Appendicitis

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By Medifit Education.

APPENDICITIS

appendicitis

 

WHAT IS APPENDICITIS?

Appendicitis refers to inappropriate activity of the vermiform appendix, a worm-shaped extension of the colon.

There are 2 basic types of Appendicitis, acute and chronic.

Symptoms of appendicitis are intense and painful, continuous abdominal pain, nausea, vomiting, constipation or diarrhea and fever.

The pain usually begins in the lower region of the abdomen and later shifts to the lower right side. Generally the pain will intensify with physical effort.

Anyone can develop appendicitis, regardless of age and sex but the illness has a higher incidence in males. Children between 3 – 15 for some reason are also at risk of developing acute appendicitis. Elderly people and patients with medical problems usually develop atypical acute appendicitis.

Appendicitis is a serious illness and can be life-threatening if it is not treated in time. Appendicitis affects about 6 – 7 percent of the population in the United States and Europe. People with symptoms of appendicitis should not take laxatives or enemas to relieve constipation because these medicines could cause the appendix to burst.

Appendicitis is inflammation of the appendix. It may be acute or chronic.

Harrison’s Principles of Internal Medicine states that appendicitis is the most common medical emergency in the United States. More than 250,000 appendectomies are performed annually.

Appendicitis occurs most often between the ages of 10 and 30. It is more common in men than in women. Untreated appendicitis can be fatal.

 

CAUSES OF APPENDICITIS

Bacteria, viruses — even air pollution — may cause appendicitis.

Appendicitis is a serious medical condition in which the appendix a small, finger-shaped organ attached to your large intestine becomes swollen and inflamed.

It’s not always clear what causes appendicitis, but it’s sometimes due to a viral, bacterial, or fungal infection that has spread to the appendix. Possible infections include, but are not limited to:

  • Bacteroides bacteria
  • Adenovirus
  • Salmonella bacteria
  • Shigella bacteria
  • Measles
  • The fungal infections mucormycosis and histoplasmosis

 

APPENDIX LUMEN BLOCKAGE

More often, appendicitis is the result of an obstruction of the area inside of the appendix, called the appendiceal lumen or appendix lumen. There are numerous issues that can cause appendix lumen blockage, including:

  • Appendicoliths or fecaliths, which are calcified fecal deposits, also known as “appendix stones”
  • Intestinal worms or parasites, including pinworm (Enterobius vermicularis)
  • Irritation and ulcers in the gastrointestinal (GI) tract resulting from long-lasting disorders, such as Crohn’s disease or ulcerative colitis
  • Abdominal injury or trauma
  • Enlarged lymph tissue of the wall of the appendix, which is typically the result of infections in the GI tract
  • Various foreign objects, such as stones, bullets, air gun pellets, and pins

Your appendix is home to many beneficial bacteria. However, when the organ becomes infected or blocked up, the bacteria multiply rapidly, causing your appendix to swell and fill with pus — a thick liquid containing bacteria, tissue cells, and dead, infection-fighting white blood cells.

 

COMPLICATIONS OF APPENDICITIS

If left untreated, appendicitis will often get progressively worse as the inflammation leads to further complications.

Pressure within the appendix will increase, and this decreases the amount of blood flowing through the walls of the appendix, which then become starved of blood and start to die. Bacteria can leak out of the dying walls of the appendix, causing the peritoneum — the silk-like membrane that lines the abdominal cavity — to become infected.

Eventually, the appendix will rupture, spewing its contents throughout the abdomen. In some cases, abscesses (pockets of pus) may form on the ruptured appendix; if the abscesses tear, they can infect the rest of the abdomen.

In other cases, the ruptured appendix may cause the peritoneum to become infected, a condition called peritonitis. This serious complication can then lead to a potentially fatal blood infection called sepsis.

 

APPENDICITIS RISK FACTORS

There is no way to predict who will get appendicitis, but scientists have uncovered several risk factors for the condition. These include:

  • Having a family history of appendicitis
  • Being a male
  • Being between the ages of 10 and 19 years old
  • Having a long-lasting inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis

Research also suggests that the typical “Western diet,” which is high in carbohydrates and low in fiber, can increase your chances of developing appendicitis. Without enough fiber in your diet, bowel movements slow down, increasing the risk of appendix obstruction.

There is also a link between air pollution — in particular, high levels of ozone — and appendicitis. Scientists aren’t sure why air pollution is associated with an increased risk of appendicitis, but it may be that high levels of ozone increase intestinal inflammation or alter the normal communities of microbes in the gut.

Indeed, studies suggests that people get appendicitis more during the summer than other times of the year, likely due to a combination of increased air pollution, more GI infections, and greater consumption of fast food and other high-carb, low-fiber meals.

