Know Vivid Facts About Appendicitis – Its Causes, Prevention & Symptoms

about-appendicitis
Editor's Note: This article has been recently updated with latest information and research studies.
 

The human body contains a lot of different mechanisms that all work together in order to ensure the body stays in a healthy, living condition.

While the majority of the mechanisms found in the human body each serves their own important function, one specific mechanism has been found to possibly play an unimportant role and may, in fact, not even be a necessity for human survival.

We are talking about the appendix – a relatively small, worm-like tube with a closed end that is attached to the cecum. The cecum is the beginning part of your colon. The appendix is also called the vermiform appendix, which literally translates to “work-like appendage”.

Even though no specific use of the appendix has been recognized by medical experts, there have been a recognized link between[1] the removal of the appendix and an increased prevalence of Crohn’s disease, as well as ulcerative colitis.

Anatomy Of The Appendix

As we have already mentioned, the appendix is a small tube that is attached to the colon. This tube[2] has a muscle layer that is similar to the muscle layer found in the colon, but, unlike the layer inside the colon, the muscles found in the appendix isn’t well developed.

Lymphatic tissue is found on the appendix’s wall, which forms parts of the human body’s immune system. The appendix’s central core is openly connected to the cecum (the beginning part of the human body’s colon). Inside the appendix, small concentrations of mucus are developed, which flows into the cecum through the central core of the appendix.

The bottom part of the appendix extends toward the abdomen’s lower right side and it usually grows to a size of approximately 3.5 inches.

What is Appendicitis

When the appendix becomes inflamed, the condition is referred to as appendicitis. In some cases, however, inflammation isn’t the only concern that affects the appendix and causes symptoms of appendicitis.

When the body pushes infection down towards the cecum, which is the part of the colon where the appendix is attached to, the infection can cause an abscess, filled with pus like substance, to develop around the appendix that is inflamed.

When this happens, the body usually sends scar tissue towards the appendix from other parts of the body’s abdominal area, in order to prevent the spreading of the infection. It is important to know that it is currently not possible to identify the source of the symptoms that are caused without surgery.

Surgery can help a doctor determine whether the patient has appendicitis or an abscess in their appendix. This is usually treated as an emergency as going without treatment may be fatal in certain cases.

Prevalence Of Appendicitis

Prevalence Of Appendicitis

Appendicitis can affect any person of any age and of any background, but a higher prevalence of the condition has been noted among people with certain traits. The Centers for Disease Control in Atlanta conducted a thorough medical study[3] on the incidence rate of appendicitis in the United States. They monitored data that were recorded over a five year period and concluded that, within the United States, an average of 250,000 cases of appendicitis is recorded every year.

Some interesting facts that they also found while monitoring the cases include:

  • People between the ages of 10 and 19 were most likely to be diagnosed and treated for appendicitis.
  • There were approximately 1.4 times more recorded cases of men with appendicitis than women.
  • A higher prevalence of appendicitis was noted among white people than among nonwhite people. In fact, the incidence rate for the condition was noted to be 1.5 times higher among white people.
  • More cases of this condition were reported during summer months than winter months.

They also concluded that the risk of being diagnosed for appendicitis during a person’s entire lifetime were 7.65% – this includes an 8.6% lifetime risk for men and a 6.7% lifetime risk for women.

Furthermore, the risk of undergoing an appendectomy, which is the removal of the appendix, during a person’s lifetime, is reported to be 17.55% – which includes a 23.1% lifetime risk for women and a 12.0% lifetime risk for men.

Causes of Appendicitis

Appendicitis occurs when the appendix becomes inflamed and is often also accompanied by an infection that causes pus to accumulate around the appendix. Medical experts have determined that there are two major causes for this condition to occur in the human body. The first major cause for appendicitis is an infection that develops in the stomach.

When the infection is not properly treated, it spreads downward and eventually starts to infect the appendix as well. This can cause pus to develop around the appendix, as well as cause the appendix to become inflamed. The other major cause that has been noted is an obstruction.

