AppendicitisAppendicitis means inflammation of the appendix. The appendix is a small pouch that comes off the gut wall. Appendicitis is common. Typical symptoms include abdominal pain and vomiting that gradually get worse over 6-24 hours. Some people have less typical symptoms. An operation to remove the inflamed appendix is usually done before it perforates (bursts). A perforated appendix is serious.What and where is the appendix?The appendix is a small dead end pouch, like a little tube, that comes off the caecum. The caecum is the first part of the large intestine (large bowel) just before the colon. The small intestine digests and absorbs food. The parts of the food that are not digested begin to be formed into faeces (motions) in the caecum.

The appendix is normally about 5-10 cm long and quite thin. The appendix appears to have no function. The reason it is there is a bit of a mystery.What is appendicitis?

Appendicitis means inflammation of the appendix. The inflamed appendix becomes infected with bacteria (germs) from the intestine. The inflamed appendix gradually swells and fills with pus. Eventually, if not treated, the swollen appendix might perforate (burst). This is very serious, as the contents of the intestine then spill into the abdominal cavity. This can cause a serious infection of the membrane that lines the abdomen (peritonitis), or an abscess in the abdomen. So, if appendicitis is suspected, early treatment is best before it bursts.Who gets appendicitis?Appendicitis is common and can affect anyone of any age. Teenagers and young adults are the most commonly affected. About 6 in 100 people in the UK have appendicitis at some time in their life. Appendicitis is the cause of the most common abdominal surgical emergency admission to hospital in the UK. It is slightly more common in men than in women. It is much more common in western countries. This is thought to be partly due to the western diet which is often low in fibre.What causes appendicitis?The reason why the appendix becomes inflamed in the first place is not known in most cases. Some cases are thought to be due to a blockage that occurs somewhere along the short appendix. This may be due to some hard faeces (sometimes called motions, stools or poo) that get stuck. Bacteria may then thrive and cause inflammation behind the blockage in the dead end of the appendix.What are the symptoms of appendicitis?Pain in the abdomen(tummy pain) is usually the main symptom. Commonly, the pain starts in the middle of the abdomen. The pain normally develops quickly, over an hour or so. Over the next few hours the pain typically travels to the lower right-hand side of the abdomen. This is over where the appendix normally lies.

Typically the pain becomes worse and worse over 6-24 hours. The pain may become severe. The pain tends to be more sharp if you cough or make any jarring movements. The pain may ease a bit if you pull your knees up towards your chest. The lower abdomen is usually tender, particularly in the lower right-hand side.

Other symptoms that may occur include the following. Feeling sickand being off food is typical. You may vomit. Feverand generally feeling unwell. Constipationmay occur. Sometimes diarrhoea. Frequent passing of urinemay develop. This is thought to be due to the inflammation irritating the nearby ureter (the tube between the kidney and bladder).If the appendix perforates (bursts) then severe pain can spread to all the abdomen. You also become very ill.

In some cases, the symptoms are not so typical. For example, in some cases the pain may develop more slowly and run a more smouldering course. The pain may also start in the lower right-hand side of the abdomen. Also, the pain may not become severe until the appendix perforates. The site of the pain may not be typical if the appendix lies in an unusual place.How is appendicitis diagnosed?A doctor may diagnose appendicitis quite easily if you have the typical symptoms. However, as described above, not everyone has typical symptoms. Sometimes it is difficult for doctors to be sure that appendicitis is the cause of the symptoms.

Some people develop pain that is similar to appendicitis, but which is caused by other conditions. For example, pelvic inflammatory disease or a urine infection. Some people have surgery only to find that the appendix is normal and not inflamed.

There is no easy and foolproof test to confirm appendicitis. A surgeon often has to make a judgement whether to operate or not. It depends on whether the symptoms and also the findings when you are examined suggest that appendicitis is the probable diagnosis. Your doctor will examine your abdomen to assess where you are tender.

Sometimes a surgeon advises to wait and see for a few hours or so while you are being monitored in hospital. This allows some time to see if your symptoms progress to a more definite diagnosis, or even if they change or go away.

