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Appendicitis: an explainer

While the jury is still out on why we have an appendix, we do know that it can occasionally pose a serious health risk – particularly for young people.

Appendicitis occurs when the thin, finger-shaped tube of tissue extending from your large intestine becomes inflamed, swollen and sore. This is usually due to an infection or blockage in the lining of the appendix. If left untreated, the appendix may burst, spreading the infection to the bloodstream. Although this situation is rare, it is potentially life-threatening.

That risk, coupled with how the symptoms of appendicitis can often be mistaken for other stomach problems, means that it is vital to be up-to-speed on early warning signs. Luckily, once you are properly informed, treatment is easy to undergo.

Who is most commonly affected?

Roughly 1 in 10 people will get appendicitis in their lifetime. While you can get it at any age, it typically arises between the ages of 10 and 20.

It is the leading cause of emergency surgery due to abdominal pain in young people. If you are a parent, pay close attention to any complaints your child has regarding stomach aches and pains – the risk of appendicitis being fatal is four times greater in children than in adults.

What are the symptoms?

Symptoms generally start with pain in the centre of the stomach. In a few hours, the pain will shift and settle in the lower right-hand side of your abdomen. The discomfort will become constant and the pain can become quite severe. Pressing down on the area will generally worsen the pain and walking can become difficult.

These accompanying symptoms are tell-tale signs that you have appendicitis:

  • A high temperature
  • A flushed face
  • Loss of appetite
  • Feelings of nausea
  • Vomiting
  • Constipation or diarrhoea

However, around half of us will not exhibit all the usual symptoms. And although the lower right-hand side of the abdomen is generally the source of the pain, some people’s appendix may be located in slightly different places (at the pelvis or behind the lower intestine or liver). While a low level of inflammation can last for several weeks before diagnosis, most people seek medical attention in under 24 hours.

What’s the next step?

Whatever your level of certainty, it is imperative that you see your GP or an out-of-hours service immediately. Your GP will assess your symptoms and examine your abdomen to make an informed medical decision.

If symptoms are atypical, there are other tests that can confirm a diagnosis (such as blood tests, urine tests and ultrasounds). However, as the results can take several days to arrive, your GP will likely err on the side of caution and advise you to attend hospital for further management and to prevent a rupture.

If pain suddenly worsens or spreads across the abdomen, call 999 for an ambulance as the appendix may have burst.

What can you expect from surgery?

Appendix removal (or an “appendectomy”) is one of the most commonly performed operations and has an excellent success rate. Two types of surgery can be undertaken, with keyhole surgery (a “laparoscopy“) favoured due to its quick recovery time. Here, small cuts are made to remove the appendix. There is minimal scarring.

Keyhole surgery may not be an option if:

  • Your appendix has burst
  • You are in the first trimester (up to week 13) of pregnancy
  • You have had previous stomach surgery

In these instances, open surgery will be carried out. This involves one large cut being made and it will leave a scar. In all cases, surgery is carried out under a general anaesthetic.

What does recovery involve?

If the appendix has not ruptured and keyhole surgery is employed, you can leave the hospital after two or three days. When the appendix is ruptured or open surgery is required, you can expect a hospital stay of a week. Antibiotics will need to be taken for a week or more. A complete recovery can be expected after a couple of weeks in both cases.

For more articles on family health, head for the Health Hub.