 

SYMPTOMS OF APPENDICITIS

Is your stomach pain a symptom of appendicitis?

Your appendix is a small, finger-like pouch that’s located at the junction of your large intestine and small intestine (at the lower right side of your abdomen).

Appendicitis occurs when your appendix becomes inflamed and filled with pus, a fluid made up of dead cells that often results from an infection. If appendicitis is left untreated, the appendix will swell and eventually burst, leaking its infected contents throughout your abdomen and potentially leading to other life-threatening infections.

There is no way to predict who will get appendicitis, so spotting the condition’s telltale signs is vital for early diagnosis. If you have appendicitis, the first symptom you will likely experience is a pain around your belly button.

Over a matter of hours, this pain slowly moves to the lower right part of your belly, and tends to focus at a spot called McBurney’s point, which lies directly above your appendix.

 

IS IT APPENDIX PAIN?

Unfortunately, abdominal pain is common for a lot of illnesses, such as irritable bowel disease, urinary tract infections (UTI), and pelvic inflammatory disease (an infection of a woman’s reproductive organs).

You could also experience stomach pain if you’re constipated, have food poisoning, kidney stones or some kind of intestinal obstruction, so it’s important to look for other signs of appendicitis if you’re experiencing abdominal pain.

 

COMMON SYMPTOMS OF APPENDICITIS

At the onset of appendicitis, people typically experience several other symptoms, along with the pain. These include:

  • Loss of appetite
  • Nausea
  • Vomiting
  • Low-grade fever
  • Inability to pass gas
  • Abdominal swelling
  • Constipation or diarrhea

 

It’s also important to note that if you have appendicitis, your abdominal pain will likely spike whenever you move around, take deep breaths, cough, or sneeze. Your lower right abdomen will be tender, and you will experience pain if you put pressure on the area and quickly release it (a symptom called “rebound tenderness”).

 

DIAGNOSING APPENDICITIS

To diagnose appendicitis, your doctor will begin with your medical history, and ask for details about your abdominal pain, other symptoms you’ve experienced, medical conditions you may have, and your alcohol and drug (both legal and illegal) habits.

Your doctor will then perform a physical exam and look for telltale signs of an inflamed appendix, including:

  • Rebound tenderness
  • Rovsing’s sign, in which you experience pain in the lower right side of your abdomen when pressure is applied and released on the lower left side of your abdomen
  • Psoas signs, in which flexing your psoas muscles near your appendix causes abdominal pain
  • Guarding, in which you subconsciously tense your abdominal muscles before your doctor touches your belly

It may also be necessary to exam your rectum, which can be tender from appendicitis.

Your doctor will likely order a number of laboratory tests that will point toward a diagnosis of appendicitis. These can include a blood test to look for signs of infection, a urine test to rule out urinary tract infections and kidney stones, and a pregnancy test if you’re a woman.

Additionally, your doctor may conduct imaging tests, including abdominal ultrasounds, magnetic resonance imaging (MRI) scans, and computerized tomography (CT) scans. These tests can reveal inflammation and rupturing of the appendix, appendix obstructions that can cause appendicitis, and other sources of abdominal pain.

But because the symptoms of appendicitis are similar to so many other conditions, it is sometimes misdiagnosed. A 2011 study found that almost 12 percent of all appendectomies performed in the United States between 1998 and 2007 occurred in people who did not in fact have appendicitis, but had some other condition.

 

TREATMENT

Surgery of Appendectomy

Surgery to remove the appendix, which is called an appendectomy, is the standard treatment for appendicitis.

If appendicitis is even suspected, doctors tend to err on the side of safety and quickly remove the appendix to avoid its rupture. If the appendix has formed an abscess, you may have two procedures: one to drain the abscess of pus and fluid, and a later one to remove the appendix.

Antibiotics are given before an appendectomy to fight possible peritonitis. General anesthesia is usually given, and the appendix is removed through a 4-inch incision or by laparoscopy. If you have peritonitis, the abdomen is also irrigated and drained of pus.

 

Post Surgery

Within 12 hours of surgery you may get up and move around. You can usually return to normal activities in 2 to 3 weeks. If surgery is done with a laparoscope (a thin telescope-like instrument for viewing inside the abdomen), the incision is smaller and recovery is faster.

 

After an appendectomy, call your doctor if you have:

  • Uncontrolled vomiting.
  • Increased pain in your abdomen.
  • Dizziness/feelings of faintness.
  • Blood in your vomit or urine.
  • Increased pain and redness in your incision.
  • Fever.
  • Pus in the wound.

 

Can Appendicitis Be Prevented?

There is no way to prevent appendicitis. However, appendicitis is less common in people who eat foods high in fiber, such as fresh fruits and vegetables.

By Medifit Education.

www.themedifit.in

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