself as only generalized fatigue and illness.

It can be difficult to diagnose but if it is caught in time, it can often be treated with antibiotics. Since it is a chronic condition, ongoing treatment is necessary.

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