It is important to recognize the signs of appendicitis and to seek immediate medical attention if experiencing symptoms.Experiencing severe stomachaches that will not seem to go away? These severe stomachaches can be a sign of appendicitis, a common medical emergency. When caught early, appendicitis is highly treatable and easy to resolve.
Lauren Gleason, M.D., assistant professor in the University of Alabama at Birmingham Division of Gastrointestinal Surgery, shares her expertise on appendicitis, including its symptoms, misconceptions and treatment. Gleason specializes in benign and malignant conditions of the small intestine, colon, rectum and anus.
What is appendicitis?
Appendicitis is the inflammation and infection of the appendix, a small organ that originates from the cecum, or the first part of the colon. It is more common during the summer because of a combination of dehydration and increased exposure to a gastrointestinal bug.
“The appendix becomes inflamed usually because it has been blocked off by stool or another process than can cause obstruction of the appendix,” Gleason said. “For younger children, sometimes viruses can cause tissue swelling and blockage of the appendix.”
When the appendix is blocked off, it will continue to create mucus like the rest of the intestine, leading to infection or perforation, which means the rupture, hole or tear through the wall of a body organ or membrane.
What are common misconceptions about appendicitis?
Gleason addresses three common misconceptions on appendicitis and the truth behind them:
- “Appendicitis only affects children.”: In reality, anyone can get appendicitis.
- “Appendicitis can be prevented by eating a healthy diet and avoiding seeds.”: While staying hydrated and consuming a healthy diet can improve digestive health, these factors have not been shown to significantly prevent appendicitis.
- “Appendicitis can safely be treated at home.”: Appendicitis must be evaluated by a medical professional.
Who is at risk for developing appendicitis?
While anyone can develop appendicitis, it is more common in those between the ages 10 and 30 and is slightly more common in males. An individual is also more likely to develop appendicitis if they have an immediate family member who has had appendicitis.
While children are at higher risk for developing appendicitis, it can be difficult to diagnose them.
“Children are more likely to present with atypical symptoms and aren’t always able to articulate their symptoms well. They may also have trouble participating in an abdominal exam,” Gleason said.
An ultrasound is commonly used to diagnose appendicitis in children, and it can be slightly more challenging to pick up appendicitis on an ultrasound compared to a CT scan typically used for adults.
“We accept this risk because it is beneficial to avoid radiation associated with a CT scan in children,” Gleason said.
What are the symptoms of appendicitis?
People who experience appendicitis commonly mistake it as a regular stomachache. It is important to understand their differences and recognize the symptoms associated with them.
The symptoms of appendicitis include:
- Abdominal pain starting near the belly button and progressing to the right lower part of the stomach
- A fever over 100.4 degrees Fahrenheit
- Nausea
- Vomiting
According to Gleason, patients with a burst appendix usually have a fever and are tender to the touch, especially in the right lower part of the stomach, which is different from a regular stomachache. Pain from the appendix can move locations in the stomach and worsen with time.
If symptoms continue to worsen, it is crucial to seek immediate medical attention.
“You know your body best. If you feel sick or feel that something is wrong, always be sure to see a medical professional,” Gleason said.
How is appendicitis treated?
An appendectomy, the surgical removal of the appendix, is the standard treatment for appendicitis. This is a common and safe procedure. In some specific cases, the use of antibiotics alone for treatment is efficient.
“Whether or not your doctor recommends surgery versus antibiotics alone depends on specific findings at the time of diagnosis,” Gleason said. “Studies show that many patients will be able to avoid surgery to remove the appendix short term, but up to 40 percent of patients may have another episode that requires surgery over the next five to 10 years.”
Gleason notes that, if the appendix has ruptured, then patients may need a drain placed by an interventional radiology team in addition to antibiotics.
UAB offers laparoscopic surgery, a minimally invasive surgery for appendix removal, antibiotic treatment and drainage tube placement as options for patients with perforated appendicitis.
Can people live without an appendix?
While it is safe to live without an appendix, it does not mean the appendix is an unnecessary organ.
“There is evidence that the appendix may have some function with the immune system,” Gleason said. “Research suggests that some people may have a slightly higher risk for some infections or autoimmune diseases, but this is emerging data. There are no recommendations to change vaccine schedule or screening exams based on history of an appendectomy.”