Stool may harden and then get trapped inside the person’s appendix. The stool that is trapped in the person’s appendix may contain trapped bacteria, which then causes an infection to develop in the appendix – thus leading to the development of appendicitis.

In most cases, fecal matter does not naturally enter the appendix and cause an obstruction. This problem is often influenced by another factor in the patient’s stomach or cecum. Some of the most common factors that may cause fecal matter or stool to accumulate inside the appendix include worms and tumors.

In some cases, it was noted that trauma to the surrounding area could also be the source of the accumulation inside the appendix. Furthermore, lymphoid follicles that are enlarged by also contribute to fecal matter building up in the appendix and causing an infection to develop.

Appendicitis Risk Factors

Several factors have been associated with a higher risk of developing appendicitis after years of research. The risk factors of the condition are split into two categories – unpreventable risk factors and preventable risk factors.
The following are unpreventable risk factors that increase* a person’s chance of developing this health concern:

  • After several years of research, it was determined that appendicitis is most common among young adults, as well as among children. If a person is between the ages of 10 and 30, they are at an increased risk of being diagnosed with appendicitis.
  • Several studies have pointed out that a larger number of men are affected by appendicitis than women, thus men are at a higher risk.
  • It appears that appendicitis is more prevalent among Western societies than any other societies.
  • People who have recently had an infection, especially one that affected their gastrointestinal system, are also at a higher risk of obtaining an infection in their appendix and developing appendicitis.
  • Internal injury that causes trauma to the appendix is also a risk factor that can cause the appendix to become inflamed. This also increases* the risk of the appendix rupturing.

The only preventable risk factor that has been associated with an increased chance of developing this health concern includes a diet that is low in fiber.
Since a low-fiber diet can cause the risk for developing constipation to increase*, fecal matter is more likely to accumulate in the appendix. This can cause a bacteria buildup, which can then lead to appendicitis.

Genetics and Appendicitis

Even though this health concern has been researched for many years, a connection between appendicitis and genetics was only recently made. In 2007, the Ankara Ataturk Teaching and Research Hospital started to investigate[4] a large number of case files related to appendicitis.

The team not only looked at each patient’s medical history and other important factors, but also drew a report regarding the medical history of each patient’s closest family members. They concluded that genetics do play a significant role in the prevalence and risk of this health concern.

In fact, they were able to determine that patients who had a family history of appendicitis were three times more likely to also suffer from the same condition, when compared to those who do not have a family history of the condition.

Symptoms of Appendicitis

Symptoms of Appendicitis

Not every patient that has appendicitis will experience the same symptoms. While one symptom may be present in a specific patient, another patient may experience a range of different symptoms.

The symptoms that are caused by the condition can vary depending on how severe the condition is and what exactly caused the condition to develop. Generally, the majority of patients who have appendicitis tend to experience mild cramps when the condition starts to develop.

As it develops, the cramps may become worse and additional symptoms may also develop. Common symptoms that patients experience when they have appendicitis include:

  • The patient may lose* their appetite and not feel like eating at all.
  • The patient may experience a painful sensation around their belly button. This painful sensation often tends to move towards the abdomen’s lower right side.
  • The patient may feel nauseous and, in some cases, this may be accompanied by vomiting.
  • Some patients also experience constipation or diarrhea. Constipation is especially common when appendicitis is caused by an obstruction.
  • In some patients, the ability to pass gas may be blocked.
  • The abdomen area may swell up – the level of swelling depends on how severe the patient’s condition is.

Complications Caused by Appendicitis

Similar to many other diseases and health concerns, when a patient develops appendicitis and does not obtain proper treatment for their condition, complications can develop.

With appendicitis, it is crucial to see a doctor and act upon the problem as fast as possible, as complications of appendicitis can be fatal. There are two major complications that have been linked to appendicitis.

Abscess

When a patient has appendicitis that is caused by a blockage, bacteria can build up and a pus substance can develop inside the appendix. If the condition is not treated properly, it can lead to the development of an infection.

Once the bacteria causes an infection, the infection can mix with contents of the intestines. When this happens, an abscess forms and spreads throughout the patient’s intestines. This can lead to further complications when the patient does not obtain urgent medical treatment.

