What is Appendicitis ?

Appendicitis is a stomach related bodily malfunction, which is caused by the inflammation of the appendix. In most cases appendicitis does not require any treatment but under acute circumstances it might require and operation involving removal of the appendix itself. Although medical fraternity does not consider appendicitis as a life threatening disease but if left untreated might lead to life threatening complications.

What causes Appendicitis ?
In order to understand appendicitis we have first to understand what an appendix is. Appendix actually is a small tube attached to the tip of the large intestine and is located at the right hand side of the stomach. It is this appendix, which swells up internally due to blockage and leads to an anomaly called the appendicitis. Now blockage can be due to several reasons like
• Faucal matter lodged inside the appendix.
• Small tumor in the internal surface of the appendix.
• Ulcer formation inside the internal lining of the appendix due to excess of lymphatic tissue formation.
• Blood clotting.

 


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Whatever be the reason the blockage inside the appendix causes extreme stress on the walls of the appendix, which blocks the flow of blood into the appendix. Now with less supply of blood the appendix looses the capacity to stop bacterial infection. As a result bacteria from the faecal matter multiplies in large amounts inside the appendix. Also the lack of blood flow results in the decay of the body tissues leading and eventually lead to rupture of the appendix with bacteria infected pus falling all over and causing septic which is quite a life threatening condition.

What are the common symptoms of Appendicitis ?
Some of the common physical characteristics often related to appendicitis are
• Loss of appetite
• Pain in the lower abdominal area
• Abdominal swelling
• Nausea
• Vomiting
• Constipation
• Diarrhea
• Light fever

However a person showing these symptoms need not be suffering from appendicitis. This is due to the fact that several other diseases show similar symptoms. Abdominal pain, nausea, and vomiting are also common during pregnancy and may or may not be the signs of appendicitis. Pregnant women who experience pain on the right side of the abdomen need to contact a doctor as it is a common issue during pregnancy.

Types of Appendix
Doctors around the world classify appendix into two different types typical appendix and atypical appendix.
• Typical Appendix This kind of appendicitis starts with acute pain on the central region of the stomach and then soon shifts to the right hand corner of the stomach. The usual symptoms like loss of appetite, nausea and vomiting might not be prominent among older patients. Diagnosis is easier in typical acute appendicitis and surgery removes a swollen appendix with little or no suppuration i.e. no pus formation.


• Atypical Appendix Histories are not unusual and are more often associated with suppurative appendicitis. This condition starts with slight pain in the lower right portion of the stomach and slight pain continues for several days before a diagnosis of appendicitis can be made. Diagnosis is more difficult and surgery removes an appendix that is suppurative, gangrenous or ruptured.

How is Appendicitis diagnosed ?
The first thing that has to be concerned during the diagnosis of a patient is the evaluation of the patient’s history. Any previous medical complications and surgical operations, family history, medications, and allergies are important information to the doctor. Use of alcohol, tobacco, and any other drugs should also be mentioned before the doctor starts any kind of medication.

 

Normally medications start with the usual practices which are measuring: temperature, pulse rate, breathing rate, and blood pressure etc. Symptoms shown by appendicitis are normal for several other diseases so a proper diagnosis of the disease is a must for proper treatment.

Whether a person is actually suffering from appendicitis or some other complications is determined by a complete examination of the lower abdominal region. Location of the pain and tenderness is a very important step in this regard. Pain is a symptom described by a patient; tenderness is the response to being touched. Depending on these above steps the doctor comes to the decision that the lining of the abdomen is inflamed and surgery may be needed. Nowadays doctors take the help of several lab test and imaging machines to come to this decision this include:
 

• Ultrasonography It is an ultrasound-based diagnostic imaging technique used to visualize muscles and internal organs, their size, structure and any pathological lesions, making them useful for scanning the organs. This machine helps in determining the inflammation of the appendix and hence correct determination of the disease.


• Computed tomography This technique produces a three dimensional image of any organ of the body. This three dimensional image of the appendix gives a complete determination of the disease and it has a 95% hit rate in determining appendix.


• Lab test Lab test include determining the white blood cell content in the body to determine the amount of infection.

What is the treatment of appendix ?
Treatment can be of basically two different types:
 

Surgical operation The most common type of treatment of appendicitis is surgical operation. This operation involves removing of the complete appendix from the stomach. Surgery can be of two types
 • open surgery The operation may be performed through a standard small incision in the right lower part of the abdomen, this kind of surgery is preferred when the appendix has ruptured and infection has spread beyond the appendix into other region.
 • Laparoscopy The operation involves making four small holes in the stomach. This kind of operation is less painful than open surgery and takes less time to heal. it basically involves insertion of a pencil thin tube with its own lightning system and camera into the abdomen in order to remove the appendix.
 

Antibiotic medication This approach is taken when the doctor presumes that the patient's symptoms may have a non surgical or medically treatable cause. If the cause of the pain is infectious, symptoms resolve with intravenous antibiotics and intravenous fluid.

 

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Article Contributed By: Pinakjit Kakati
 

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