Topic Overview
What is appendicitis?
Appendicitis is one of the
causes of serious belly pain. It happens when the
appendix, a part of the large intestine, becomes
infected and inflamed. Experts do not know what the appendix does in the body,
but most of the time it does not cause problems.
About 8 out of
100 people will get appendicitis sometime during their lives. It is most common
in people ages 10 to 30, but it can happen at any age.
What causes appendicitis?
It is not clear why
people get appendicitis. Infection in the appendix causes appendicitis. But
doctors and scientists are not sure what causes the infection. In many cases, a
small object (such as a hard piece of stool) blocks the opening to the
appendix. Then bacteria can grow in the appendix and cause an infection.
What are the symptoms?
The main symptom of
appendicitis is belly pain. Many people feel the first pain near the belly
button. Then it moves to the lower right side of the belly. But the pain can be
in different parts of your belly or even on your side or back. The pain may get
worse if you move, walk, or cough. You may also have a fever or feel sick to
your stomach.
Sometimes the only symptom is a general feeling of
not being well and a pain that is hard to describe. The pain in your belly may
be different than any pain you have had before. It may be severe. Or it may not
seem like a very strong pain, but you may have the feeling that something is
wrong. Trust your instincts.
Because the diagnosis is not always
easy to make, it is very important to see a doctor as soon as possible if you
have symptoms.
In some cases, appendicitis does not cause any
symptoms except for belly pain. If you have
moderate belly pain that does not go away after 4
hours, call your doctor. If you have
severe belly pain, call your doctor right away.
How is appendicitis diagnosed?
Your doctor will
ask you questions about what symptoms you have, when they started, and what was
happening before the pain began. Your doctor will press on your belly to see
where the pain is. He or she will take your temperature to see if you have a
fever, which is a sign of infection. You also may have blood tests to look for
signs of infection.
Your doctor may not be sure whether you have
appendicitis. You may need other tests, such as a
CT scan or an
ultrasound of your belly.
Sometimes
tests can't show for certain that you have appendicitis, but your doctor may
strongly suspect that you do because of your symptoms. In this case, your
doctor probably will recommend you have surgery to have your appendix taken
out. Most of the time, the doctor is right and the appendix is infected. During
surgery your doctor may find that your appendix is normal and something else
caused your pain. Your doctor will go ahead and remove your appendix. You can
live just fine without it, and taking it out gets rid of any chance that it
could cause problems later.
How is it treated?
The only treatment for
appendicitis is surgery to remove your appendix (appendectomy). If you have
appendicitis and do not have surgery in time, your appendix can burst. A burst
appendix can cause serious problems. It’s best to remove the appendix before it
bursts.
There are different types of surgery for appendicitis.
Your surgeon may operate through a large cut (incision) in your belly or use a
tool called a laparoscope to remove your appendix through a few smaller
incisions. Either way, you may take
antibiotics before your surgery, after your surgery,
or both. There are advantages and disadvantages to each type of surgery. Talk
with your surgeon about which type is best for you.
If your
appendix does burst, you will need antibiotics. Surgery to remove a burst
appendix may be more complicated.
Frequently Asked Questions
|
Learning about appendicitis:
|
|
|
Being diagnosed:
|
|
|
Getting treatment:
|
|
Symptoms
The main symptom of
appendicitis is belly (abdominal) pain. The pain can
feel like
indigestion or like you need to have a bowel movement
or pass gas. Many people feel the first pain near the belly button. Then it
moves to the
lower right side of the belly. But the pain can be in different parts of your
belly or even on your side. The pain may get worse if you move, walk, or cough.
You may also have a fever or feel sick to your stomach.
Many
people who have had appendicitis say the pain is hard to describe. It may not
feel like any pain you have had before. It may not even be a very bad pain, but
you may feel like something is wrong. If you have
moderate belly pain that does not go away after 4
hours, call your doctor. If you have
severe belly pain, call your doctor right away.
