Introduction:

Appendicitis happens when your appendix, a small finger-shaped structure that protrudes from your large intestine on the right side, gets inflamed. The inflammation is usually caused by a blockage, but may be caused by an infection. Without treatment, an inflamed appendix can rupture, causing infection of the peritoneal cavity (the lining around the abdominal organs) and even death. Appendicitis is one of the most common causes of emergency abdominal surgery. Up to 75,000 appendectomies are done each year in the U.S.

Signs and Symptoms:

The following signs and symptoms may accompany appendicitis:

• Pain, starting around the navel, then moving down and to the right side of the abdomen. The pain gets worse when moving, taking deep breaths, coughing, sneezing, or being touched in this area.
• Loss of appetite
• Nausea
• Vomiting
• Change in bowel movements, including diarrhea or not being able to have a bowel movement or pass gas
• Low fever that starts after other symptoms
• Urinating often, or difficult or painful urination

What Causes It?:

Appendicitis usually happens after an infection in the digestive tract, or when the tube connecting the large intestine and appendix is blocked by trapped feces or food. Both situations cause inflammation, which can lead to infection or rupture of the appendix.

Who's Most At Risk?:

The following factors can put you at higher risk for developing appendicitis:

• Family history
• Age -- children 2 years of age or younger and people 70 years of age or older are at higher risk for a ruptured appendix

What to Expect at Your Provider's Office:

Appendicitis is an emergency, because the appendix could rupture. If you have appendicitis symptoms, you should go to an emergency room. The doctor will ask about your symptoms and your medical history, do a physical exam to check for abdominal tenderness, and may order blood and urine tests. Some health care providers use ultrasound to check whether the appendix is inflamed (and to rule out ovarian cysts or ectopic pregnancy in women). A computed tomography (CT) scan may also be done.

Treatment Options:

Prevention

There is no proven way to prevent appendicitis. However, eating a diet that includes fresh vegetables and fruit may lower your risk of getting appendicitis.

Treatment Plan

Appendicitisis most often treated with a combination of surgery and antibiotics. Along with antibiotics, you may receive intravenous (IV) fluids and medication to control vomiting. If your doctor can' t tell from the CT scan or ultrasound whether you have appendicitis, you may have exploratory surgery. If you do have appendicitis, your appendix will be removed (appendectomy).

Drug Therapies

Your health care provider may prescribe the following medications:

• Antibiotics
• Medications taken to ease nausea (anti-emetics)

Surgical and Other Procedures

An appendectomy is the surgical removal of the appendix through an incision in your abdomen that can be several inches long. A laparoscopic appendectomy involves making several tiny cuts in the abdomen and inserting a tiny camera and surgical instruments. The surgeon then removes the appendix through one of the small incisions. Recovery is usually faster than with traditional surgery, and the scars are smaller. However, not everyone is a candidate for a laparoscopic appendectomy.

Complementary and Alternative Therapies

Acute appendicitis is a medical emergency, and you should get conventional treatment immediately. Never try to treat appendicitis with alternative therapies alone. Some studies show that certain herbs and supplements may help to prevent appendicitis, strengthen your immune system, or help you recover faster from surgery.

Nutrition

In England and Wales, a study reviewed whether a diet that was low in fiber and high in sugar and meat had any influence on people getting appendicitis. No specific link was found with sugar or meat. But the study did suggest that the more fresh and frozen green vegetables and fresh and processed tomatoes people ate, the less likely they were to develop appendicitis. Eating green vegetables -- particularly cabbages, cauliflowers, peas, beans, and Brussels sprouts and maybe tomatoes -- may protect against appendicitis.

Herbs

Appendicitis should be treated with surgery. There are herbs that may help you recover faster from surgery; ask your doctor.

Acupuncture

In Chinese medical terms, appendicitis is thought to be caused by blockages in the circulation of blood and flow of vitality. Acupuncture may help relieve pain, control peristalsis (the wave-like movements of muscles in the intestines), and improve blood flow. A licensed and certified acupuncturist would work with your doctor to monitor your condition closely. In some parts of the world, an acupuncturist works in the hospital to deliver care at the same time as conventional medical practices. Even with surgery, acupuncture may be helpful for anesthesia, pain control, and better recovery.

Prognosis and Possible Complications:

If the appendix does not rupture, the risk of death is very low. In cases where the appendix ruptures, the death rate is higher, especially among the elderly (15%). Complications may include recurring appendicitis, inflammation of the abdominal lining, abscess (pus-filled inflamed area), sepsis (“blood poisoning” caused by infectious bacteria), blocking of a fallopian tube, infertility, and wound infection. Appendicitis occurs in only about 1 in 1,000 pregnancies.

Following Up:

If you have surgery, you will need to see your health care provider 2 weeks after the operation, and again at 6 weeks.