The best solution to treating an abscess that is caused by appendicitis is to have the substance drained through a surgical procedure where a tube is placed in the abdomen.

If the abscess is not too severe, a doctor may first prescribe antibiotics for the patient in order to try and eliminate* the abscess without surgical intervention.

Sometimes, however, the removal of the appendix is recommended – in this case, an open surgery protocol can be followed and the infection can be cleaned out during the procedure.

Peritonitis / Ruptured Appendix

A more fatal complication of appendicitis is peritonitis. This condition develops when the abscess or infection of the appendix worsens and is not treated properly. Eventually, the appendix ruptures, causing the infection to flow into the patient’s abdomen and affect his intestines.

In such a case, the peritoneum (a membrane that is located in the lining of the abdominal organs and abdominal cavity) becomes inflamed and infected. This condition causes the patient’s bowel movements to completely stop and their intestines become blocked.

This is a dangerous condition that causes the patient to develop a high fever. Many patients who experience this condition go into shock.

This condition needs urgent treatment or the patient may face life-threatening symptoms. Treatment usually involves the removal of the appendix, followed by a procedure where the surgeon cleans out the intestines that were affected.

In some cases, the tissues that have been infected may also be removed. Antibiotics can be used to ensure any infection that is left behind is eliminated following the surgery.

Death

The most severe complication that can be caused by appendicitis is death. The condition starts out as inflammation and infection, which then leads to the development of an abscess. Thereafter, it can lead to peritonitis.

When peritonitis develops, the pus from the abscess and infection is carried through the intestines and enters the bloodstream. In response to these foreign substances circulating through the body, certain chemicals are released back into the bloodstream in order to fight the infection.

These chemicals then trigger the body’s inflammatory response – due to the fact that the infection is circulating throughout the entire body, inflammatory responses are triggered throughout the patient’s whole body, which leads to a condition known as sepsis.

Additional biological reactions occur when sepsis develops, which leads to severe hypertension, also known as septic shock. In turn, septic shock can cause numerous organs to fail and completely stop functioning, which can then lead to the death of the patient.

Things to Avoid When you have Appendicitis

Things to Avoid When you have Appendicitis

Many patients who experience one or more of the symptoms of appendicitis may want to diagnose themselves and start with a self-care routine in order to treat* their problem without going to a doctor for a professional medical diagnosis.

The reason why a patient would avoid seeing a doctor may defer from one person to another – while one patient may not have access to a medical plan, another may prefer to first try and treat* such a condition themselves.

It is important to note that, even while many claims are made that the body is able to treat* appendicitis on its own, the fact of the matter is if the appendix ruptures due to the infection, it could lead to the pus spreading (and infection) spreading throughout the colon and, in some cases, can be fatal.

There are a couple of important things that a patient should always avoid if they suspect that they might have appendicitis and haven’t yet obtained more accurate diagnoses from their healthcare provider.

In some cases, a healthcare provider may not immediately proceed with a surgical treatment option and may send the patient home (sometimes with a dose of antibiotics) – in such a case, these things should also be avoided as they may cause the condition to grow worse. These things include:

  • Avoid the use of laxatives or enemas as they can cause the appendix to rupture, especially when the infection has developed to a more severe level. Even when a healthcare provider has provided the patient with antibiotics to treat* the infection, the use of an enema or laxatives should be strictly avoided.
  • Even though the condition may be somewhat painful, it is recommended to avoid using any type of pain medication. The doctor may subscribe some antibiotics to fight off the infection, but will usually not provide the patient with painkillers – the patient should also not pick up a dose of painkillers on their trip to the pharmacy.

This may seem harsh, but the reason for this is because the pain that is caused by appendicitis need to be monitored at all times. If the level of pain that is experienced start to reduce*, then it means the antibiotics are starting to work and is fighting off the infection.

On the other hand, if the pain is getting worse, then it might mean that the condition is getting worse and urgent medical attention may be required – when painkillers are used, the patient would be unable to accurately monitor the pain, thus complications may develop if the condition does get worse.