Sometimes tests are used if there is doubt about the diagnosis. For example, an ultrasound scan or a CT scan may help to clarify the cause of the symptoms in some cases. Blood tests are also done when you are admitted to hospital. A new urine test has recently been assessed in clinical trials which looks promising to help the diagnosis of appendicitis. This is not yet widely available though.

However, doing scans takes time and may get in the way of doing prompt surgery, which is often the top priority (see below).What is the treatment for appendicitis?You will be admitted to hospital if appendicitis is suspected. An operation to remove the inflamed appendix is usually done quite quickly once the diagnosis is made. It is much better to remove an inflamed appendix before it bursts. The inflamed appendix is found and cut off the caecum. The hole left in the caecum is stitched up to stop any contents from the gut leaking out. Antibiotic medicine is given just before the operation to reduce the risk of an infection developing at the site of the operation.

Removal of the appendix is one of the most commonly performed operations in the UK. In most cases, the operation is done before the appendix perforates. This is usually a straightforward and successful operation needing just a short recovery. However, surgery can be more difficult and you will take longer to recover if the appendix has perforated.

Surgery is commonly done by a keyhole operation, as the recovery is quicker compared to having an open operation. The keyhole operation is performed through three tiny cuts, the largest of which is only around 1.5 cm in size.

There are usually no long-term complications after the operation. As with any operation, there is a small risk of complications from the operation itself and from the anaesthetic. However, if you don't have an operation, an inflamed appendix is likely to perforate and cause a serious infection in the abdomen (peritonitis) which can be life-threatening.

Appendicitisis an inflammation of theappendix, a 3 1/2-inch-long tube of tissue that extends from the large intestine. No one is absolutely certain what the function of the appendix is. One thing we do know: We can live without it, without apparent consequences.Appendicitis is a medical emergency that requires prompt surgery to remove the appendix. Left untreated, an inflamed appendix will eventually burst, or perforate, spilling infectious materials into the abdominal cavity. This can lead toperitonitis, a serious inflammation of the abdominal cavity's lining (the peritoneum) that can be fatal unless it is treated quickly with strong antibiotics.

Sometimes a pus-filledabscess(infection that is walled off from the rest of the body) forms outside the inflamed appendix. Scar tissue then "walls off" the appendix from the rest of theabdomen, preventing infection from spreading. An abscessed appendix is a less urgent situation, but unfortunately, it can't be identified without surgery. For this reason, all cases of appendicitis are treated as emergencies, requiring surgery.In the U.S., one in 15 people will get appendicitis. Although it can strike at any age, appendicitis is rare under age 2 and most common between ages 10 and 30.What Causes Appendicitis?Appendicitis occurs when the appendix becomes blocked, often by stool, a foreign body, orcancer. Blockage may also occur from infection, since the appendix swells in response to any infection in the body.What Are the Symptoms of Appendicitis?The classic symptoms of appendicitis include: Dullpainnear the navel or the upper abdomen that becomes sharp as it moves to the lower right abdomen. This is usually the first sign. Loss of appetite Nausea and/orvomitingsoon afterabdominal painbegins Abdominal swelling Fever of 99-102 degrees Fahrenheit Inability to pass gasAlmost half the time, other symptoms of appendicitis appear, including: Dull or sharp pain anywhere in the upper or lower abdomen, back, or rectum Painful urination Vomiting that precedes the abdominal pain Severe cramps Constipation ordiarrheawith gasIf you have any of the mentioned symptoms, seek medical attention immediately since timely diagnosis and treatment is very important. Do not eat, drink, or use any pain remedies, antacids,laxatives, or heating pads, which can cause an inflamed appendix to rupture.

