“Appy” is the common term used to refer to appendicitis, the acute inflammation of the appendix. The appendix is a small, finger-shaped pouch attached to the large intestine in the lower right portion of the abdomen. If left untreated, the inflamed tissue can rupture, leading to a widespread infection throughout the abdominal cavity.
What Causes the Appendix to Become Inflamed
The appendix becomes inflamed when its inner cavity, known as the lumen, becomes blocked. This blockage is often caused by a small, hardened piece of stool (fecalith), foreign objects, or enlarged lymphoid tissue swelling due to a gastrointestinal infection.
Once the appendix is blocked, bacteria that naturally reside within the gut begin to multiply rapidly inside the trapped space. This bacterial overgrowth causes the appendix to swell, become infected, and fill with pus. The resulting inflammation increases pressure within the organ, which restricts blood flow to the appendix wall.
A lack of adequate blood supply causes the tissue to weaken and can ultimately lead to rupture. This process can occur quickly, usually within 48 to 72 hours of the first symptoms.
Recognizing the Key Symptoms
The initial symptom of appendicitis is typically the onset of pain that feels dull and vague, often originating near the navel. This discomfort may come and go at first, making it difficult for a person to pinpoint the exact source of the problem.
Over several hours, the pain becomes sharper and more constant as inflammation increases. This localized, intensifying pain usually migrates to the lower right side of the abdomen, specifically to an area known as McBurney’s point. The pain may worsen significantly with movement, coughing, or any jarring action.
Other common symptoms include nausea, vomiting, and a noticeable loss of appetite. A low-grade fever may also develop and increase as the condition progresses.
Additional symptoms might include constipation or diarrhea, abdominal swelling, and the inability to pass gas. Because the classic presentation of symptoms is not always present, especially in young children or pregnant women, any new, severe abdominal pain should prompt an immediate medical evaluation.
Diagnosis and the Surgical Procedure
A doctor begins the diagnostic process by performing a physical examination, which includes gently applying pressure to the abdominal area. A characteristic sign of appendicitis is rebound tenderness, where pain intensifies when the pressure is quickly released from the lower right abdomen. Blood tests are also ordered to check for an elevated white blood cell count, which is a common indicator of infection and inflammation within the body.
To confirm the diagnosis and rule out other conditions, medical imaging is frequently used. An ultrasound is often a first-line imaging tool, particularly for children and women, due to its lack of radiation. A computed tomography (CT) scan is also highly effective, providing detailed images of the appendix and surrounding structures to confirm swelling and inflammation.
The standard and most definitive treatment for acute appendicitis is an appendectomy, which is the surgical removal of the inflamed appendix. This procedure is performed to prevent the appendix from rupturing and spreading infection.
Surgeons typically use a minimally invasive technique called laparoscopic appendectomy, which involves making three small incisions to insert a camera and surgical instruments. This approach generally results in a shorter recovery time and less scarring compared to the alternative, which is the open appendectomy. An open procedure involves a single, larger incision and is usually reserved for cases where the appendix has already ruptured or when the infection is widespread.
Recovery and Long-Term Outlook
Following an uncomplicated appendectomy, the hospital stay is often short, with many patients going home within 24 to 48 hours of the procedure. Pain management is a priority immediately after surgery, and patients receive medication to control discomfort at the incision sites.
Patients are advised to restrict physical activity, such as heavy lifting or strenuous exercise, for several weeks to allow the internal and external wounds to heal fully. Walking is encouraged shortly after surgery to promote circulation and aid in the recovery process. Wound care involves keeping the small incisions clean and dry to prevent infection.
The long-term outlook after an appendectomy is excellent, and the removal of the appendix causes no known health issues or changes to digestion. A full return to normal activities typically occurs within two to four weeks following a laparoscopic procedure.