  • If a doctor did not prescribe a dose of antibiotics for the patient, they should not use any type of antibiotics. The doctor will know whether or not antibiotics will be required to treat* the condition.
  • Do not allow the pain to get out of control. The more the pain develops, the worse the condition becomes. When changes in pain are noted, especially in a negative way, a doctor should be contacted as soon as possible.

Diagnosing Appendicitis

When a patient experiences symptoms that are related to appendicitis, their best option is to visit a healthcare provider for a diagnosis. Even when all of the symptoms point towards this condition, another condition may also be causing the symptoms to develop, thus a complete examination by a medical professional is required.

When a patient visits a doctor in order to get diagnosed, the doctor will start by asking about the symptoms they are experiencing. If the doctor suspects appendicitis, then he will continue with a physical examination.

The physical examination often also includes a rectal examination. Apart from the physical examination, the doctor may also conduct a series of blood tests to check the patient’s white blood cell count and to determine whether any infections are present in the patient’s body.

Ultrasound tests can also be used to determine whether or not the appendix is inflamed, which will assist a doctor with diagnosing the condition.

In some cases, a urine test may be requested. This is done to ensure the symptoms are not caused by a urinary tract infection instead.

A doctor may also request X-rays of the patient’s chest to rule out pneumonia, as this condition in the lower part of the right lung may also cause several symptoms that are similar to the symptoms of appendicitis.

What Happens After Being Diagnosed With Appendicitis?

Diagnosed With Appendicitis

Before any treatment plan for appendicitis can start, the doctor first needs to complete all of the necessary examinations and tests in order to provide an accurate diagnosis. If the doctor finds that the symptoms are caused by appendicitis, then treatment may commence.

Depending on the severity of the condition, a doctor may hospitalize a patient in order to have the condition monitored by professional, or send the patient home and ask them to closely monitor the condition. If any changes in the condition are noted, emergency medical intervention may be required.

If The Patient Is Hospitalized

It is not uncommon for a patient to be hospitalized once the doctor has confirmed they have appendicitis. The doctor will usually request that the patient stays in the hospital for a minimum of 12 hours, but this time may be extended to up to 24 hours.

If the appendicitis is too severe, the doctor may request immediate action to be taken in order to avoid further complications.

If The Patient Is Sent Home

In cases where the condition does not seem to be too severe, a doctor may choose to allow the patient to go home. This, however, does not mean the patient is out of danger and they will need to closely monitor themselves for the next couple of days.

The doctor will provide the patient with a list of instructions that should be closely followed. These instructions include taking their own temperature every two hours and keeping a record and returning for an appointment with a urine sample and an empty stomach.

If an infection is noted, the patient is likely to obtain a prescription for antibiotics in order to treat* the infection.

Patients who are sent home should not fail to monitor the status of their appendicitis as failure to do so may result in serious consequences.

A patient should immediately contact their doctor if they start to vomit continuously, experience an increase* in abdominal pain, feel dizzy or if the faint. If there is blood in their urine or vomit, they should also immediately contact their doctor.

Appendectomy – Treatment Option for Appendicitis

If a patient has appendicitis, the changes are very high that they will have to undergo an appendectomy. This is the best and the most common treatment option available for effectively treating the condition and stopping the symptoms that the patient is experiencing.

An appendectomy is the removal of the appendix through surgery. This is also the fastest and safest way to treat* appendicitis, and often done soon after the condition has been diagnosed as this removes* the risk of the appendix rupturing, which may cause life-threatening adverse events to occur.

Preparing For an Appendectomy

If a doctor diagnoses appendicitis and advises the best solution to be an appendectomy, then the patient needs to thoroughly prepare themselves for the procedure.

The first objective is to advise the doctor that will be performing the procedure if the patient is pregnant (or might be pregnant), are sensitive to latex or allergic to certain types of medication (if a patient is allergic to anesthesia, it is vital that they mention it to the doctor).

A patient should also mention to the doctor if they have had any problems with bleeding disorders in the past. Furthermore, the doctor should know about any medication the patient is currently taking – be it over-the-counter or prescription medication – as dosage may have to be adjusted for a while before and after the procedure.

