Digestive health centre

Appendicitis

Appendicitis is an inflammation of the appendix, a five to 10 centimetre long tube of tissue that extends from the large intestine. No one is absolutely certain what the function of the appendix is. One thing we do know: we can live without it, and without any apparent consequences.

Appendicitis is a medical emergency that usually requires prompt surgery to remove the appendix. Left untreated, an inflamed appendix may eventually burst or perforate, spilling infectious materials into the abdominal cavity. This can lead to peritonitis, a serious inflammation of the abdominal cavity's lining (the peritoneum) that can be fatal unless it is treated quickly with strong antibiotics.

appendix

Sometimes a pus-filled abscess (an infection closed off from the rest of the body) forms outside the inflamed appendix. Scar tissue then "walls off" the appendix from the rest of the abdomen, preventing infection from spreading. An appendiceal appendix is a less urgent situation, but unfortunately can be difficult to identify without surgery. An abscess may be detected on an ultrasound examination or CT scan. If symptoms settle, this may make it possible to delay or avoid surgery.

An estimated 7% of people in the UK will get appendicitis at some point in their lives. The condition is more common in men than in women, usually occurring between the ages of 10 and 30 years. It is rarely seen in children younger than two years old.

What causes appendicitis?

Appendicitis occurs when the appendix becomes blocked, often by a stool, a foreign body, or cancer. The blockage may also be due to an infection, since the appendix swells up in response to any infection in the body.

What are the symptoms of appendicitis?

The classic symptoms of appendicitis include:

Dull pain near the navel or the upper abdomen that becomes sharp as it moves to the lower right abdomen. This is usually the first sign.
Loss of appetite.
Nausea or vomiting soon after the abdominal pain begins.
Abdominal swelling.
A raised temperature.
Inability to pass wind.

In around 50% of cases there are other symptoms, including:

Dull or sharp pain anywhere in the upper or lower abdomen, back or rectum.
Painful urination.
Vomiting that precedes the abdominal pain.
Severe cramps.
Constipation or diarrhoea with wind.

Seek medical attention if:

You have pain that matches these symptoms.
If you have any of the above symptoms, seek medical attention immediately as timely diagnosis and treatment are very important.

How is appendicitis diagnosed?

Diagnosing appendicitis can be tricky. The symptoms are often vague or extremely similar to other ailments, including gall bladder problems, bladder or urinary tract infections, Crohn's disease, gastritis, intestinal infection and ovary problems.

The following tests are usually used to make the diagnosis: