It’s not uncommon for a doctor to come across appendicitis in their years of service. It is a relatively common gastrointestinal disease that can be a painful experience for the patient.
But, the symptoms of appendicitis are not very specific. So how do doctors identify it? Next, we explain what you should know about it.
What is appendicitis?
It is the inflammation of the vermiform appendix, a small organ located in the cecum where the large intestine begins. It is a single, hollow (like a small sac) organ measuring approximately 11.4 cm. (1)
The most frequent cause of appendicitis is an obstruction inside the organ , generally due to causes such as the accumulation of stones (appendicolith), overgrowth of lymphatic tissue inside it, parasite infestation, etc.
Important: This obstruction is dangerous, since anaerobic bacteria are found inside the appendix whose function has not yet been fully elucidated, but when the communication between the ileum and the appendix is obstructed, they accumulate, causing inflammation.
What are the symptoms of appendicitis?
Appendicitis is a relatively common clinical emergency (in the US alone, there are approximately 300,000 annual hospital visits for appendicitis) (2) , so there are signs and symptoms that doctors use to quickly diagnose it. Next, we will explain some of these:
1. Abdominal pain and bloating
It is one of the most distinctive signs. In clinical practice, the abdomen is divided into four quadrants (upper and lower left, upper and lower right). Pain from appendicitis is usually located in the area around the navel and in the lower right quadrant.
Important: Pain can present itself in multiple ways ; in the affected area just after waking, walking or coughing or pain in the right lower quadrant when the doctor palpates the left lower quadrant.
2. Nausea and vomiting
Caused by abdominal pain, particularly during the most acute and painful episodes. These resolve when starting treatment for appendicitis.
3. Loss of appetite
The patient experiences episodes of anorexia (medical term for lack of appetite). Depending on the intensity and duration of the appendicitis, the patient may lose a certain amount of weight and even become dehydrated, which medical personnel must replace with fluids.
4. Fever and chills
Only 40% of patients experience fever. The rest experience a fever , which is an increase in body temperature that is greater than 37.5°C, but equal to or less than 38.5°C.
Important: If the fever increases beyond 38°C, it is a serious sign. It is an indicator that the appendix has possibly burst, generating peritonitis (inflammation of a membrane that separates the organs of the abdomen).
5. Constipation or diarrhea
Intestinal transit (known as peristaltic movements) are altered, increasing or decreasing the number of evacuations , which can cause discomfort.
Note: In certain patients, cases of appendicitis presenting as acute diarrhea , causing a loss of electrolytes, such as sodium, have been reported. This can lead to diagnostic problems, since these are infrequent symptoms. (3)
What is the treatment for appendicitis?
Due to its frequency, there are various approaches to it . If appendicitis is not treated quickly, it can lead to deadly consequences. We will explain the most frequent treatments in clinical practice.
1. Appendectomy
Surgery is the most common medical treatment . It can be done in two ways; The first is to make a large cut in the abdomen, specifically the lower right quadrant. The doctor then makes an incision and removes the appendix. This surgery only leaves a small scar on the person’s abdomen.
The second is laparoscopic appendectomy. From 1 to 3 small cuts are made in the abdomen, a small tube called a laparoscope is inserted that contains a small camera at the end.
2. Drainage
Drainage of purulent material, plus an adjunct antimicrobial treatment could be beneficial , although more evidence is still required for its routine use, according to recommendations published in the World Journal of Emergency Surgery. (4)
3. Antibiotics
After surgery, the doctor prescribes antibiotics for a variable time, both for complicated and uncomplicated appendicitis. During surgery, bacteria may enter the bloodstream, antibiotics prevent infection of other organs.
Note: A study published in JAMA in 2020 showed that 66% of children treated with drugs did not require appendectomy (5) . However, this study is still not enough to reach a consensus between surgeries or the use of antibiotics in children.
Key Findings
- Appendicitis is the inflammation of the appendix , it is a frequent clinical emergency in public health.
- Its main symptoms are pain in the lower right quadrant , distension of the abdomen, fever, malaise and even diarrhea.
- The most common treatment is surgery , in which the appendix is removed. It can be done in two ways.
- Pus drainage and antibiotics are part of the patient’s postoperative care, especially if a complication has occurred.
University Professional in the area of Human Resources, Postgraduate in Occupational Health and Hygiene of the Work Environment, 14 years of experience in the area of health. Interested in topics of Psychology, Occupational Health, and General Medicine.