In preparation for the actual procedure[5], the patient should ensure they do not consume and liquids or solids for eight hours before they have the procedure. This is an important step as failing to adhere to this instruction may result in aspiration, which causes the content of the stomach to enter the lungs.

Since the procedure is usually performed with the use of general anesthesia, the patient should always ensure they have arranged transport back to home for when the procedure is done.

Due to the fact that general anesthesia may cause the patient to become drowsy, they will not be able to drive back home after the procedure on their own.

Different Types of Appendectomy

While the term “appendectomy” refers to the removal of the appendix, patients should realize that there are different kinds of procedures that can be used to remove* the tube.

The specific type of appendectomy that is used to remove* the appendix will often depend on how severe the patient’s condition is and whether or not the appendix has ruptured.

Open Surgery

Open Surgery

This is a common type of appendectomy that is also sometimes referred to as “traditional appendectomy”. It is also the only method that can be used to completely treat* appendicitis if the appendix ruptured as the area that the infection and pus have spread to will need to be cleaned out.

Open surgery involves an incision that is made in the area where the appendix is located – this is in the lower right abdomen region. During this type of appendectomy, the appendix is surgically removed and then the abdominal cavity, which refers to the area that the infection has affected, is thoroughly cleaned out.

Once the appendix has been removed and the area has been cleaned out, stitches are used to close the area where the incision was made. The patient is given a dose of antibiotics intravenously after the operation to clear out any remaining infection.

Laparoscopy

Another option that is becoming quite popular is a laparoscopy. This type of appendectomy is less invasive than open surgery and also helps the patient recover faster from the procedure. A laparoscopy involves a small incision that is made in the abdomen where the appendix is located.

A cannula, which is a hollow instrument, is then inserted into the incision, accompanied by a tube that contains a video camera and a small light at the end. The surgeon is able to see the inside of the patient’s abdomen on a monitor through the video camera that is attached to the laparoscope.

This helps the surgeon remove* the appendix without having to make a large incision and with minimal blood loss. Another positive attribute of a laparoscopy, compared to open surgery, is the fact that the scarring that is left behind from the procedure is much smaller.

Recovering From An Appendectomy

After an appendectomy has been performed on a patient, they are kept in the hospital for several hours in order to monitor their recovery and to ensure complications do not develop.

The hospital will continue to monitor the patient’s heart rate, breathing and other vital signs for several hours, as well as ensure that the patient does not experience any adverse effects in reaction to the procedure or the anesthesia that was used during the procedure.

Once the staff at the hospital is happy with the recovery rate and vital signs of the patient, they may issue a release.

There are no specific amount of hours that a hospital keeps a patient for observation at the time of the patient’s release depends on several factors, such as their overall health and the reaction their body had to the surgery.
Patients may also be kept longer if they had open surgery instead of a laparoscopy. In some cases, a patient may be requested to stay at the hospital for one night.

The first few days after the procedure will is used as recovery time. During this time, the patient is likely to experience a moderate amount of pain in the location where the incision was made. The pain should, however, clear within just a couple of days.

It is important to follow all instructions that are given by a doctor – such as administering a daily dose of antibiotics in order to avoid infection from developing in the area where the surgery was performed. A patient will also be advised to keep the incision clean at all times in order to minimize the risk of infection.

The amount of time it takes to fully recover from the procedure depends on the patient’s health and the type of appendectomy that was performed, but most patients find that they are able to fully recover after approximately four weeks.

It may take up to six weeks or more for some patients to fully recover. In order to allow the body to heal, physical activity should be limited during the first few weeks.

Appendectomy Procedure

Risks Associated With An Appendectomy

Having your appendix removed through an appendectomy procedure is considered to be a simple procedure that doesn’t take long and is usually easy to recover from.

Even though this is an essential procedure that is needed by many patients who is diagnosed with appendicitis – in some cases as an emergency – the procedure also comes with a couple of risks. It is important for patients to understand what risks are involved before they undergo the procedure.

