How do I know if I have appendicitis?

photo: about.com

Q: What is appendicitis? How do I know if I have it?

A: Appendicitis is a condition in which the appendix, a small finger-like tube that is attached to the colon, becomes infected. It is a relatively common disease that affects one in fifteen people. It is mostly seen in people aged 10-30.  We don’t really know what the appendix does, but we do know that people without an appendix lead perfectly normal lives and are not affected by its absence.

Appendicitis can manifest in many ways, but classically presents as pain around the belly button which increases and eventually shifts to the right lower side.  The pain can also be accompanied by fever, nausea, vomiting, or loss of appetite.  People with appendicitis classically have sharp abdominal pain that increases with movement or jarring. Another classic sign is “rebound tenderness”, which is sharp pain that occurs when compression is released quickly from the tender area. In other words, you tell your doctor where it hurts and she presses hard, releases, and winces when you scream.

Appendicitis can be caused by a blockage that allows bacteria to grow in the tubular structure.  It can also occur after a gastrointestinal infection, which causes the appendix to become inflamed. Sometimes appendicitis occurs spontaneously and a cause is never identified.

Sometimes, if left too long, the appendix swells up like a balloon and explodes, spilling the infectious goo into the entire abdominal cavity (bacterial peritonitis).  Sometimes an abdominal abscess forms.  In any event, the treatment for appendicitis is surgery: Get it out. Antibiotics are necessary for peritonitis or an abscess.

Fortunately, almost everybody recovers uneventfully from the surgery within a few weeks with a small scar and a good story. Because of the serious complications of appendicitis, it is important for anyone experiencing severe pain for more than a few hours, especially with a fever, nausea, and/or vomiting to be seen by a physician.

Adam Brandeberry, Med IV (Ohio State College of Medicine)

Victoria Rentel, MD (Ohio State Student Health Services)

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