Appendix is a small finger-like pouch that projects out from the colon on the lower right side of the tummy. Appendicitis describes the inflammation and infection of the appendix.

What causes appendicitis?

Appendicitis can affect anybody, but it commonly occurs in individuals between 10 and 30 years old. The cause of appendicitis is not always obvious. Appendicitis can develop because of an obstruction when a hard piece of stool blocks the opening of the appendix. Appendicitis may also follow an intestinal infection or result from some other types of inflammation. The number of germs within the cavity of the appendix grows rapidly causing the appendix to be swollen, inflamed and filled with pus.

What are the symptoms?

Appendicitis typically causes tummy pain that starts around the navel and then shifts to stay in the lower right area of the tummy. The pain from appendicitis usually increases over hours and becomes very severe. There may be soreness when you press on your lower right area of the tummy. You may also have some of the following symptoms: mild fever, nausea, vomiting, loss of appetite, constipation or diarrhoea.

Call your doctor if you or your child experiences the above signs and symptoms that make you worry. If the tummy pain is so severe that you cannot sit or lie still, immediate medical attention is required.

How to confirm the diagnosis of appendicitis?

In many patients the diagnosis of appendicitis is straightforward but the signs and symptoms do not always follow a simple pattern. Other conditions may present with similar signs and symptoms. Hence, the diagnosis is based on clinical judgement. There are dangers associated with a missed diagnosis of appendicitis. Appendicitis can cause serious complications. If the appendix gives way, pus and infected material will leak into the whole abdomen causing an infection of the abdominal cavity known as peritonitis, a life-threatening infection. If the appendix ruptures but the pus is contained in a pocket, an abscess or collection of pus develops.

Appendicitis may be confirmed by physical examination by your doctor. Blood test that checks for a possible increased white blood cell count may indicate an infection. A urine test may be ordered to check whether urinary infection or kidney stones are the cause of the pain. An abdominal x-ray or scan may be recommended to help confirm the diagnosis of appendicitis or to look for other causes of pain.

What is the treatment of appendicitis?

Appendicitis treatment requires surgery to remove the offending appendix, an appendicectomy. Other treatment may be needed depending on your situation. Appendix surgery may be performed as open surgery or as laparoscopic (keyhole) surgery. Your surgeon will advise you which procedure is most suitable for your condition. In general, keyhole surgery allows faster recovery and causes less scarring. Expect to spend one to two days in the hospital after surgery for appendicitis.
Occasionally, a decision may be made to operate even though the diagnosis is not certain because there are dangers associated with a missed diagnosis of appendicitis. It is expected that the appendix will be found to be normal in 10-15% of patients. If the surgeon finds that the appendix is normal, he will thoroughly check the other abdominal organs for a source of the problem. Sometimes an alternative diagnosis is discovered during surgery and another appropriate procedure may be required. The appendix will be removed even though it is normal because leaving the appendix may cause future confusion. The appendix serves no useful function and there are no long-term consequences to its removal.