Appendicitis

At first Miguel thought he had a "stomach virus" (also called a gastrointestinal infection). His stomach hurt and he was throwing up. He wasn't hungry at all. The next day, instead of feeling better, he felt worse and also had a fever.

Miguel's dad called the doctor, who asked them to come in right away. After examining Miguel, the doctor said they had done the right thing by calling because Miguel, as it turned out, had appendicitis and needed surgery.

What Is Appendicitis?

Appendicitis is an inflammation of the appendix. The appendix is a tube-shaped piece of tissue, the size of a finger, which connects to the large intestine at the lower right side of the abdomen. The inside of the appendix forms a pouch that opens to the large intestine.

Appendicitis can happen when the opening of the appendix to the large intestine gets blocked. Blockage can be due to hard rock-like stool (also called a fecolith), inflammation of lymph nodes in the intestines, or even parasites. Once the appendix is blocked, it becomes inflamed and bacteria can overgrow in it. Appendicitis is not contagious.

If the infected appendix is not removed, it can eventually burst (or rupture) from the buildup of pressure. This may happen as soon as 24 to 72 hours after symptoms start. The infection from a ruptured appendix is very serious — it can form an abscess (a walled-off infection of pus) or spread throughout the abdomen (a type of infection known as peritonitis).

Symptoms of Appendicitis

The classic symptoms of appendicitis are abdominal pain and loss of appetite. Pain usually begins in the center of the abdomen, around the umbilical (belly button) area. Later, the pain may move downward and to the right, to an area called McBurney's point, which roughly corresponds to the location of the appendix. The pain may be worse with moving, jumping, coughing, and deep breaths.

After abdominal pain begins, a person with appendicitis may develop a slight fever, have a loss of appetite, feel nauseated, or vomit. The pain can become steadily worse. If appendicitis isn't treated promptly, the infected appendix could rupture and the infection may spread to other areas of the abdomen and cause pain over the whole abdomen.

Of course, some of the symptoms of appendicitis can happen in other illnesses (like kidney stones, pneumonia, and urinary tract infections). That's why it's important to call your doctor.

Development and Duration of Appendicitis

Once the appendicitis symptoms appear, it can take as little as 24 to 72 hours for the infected appendix to rupture.

If the appendix ruptures, the infection can spread to other areas of the abdomen, increasing the risk of serious complications and making treatment more difficult.

When to Call the Doctor

If you suspect that you have appendicitis, call a doctor immediately. Appendicitis is an emergency that must be treated surgically. It can't be treated at home.

To help make a diagnosis, your doctor will ask you about your medical history and do a physical exam. The doctor will usually order some blood tests and urine studies, and may recommend X-rays, a CAT scan, or an ultrasound. The doctor will decide whether you need surgery.

Ask before taking any pain medicines (such as acetaminophen or ibuprofen) because your doctor will need to examine your abdomen for signs of pain and tenderness. Don't take laxatives or use enemas until your doctor sees you.

Also, if your doctor suspects you have appendicitis, you will probably be asked to stop eating or drinking (an important precaution when a person might be having surgery).

Treating Appendicitis

Appendicitis is treated with surgery to remove the infected appendix. The operation is called an appendectomy. To prepare for the surgery, a person will receive anesthesia, which puts him or her in a deep sleep and prevents pain.

An appendectomy usually means a hospital stay of 1 to 3 days, and most have no complications. However, if the infected appendix ruptures before surgery, the patient usually stays in the hospital longer to receive antibiotics to kill bacteria that may have spread to the abdominal cavity. Even if the appendix has not ruptured, the doctor may prescribe antibiotics because they can decrease the risk of infection after surgery.

After an appendectomy, most patients can safely return to school or work after about a week.

If You Think You Have Appendicitis

Get help from your doctor right away if you suspect that you have appendicitis, because this is a surgical emergency. Quick treatment of appendicitis can help prevent complications and get you back on your feet.