These are the most common risks that are associated with an appendectomy procedure:

  • The patient is at risk of bleeding and losing a lot of blood. This, however, depends on the type of appendectomy that is performed. A laparoscopy has a significantly lower risk of blood loss and bleeding, when compared to an open surgery.
  • Even if the incision is properly closed with stitches and cleaned, the patient is still at risk of developing an infection in the area where the incision was made.
  • During the operation, there is a risk that organs that are located close to the appendix may be injured. This is why it is important for the patient to choose an experienced surgeon that has done an appendectomy procedure before.
  • The patient is also at risk of having blocked bowel movements after the procedure has been conducted.
    Even though some of these risks that are associated with appendectomy may seem undesirable, patients should realize that they are less severe than any of the risks and complications associated with appendicitis.

Signs of An Infection

Even though the majority of patients are able to recover within the first few weeks following their procedure, without experiencing any adverse effects, it is still important to monitor the area where the incision was made, as well as several vital signs, during the recovery period.

An infection may develop and knowing about the signs of an infection is vital – should an infection develop, the patient needs to seek medical attention from their doctor immediately to stop the infection before it results in complications.

Some of the most common signs that an infection is developing include:

  • The area around the incision becomes red and it may swell up.
  • The patient may experience a reduced* appetite.
  • Chills are quite common among patients who develops an infection after the procedure.
  • Abdominal cramps may be experienced.
  • The patient may find that they have constipation or diarrhea. If any of these two conditions last for a period of two days or longer, it may be a sign that an infection is developing.
  • Nausea, accompanied by vomiting, is also a sign of an infection.
  • If a patient has a high fever, it may also be a sign that the patient is developing an infection.

Can Appendicitis be Prevented?

A lot of research has been conducted on appendicitis, but, unfortunately, medical experts haven’t been able to identify a lot of methods that can be used to prevent the development of appendicitis.

They have, however, observed a connection between a high-fiber diet and a lower prevalence of appendicitis. Due to this discovery, a diet that contains a large number of food sources that are high in dietary fiber may help to prevent appendicitis.

A lot of fiber in a person’s diet can ensure stool are softer at all times, which decreases* the risk of hardened stool building up in the appendix – this is how a high-fiber diet can help to prevent appendicitis.

Facts about Appendicitis

Facts about Appendicitis Info

Here are some interesting facts about appendicitis that you should know about:

  • In the United States alone, approximately 400 cases of appendicitis result in the death of the patient every year.
  • If you follow a diet that includes little fiber and lots of carbohydrates, you are much more likely to have problems with your appendix.
  • Nine in every 10,000 individuals (all ages included) suffer from acute appendicitis every year. That accounts for an approximate amount of 300,000 people.
  • There are two forms of appendicitis – acute and chronic. Many people who have chronic appendicitis doesn’t even know they have this condition.

Conclusion

Appendicitis is a serious health condition that may even lead to death. Thus, this condition should not be taken lightly and patients should always be informed of the symptoms it may cause.

When these symptoms develop, the patient should immediately see a doctor in order to obtain a professional diagnosis.
If the condition turns out to be appendicitis, medical treatment should immediately commence as a delay in treatment may result in the development of fatal complications that will not only cause severe pain, discomfort and various adverse effects, but may even lead to death.

References:

[1] https://www.verywell.com/ibd-and-your-appendix-1941584
[2] http://www.medicinenet.com/appendicitis/article.htm
[3] https://www.ncbi.nlm.nih.gov/pubmed/2239906
[4] https://www.ncbi.nlm.nih.gov/pubmed/18265855
[5] https://www.hss.edu/anesthesiology-frequently-asked-questions.asp

Image Credits
Feature Image: Shutterstock.com
In-Post Image: Shutterstock.com, medicinet.com & childrensmn.org

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Author

Expert Author : Dr. Ahmed Zayed (Consumer Health Digest)

Dr. Ahmed Zayed Helmy holds a baccalaureate of Medicine and Surgery. He has completed his degree in 2011 at the University of Alexandria, Egypt. Dr. Ahmed believes in providing knowledgeable information to readers. Other than his passion for writing, currently he is working as a Plastic surgeon and is doing his masters at Ain shams University.