Appendicitis is inflammation of the appendix. The appendix is a small pouch attached to the beginning of your large intestine.
Symptoms
The symptoms of appendicitis vary. It can be hard to diagnose appendicitis in young children, the elderly, and women of childbearing age.
Typically, the first symptoms are:
Pain around your belly button (it may be vague at first, but becomes increasingly sharp and severe)
Reduced appetite
Nausea
Vomiting
Low-grade fever
As the inflammation in the appendix increases, the pain tends to move into your right lower abdomen and focuses directly above the appendix at a place called McBurney's point. If your appendix ruptures, the pain may lessen briefly and you may feel better. However, once the lining of your abdominal cavity becomes inflamed and infected (a condition called peritonitis), the pain gets worse and you become sicker. Your abdominal pain may be worse when walking or coughing. You may prefer to lie still because sudden movement causes pain.
Later symptoms include:
Chills
Constipation
Diarrhea
Fever
Loss of appetite
Nausea
Shaking
Vomiting
Treatment
If you have an uncomplicated case, a surgeon will usually remove your appendix soon after your doctor thinks you might have the condition. For information on this type of surgery see: appendectomy.
If a CT scan shows that you have an abscess from a ruptured appendix, you may be treated for infection and have your appendix removed after the infection and inflammation have gone away.
Causes
Appendicitis is one of the most common causes of emergency abdominal surgery in the United States. It usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor.
Tests & diagnosis
If you have appendicitis, your pain will increase when the doctor suddenly releases the pressure after gently pressing on your lower right belly area. If you have peritonitis, touching the belly area may cause a spasm of the muscles. A rectal examination may reveal tenderness on the right side of your rectum.
Doctors can usually diagnose appendicitis by your description of the symptoms, the physical exam, and laboratory tests. In some cases, additional tests may be needed. These may include:
Abdominal CT scan
Abdominal ultrasound (sonogram)
Prognosis
If your appendix is removed before it ruptures, you will likely get well very soon after surgery. If your appendix ruptures before surgery, you will probably recover more slowly, and are more likely to develop an abscess or other complications.
Complications
Abnormal connections between abdominal organs or between these organs and the skin surface (fistula)
Abscess
Infection of the surgical wound
Peritonitis
When to contact a doctor
Call 911 or go to the nearest emergency room if:
Your pain is severe, sudden, or sharp
You have a fever along with your pain
You are vomiting blood or have bloody diarrhea
You have a rigid, hard abdomen that is tender to touch
You are unable to pass stool, especially if you are also vomiting
You have chest, neck, or shoulder pain
You are dizzy or light-headed
Call your health care provider if you develop abdominal pain in the lower-right portion of your belly, or any other symptoms of appendicitis. Also call your doctor if:
You have nausea and lack of appetite
You are unintentionally losing weight
You have yellowing of your eyes or skin
You have bloating for more than 2 days
You have had abdominal discomfort for more than 1 week
You have burning with urination or you are urinating more often than usual
Your pain gets worse when you take antacids or eat something
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