Appendicitis

Appendicitis is a condition that happens when your appendix gets inflamed. When your appendix gets inflamed, it can lead to serious health problems if you don’t get it treated right away. It can get worse quickly and burst within 36 to 72 hours, causing a medical emergency that can be life-threatening. If you have appendicitis and don’t have it treated, you’re likely to get a ruptured appendix.

It’s important to recognize the symptoms of appendicitis and get immediate medical care.

What is the appendix?

The appendix is a small, tube-like organ located where your small intestine meets your large intestine, in the lower right part of your belly (abdomen). It’s not clear what its function is, but it may play a role in the immune system, especially in younger people. You don’t need your appendix to survive, so it’s important to get care right away and have it removed if you have appendicitis.

What causes appendicitis?

Your appendix can become inflamed due to hardened stool (fecaliths), enlarged tissues or lymph nodes or, rarely, tumors that can block the appendix. Bacteria from gastrointestinal illnesses can also infect the appendix. In some cases, viral infections and parasites can spread to the appendix, though they are less common than bacterial infections. 

When bacteria are not able to flow freely from the appendix to the large intestine, they can multiply and cause an infection. Sometimes, this infection can cause appendicitis. 

Risk factors for appendicitis

These factors can increase your risk of developing appendicitis:

• Age: Appendicitis can occur at any age but is most common between the ages of 10 and 30.
• Family history: You’re more likely to develop appendicitis if others in your family have had it.
• Diet: A low-fiber diet can make appendicitis more likely.
• Gender: Males have a slightly higher risk than females.
• Prior abdominal surgery: Surgery can cause scar tissue that can raise your risk of appendicitis.

Symptoms of appendicitis

You may notice signs of appendicitis such as:

• Abdominal pain: The pain usually starts around the belly button and moves to the lower right abdomen. It may get worse over time or when you move, walk or cough. This type of pain is the most common symptom of appendicitis.
• Loss of appetite: A noticeable decrease in appetite is common.
• Fever: You may have a low-grade fever as your body responds to the infection.
• Change in bowel function: You may have diarrhea, constipation, bloating or gas.
• Feeling unwell: You may feel sick or tired.

Signs can be different in children, seniors and pregnant women, so contact your health care provider with any concerns about abdominal symptoms.

If you have symptoms of appendicitis, it’s important to get medical care right away. Don’t take pain medication unless your provider recommends it. Medicine could block symptoms that help with your diagnosis.

Appendicitis is easier to treat when it’s spotted early. And treating appendicitis sooner means your appendix is less likely to rupture and lead to a more serious infection.

Ruptured (burst) appendix

A ruptured appendix is a serious complication. It can occur if your appendix gets holes in its walls and bursts. That can spread bacteria, mucus and stool outside of your digestive tract. Symptoms include:

• Pain that eases up and then gets worse.
• A fever that spikes.
• Pain that may spread across your abdomen.
• Nausea and vomiting, sometimes with bile or blood as the condition gets worse. You may not be able to keep liquids down.
• Abdominal tenderness or swelling.

A ruptured appendix can cause an infection that spreads through the belly (peritonitis) or the body (sepsis) and can be life-threatening. It’s very important to get medical care right away.

How appendicitis is diagnosed

A health care provider will typically diagnose appendicitis with:

• Physical exam: Feeling for tenderness and pain, especially pain that gets worse when you press on the abdomen and release the pressure. They will also check for signs of infection like fever and rapid heart rate.
• Imaging tests: Ultrasound and/or CT scans can show the appendix and the surrounding area. Your provider may recommend an MRI if you’re pregnant.
• Blood tests: High levels of white blood cells and other markers can be signs of inflammation or infection.
• Urine tests: Urine tests can check for urinary or kidney issues that could be causing symptoms.

Your provider will check to make sure you have appendicitis and not another condition with similar symptoms, such as:

• Urinary tract infection (UTI)
• Gallstones
• Kidney infections or kidney stones
• Digestive issues like Crohn's disease, inflammatory bowel disease, diverticulitis, gastroenteritis or intestinal obstruction
• Female reproductive issues like ovarian cysts, endometriosis or pelvic inflammatory disease
• Stomach flu
• Pancreatitis

If you’re not sure about what’s causing abdominal pain, get medical care right away. Early diagnosis and treatment may reduce your risk of dangerous complications.

Surgery for appendicitis

Surgery to remove the appendix (appendectomy) is the standard of care for appendicitis.

• Laparoscopic appendectomy: With this minimally invasive procedure, surgeons use small surgical tools and a tiny camera (laparoscope) to remove the appendix through several small incisions. With this approach, you usually recover more quickly with less pain. You may go home the same day or stay in the hospital for a day or two after surgery.
• Open appendectomy: With this procedure, surgeons make one larger incision in the abdominal cavity to remove the appendix. You might need this approach if your appendix has ruptured or you have complications.

If your appendix has burst, a pocket of pus (an abscess) might form. In that case, you may need to have the abscess drained first, and then have appendectomy a few weeks later when the infection is under control.

After surgery, you’ll need to have a clear liquid diet and gradually move on to solid foods. You won’t be able to lift objects heavier than 10 pounds until your surgical site has healed. That takes about two weeks for laparoscopic surgery or four to six weeks for open surgery. You can perform light activity after surgery and gradually return to normal activities in a few weeks.

Your provider will schedule follow-up appointments to check your recovery and remove any stitches or staples. Most people recover fully from appendectomy without any long-term complications or ongoing restrictions on diet or activities. Contact your health care provider if you notice fever, increased pain, nausea, vomiting, swelling or redness around the incision site or bleeding or fluid leakage from the incision site.

In rare cases, a cancerous tumor blocks the appendix and causes appendicitis. So, after surgery, your appendix should be tested for signs of cancer. If you have cancer, you may need further treatment.

Antibiotics for appendicitis

In some cases, antibiotics may treat appendicitis. They could be an option if a CT scan shows a perforation or abscess. In that case, it might be possible to treat it by draining it with a needle and taking antibiotics. But some people still need an appendectomy weeks or months later.

Antibiotics may also be an option for people who have other health conditions that make surgery risky. However, there’s a higher chance of appendicitis coming back. 

You and your health care provider can discuss the pros and cons of antibiotics depending on your situation.

Getting care

Appendicitis is a condition where the appendix becomes inflamed. It can cause severe abdominal pain, nausea and other symptoms. It’s usually diagnosed with a physical exam, imaging studies and blood tests and treated with surgery. 

It’s important to get medical care right away if you have symptoms of appendicitis. Choose Banner Health for appendicitis care and you’ll have:

• Experienced health care providers who specialize in emergency and surgical care.
• State-of-the-art diagnostic and treatment technologies, including minimally invasive surgery options.
• Care focused on your comfort and well-being throughout diagnosis, treatment and recovery.