You may have appendicitis if:
- You have pain in your belly. The pain may begin
around your belly button.
- The pain in your belly gets stronger and
moves below your belly button on your right side (the
lower right quadrant). This is the most common place to feel pain when you
have appendicitis.
- The pain does not go away and gets worse when
you move, walk, or cough.
- You have pain in any part of your belly
or on your side.
- You feel nauseated or throw up a few times. You
also may not feel like eating.
- You have constipation, back pain, a
slight fever, or a swollen abdomen.
Some people do not have the symptoms listed above. Older
people, children younger than 2 years, and pregnant women may not have pain in
the lower right part of the belly. Other people feel pain in the side because
their appendix is in a different position than normal.
Pain in the abdomen is very common. For more information, see the
topics
Abdominal Pain, Age 12 and Older, and
Abdominal Pain, Age 11 and Younger.
There are also many
conditions with symptoms similar to appendicitis. But
because appendicitis can become serious in a short amount of time, call your
doctor right away if you have any of the symptoms listed above. Treatment is
much easier if the appendix has not ruptured. In most people, the appendix does
not rupture until they have felt sick for at least 24 hours.
Exams and Tests
Appendicitis
is
diagnosed with a medical history, physical examination, lab tests, and
sometimes imaging tests. Appendicitis can be difficult to diagnose, especially
in children, pregnant women, and older people.
Medical history
The doctor will ask you questions
about your symptoms, including the order in which your symptoms appeared and
what was happening before the pain began.
Physical exam
The doctor will push on different
parts of your belly to see where the pain is. The doctor will probably focus on
the lower right quadrant, where most people feel pain when
they have appendicitis.
The doctor may insert a gloved finger into
your anus (digital rectal exam) to help identify the cause of
your pain. Women may have a
pelvic exam to help rule out other problems.
Lab tests
There is no specific lab test for
appendicitis. But your doctor probably will do a
complete blood count (CBC) to look for signs of
infection.
The doctor also may do a
urine test to make sure that a
urinary tract infection or
kidney stone is not causing the problem. A woman may
have a pregnancy test to make sure she is not pregnant.
Imaging tests
A
CT scan may be used when a diagnosis of appendicitis
is uncertain. CT is more accurate than ultrasound in diagnosing
appendicitis.
Ultrasound can be used to take pictures
of the appendix. Ultrasound is used more with pregnant women
who cannot have a CT scan. It also may be used with children when their
symptoms are not obvious. But the appendix cannot always be seen with an
ultrasound.
Treatment Overview
The only treatment for
appendicitis is surgery to remove the
appendix (appendectomy). The goal is to remove the
appendix before it ruptures and spreads infection to the abdomen (peritonitis).
If your doctor is not sure
if you have appendicitis, you may have to wait for several hours at home or in
the hospital before a decision about surgery is made. Your doctor may send you
home and have you come back in 6 or 8 hours to be rechecked.
Surgery to remove the appendix can be done one of two ways—laparoscopic or traditional. Experts do not agree on
which surgery is best. It often depends on what your surgeon prefers.
Laparoscopic surgery uses three or four small cuts or
incisions, and traditional appendectomy uses one larger incision. Most people
feel better immediately after surgery. Some people can even go home the same
day.
If your appendix has burst and there is infection in your
abdomen, you may have to stay in the hospital longer. Your treatment will
include
intravenous (IV) fluids and
antibiotics. Surgery for a burst appendix may be more
complicated. If you have a burst appendix, a
radiologist may place a drain in your belly to help
remove some of the infection before you have surgery to remove it. In this
case, the appendix will be taken out a few weeks later. After you have your
appendix removed, the doctor may leave the incision (cut) open to heal from the
inside to the outside. You may also have a drain placed within the wound to
help drain the infection.
You will also have to stay in the
hospital longer if you have health problems that get worse after
surgery.
