Appendicitis | اپینڈکس

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Appendicitis (itis: means inflammation) is a condition in which the appendix is inflamed or swollen.

Appendix - pic1

The appendix is a small pouch (protrusion) that is on the lower right portion of the abdomen, extending from the colon (connected with the large intestine).  The main function of the appendix in our body is not clearly known.

Appendicitis is considered as a medical emergency and requires surgery (operation to remove the appendix).

This condition is most commonly occurs in ages 10 years to 30 years, but it can happen to any age. Knowing the risk factors it is important to be aware of its symptoms because the patient requires prompt treatment.  

Several symptoms can occur with appendicitis, including

  • Sudden pain on the lower right sideGastrointestinal - Appendix -pic3
  • Pain that gets worse with movements or coughing
  • Loss of appetite
  • Diarrhea or constipation (difficulty in passing stool)
  • Sudden pain around the belly button that travels to the right side
  • Nausea and vomiting
  • Low-grade fever that gets worse
  • Abdominal bloating

Appendicitis results from a blockage in the appendix.

The blockage could be because of a piece of feaces or stool enter and stuck in the appendix.  This blockage allows bacteria to grow and produce pus, resulting in inflammation and swelling. Without immediate treatment, there is a risk of the rupture of appendix.  In case of rupture, the bacteria and pus can spread in the abdomen, causing severe infection or even death.

There are no specific risk factors for this condition. It is most common in people ages 10 years  to 30 years, but that is the only common factor among patients.  However, it can happen in any age.

Diagnosis of appendicitis is not very clear cut because symptoms vary in different people.  At this point, there is no single test, which can confirm the appendicitis or inflammation/infection in the appendix. 

However, the signs and symptoms will give the doctor a good idea about what the patient is experiencing. The doctor may request a few tests to help confirm the diagnosis, such as: 

  • Pain assessment and physical exam: Your doctor will use their hands to feel the painful area. A common characteristic of appendicitis is worsening pain when your doctor releases pressure.
  • Urine testing:   This may be performed to rule out a urinary tract infection.
  • Blood testing:   This testing is done to look for signs of infection, including an elevated while blood cell count.
  • Imaging tests:   For e.g. Ultrasound, X-ray, this allows your doctor to rule out other conditions or confirm appendicitis


Appendicitis can be cured by surgically removing the inflamed appendix.  The procedure is referred as appendectomy.  It is considered as a minor surgery and at most occasions does not result in any complication.

When the patient arrive at the hospital emergency room, the doctor will get him prepared for surgery. The operation can be laparoscopic which involves multiple small holes/ incisions or one incision of two to four inches. Through the holes/ incisions, doctor can insert a tube which is attached with a camera and light source.  Following image on the screen the doctor removes the appendix and stitch up the incisions.

On average, the patient will spend 24 to 48 hours in the hospital after surgery for monitoring and pain control. The patient may also receive antibiotics during this time, either orally or via Intravenous.

If the patient has an abscess due to the appendix bursting, the doctor may need to drain and clean the abscess before removing the appendix. Once the infection is under control, which can take several weeks, the doctor will remove the appendix.

Serious complications can occur with appendicitis. If it ruptures, there is the risk for peritonitis; a condition in which the infection goes throughout the abdomen. This can be life-threatening and requires extensive surgery.

A rupture may also lead to an abscess in the abdomen. If this occurs, usually two weeks of antibiotics therapy prior to surgery are required.  The patient may also have a tube into the abdomen for two weeks to allow for continuous drainage.

Appendicitis needs to be diagnosed and treated immediately. Following the surgery, there are things that the patient should do to ensure that proper healing and reducing the risk of complications.  These include:

  • Avoid strenuous activity for up to 14 days
  • Take pain medication on time every day
  • Take naps and sleep when feel tired
  • When cough, make sure to support your abdomen
  • Slowly increase physical activity levels
  • Follow doctor's instructions as to when can return to school or work
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