What Is It?

Appendicitis is an inflammation of the appendix, a small, fingerlike tube that hangs from the lower right side of the large intestine. The purpose of the appendix is not known. It usually becomes inflamed because of an infection or an obstruction in the digestive tract. If untreated, an infected appendix can rupture (burst) and spread the infection throughout the abdominal cavity and into the bloodstream.

Appendicitis affects one in every 500 people in the United States each year. The risk of appendicitis increases with age, and peaks between the ages of 15 and 30. Appendicitis is the main reason for abdominal surgery in children, with four of every 1,000 children needing the appendix removed before age 14.

Symptoms of appendicitis include:

• Abdominal pain, usually starting in the middle of the abdomen (just above the belly button) and then moving to the right lower side of the abdomen
• Nausea
• Vomiting
• Abdominal swelling
• Pain when the right side of the abdomen is touched
• Low-grade fever
• Inability to pass gas
• Change in normal bowel pattern

If you have symptoms of appendicitis, do not take enemas or laxatives to relieve constipation, because these medicines increase the chance that the appendix will burst. Also, avoid taking pain medicines before seeing your doctor, since these medications can mask appendicitis symptoms and make diagnosis difficult.

Your doctor will review your medical history, especially your history of digestive illnesses. Your doctor also will ask about your current digestive symptoms, including details about your most recent bowel movements: timing, frequency, character (watery or hard), and whether the stool was streaked with blood or mucus.

Your doctor will examine you, and will check for pain in your lower right abdomen. If the patient is a child, the doctor will look to see whether the child holds his or her hands over the naval when asked where it hurts. In an infant, flexed hips (knees held toward the chest) and a tender abdomen can be important clues to the diagnosis.

After the physical examination, your doctor will order blood tests to check for signs of infection and a urinalysis to rule out a urinary-tract problem. Your doctor may order an Ultrasound or Computed tomography scan (CT) to help confirm the diagnosis. In very young children, a chest X-ray may be needed to rule out pneumonia.

Most patients will seek medical attention within 12 to 48 hours because of the abdominal pain. In some cases, a low level of inflammation exists for several weeks before a diagnosis is made.

There is no way to prevent appendicitis.

For acute appendicitis, the standard treatment is to remove the appendix, and the surgery, called an appendectomy, should be done as soon as possible to reduce the risk of the appendix rupturing. Usually, if appendicitis is strongly suspected, a surgeon will advise removing the appendix even if an ultrasound or CT scan cannot confirm the diagnosis. The surgeon’s recommendation to operate reflects the danger of a ruptured appendix. A ruptured appendix can be life threatening, and an appendectomy is a relatively low-risk procedure.

Patients usually are given a dose of antibiotic intravenously (into a vein) during surgery and the antibiotic is continued until the day after surgery. If the appendix ruptured, the patient will need to take antibiotics for a week or more. To allow the digestive tract to rest after surgery, patients will not be given anything to eat or drink for the first 24 hours after an appendectomy. After that, they gradually will be given small amounts of water, then clear liquids, and then some solid foods, until finally they are able to handle a regular diet.

To avoid the risk of a ruptured appendix, contact your doctor immediately if you or a family member has symptoms of appendicitis. Appendicitis is an emergency, and it requires immediate attention.

Patients requiring surgery often stay in the hospital for three to four days (if the appendix did not rupture). People who have an appendectomy normally recover completely.

In cases of a ruptured appendix, the hospital stay is usually prolonged. Although it is rare, a person can die of appendicitis if a ruptured appendix spreads infection throughout the abdomen and into the blood.

Diseases and Conditions Center

All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.