Sometimes a doctor will recommend surgery even if he or
she is not sure you have appendicitis. Surgery can eliminate the chances of a
ruptured appendix. If you have surgery and your appendix is normal, your
appendix will still be removed so that it will not cause future
problems.
Home Treatment
If you think you may have
appendicitis, do not try to treat it at home. If you
have
moderate belly pain that does not go away after 4
hours, call your doctor. If you have
severe belly pain, call your doctor right away. It may
be more likely that you have appendicitis if you have:
If you think appendicitis may be causing your abdominal
pain:
- Seek medical treatment immediately. If you have
appendicitis, it is very important to be treated right away.
- Do not eat or drink, unless your doctor says it is okay. If you need surgery for appendicitis, it is best if you have not had anything to eat or drink. You can rinse your mouth with water or suck on hard candy if you are thirsty.
After surgery
Most people leave the hospital 1
to 3 days after having surgery to remove the
appendix. But if the appendix has ruptured and there
is infection in the abdomen or other problems, it takes longer to get better.
People who have
laparoscopic surgery usually return to normal
activities in 1 to 3 weeks. Those who have a traditional appendectomy generally
return to normal activities in 3 to 4 weeks.
While you are at
home recovering from an appendectomy, check your incision(s) for infection.
Call your doctor if you have a fever or notice other signs of infection such as
redness, swelling, pus, or pain in your lower abdomen. You should also call
your doctor if you are not able to eat normal foods after 5 days.
Other Places To Get Help
Organizations
|
American College of Surgeons
|
| 633 North Saint Claire Street |
| Chicago, IL 60611-3211 |
| Phone: |
1-800-621-4111
(312) 202-5000 |
| Fax: |
(312) 202-5001 |
| Email: |
postmaster@facs.org |
| Web Address: |
www.facs.org |
| |
|
Contact the American College of Surgeons for the names
of surgeons in your area. The Web site also has educational information to help
people learn about operations and surgical care. The American College of
Surgeons Web site has the most current information about surgical procedures,
diseases, tests, medicines, and pain management, collected from government and
professional sources.
|
|
|
KidsHealth for Parents, Children, and
Teens
|
| 10140 Centurion Parkway North |
| Jacksonville, FL 32256 |
| Phone: |
(904) 697-4100 |
| Fax: |
(904) 697-4125 |
| Web Address: |
www.kidshealth.org |
| |
|
This Web site is sponsored by the Nemours Foundation. It
has a wide range of information about children's health, from allergies and
diseases to normal growth and development (birth to adolescence). This Web site
offers separate areas for kids, teens, and parents, each providing
age-appropriate information that the child or parent can understand. You can
sign up to get weekly e-mails about your area of interest.
|
|
|
National Digestive Diseases Information Clearinghouse
(NDDIC)
|
| 2 Information Way |
| Bethesda, MD 20892-3570 |
| Phone: |
1-800-891-5389 |
| Fax: |
(703) 738-4929 |
| Email: |
nddic@info.niddk.nih.gov |
| Web Address: |
www.digestive.niddk.nih.gov |
| |
|
This clearinghouse is a service of the U.S. National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the
U.S. National Institutes of Health. The clearinghouse answers questions;
develops, reviews, and sends out publications; and coordinates information
resources about digestive diseases. Publications produced by the clearinghouse
are reviewed carefully for scientific accuracy, content, and readability.
|
|
References
Other Works Consulted
- Humes D, et al. (2007). Appendicitis, search date
November 2006. Online version of BMJ Clinical Evidence.
Also available online: http://www.clinicalevidence.com.
- Sarosi GA, Turnage RH (2006). Appendicitis. In M
Feldman et al., eds., Sleisinger and Fordtran's Gastrointestinal and Liver Disease, 8th ed., vol. 2, pp. 2599–2612.
Philadelphia: Saunders.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Kathleen Romito, MD - Family Medicine |
|
Specialist Medical Reviewer
|
Brent Shoji, MD - General Surgery |
|
Last Revised
|
August 18, 2009 |