Appendix Conditions Appendicitis: For unclear reasons, the appendix often becomes inflamed, infected, and can rupture. This causes severe pain in the right lower part of the belly, along with nausea and vomiting. Tumors of the appendix:Carcinoid tumorssecrete chemicals that cause periodic flushing, wheezing, and diarrhea. Epithelial tumors are growths in the appendix that can be benign or cancerous. Appendix tumors are rare.Appendix Tests Medical examination: The original test for appendicitis, a simple examination of the belly remains important in making the diagnosis. Changes in the abdominal exam help doctors tell if appendicitis is progressing, as well. CT scan (computed tomography): A CT scanner uses X-rays and a computer to create detailed images. In appendicitis, CT scans can show the inflamed appendix, and whether it has ruptured. Ultrasound: An ultrasound uses sound waves to detect signs of appendicitis, such as a swollen appendix. Complete blood count (CBC): An increased number of white blood cells -- a sign of infection and inflammation -- are often seen on blood tests during appendicitis. Other imaging tests: When a rare tumor of the appendix is suspected, imaging exams may locate it. These includemagnetic resonance imaging (MRI),positron emission tomography (PET), andCT scans.Appendix Treatment Appendectomy: Surgery is the only treatment for appendicitis. The doctor may use the traditional technique (one large cut) or laparoscopy (several small cuts and using a camera to see inside). Surgery is also needed to remove tumors of the appendix. If the tumor is large, it may require more aggressive surgery with removal of part of the colon. Antibiotics: While the diagnosis is in question, antibiotics treat any potential infection that might be causing the symptoms. In general, antibiotics alone cannot effectively treat appendicitis.

Appendicitis symptomsby Tammy WorthAppendicitis occurs when your appendix, a worm-shaped pouch attached to the large intestine, becomes inflamed.

It can be life threatening if the appendix bursts, but doctors usually remove it surgically before this happens.

A diagnosis can be tricky, however, says Michael Payne, MD, a gastroenterologist with Cambridge Health Alliance, a Harvard-affiliated public healthcare system, in Cambridge, Mass. "It is a very common illness and many people don't have classic symptoms," he says. "We actually have to put our hands on a belly to see for sure."

See your doctor if you have the following symptoms.Belly-button painAppendicitis pain often occurs in the lower-right side of the abdomen. The first sign, however, is typically discomfort near the belly button, which then moves to the lower abdomen.

Some people, including children and pregnant women, may experience pain in different areas of their abdomen or on their side.

The pain also will get worse if you move your legs or abdomen; cough or sneeze; or are jarredduring a bumpy car ride, for instance.Rapidly worsening painOnce the pain is in the lower part of the abdomen, it can be very intense. Dr. Payne says many of his patients describe it as, "like no other pain they have felt before."

Appendicitis is severe enough to wake someone who is sleeping. Once it hits, the severity of pain can increase quicklywithin a matter of hours, Dr. Payne says.Low-grade fever and chillsAppendicitis symptoms may mimic those of a stomach bug, including a low-grade fever, chills, and shaking.

Dr. Payne says that if you have stomach pain with a 100-degree fever, it's probably nothing to worry much about. But if you have a 103-degree fever and your stomach pain is severe enough that you can't stand up straight, it may be appendicitis.Vomiting, nausea, or loss of appetite"You won't have projectile vomiting," Dr. Payne says. "It's not likeThe Exorcist."

You may, however, have a couple days where your appetite is low with some mild nausea and vomiting, similar to what you might have with a stomach bug. If it improves after a day or so, you're probably fine.

But if it continues to get worseparticularly if you also have a fever and lower-right abdominal painDr. Payne says to seek medical attention. If you have been vomiting for more than 12 hours, or have had diarrhea for more than a couple days, you should call your doctor.Constipation or diarrheaLike many of the other symptoms, these may not be severe and probably will come on after youve already experienced abdominal pain.

But if you have mild diarrheaespecially if there is a lot of mucus in itin addition to lower-right abdominal pain, see your doctor.

Gas and bloatingEating five pieces of pizza and washing them down with a few beers would cause bloating and indigestion in anyone.

But if you go to sleep after your indulgence and wake up still in painor the pain is worseyou should beware. Also beware if you have been bloated for more than a couple days, have a lot of gas accompanied by bowel pain, or have trouble passing gas.

These are general symptoms that may indicate appendicitis if they occur in conjunction with other telltale signs, such as fever and pain in the lower-right abdomen.Rebound tendernessRebound tenderness occurs when you push on the lower-right part of your abdomen and then experience pain when releasing the pressure. Dr. Payne says not to push on your abdomen again"if it hurts, don't do it again" is a good rule with appendicitis-related abdominal painand see your doctor if you experience rebound tenderness, particularly if you have a fever, nausea, or other symptoms.What else it could beThe skin is loaded with sensors that pinpoint the pain if, for instance, you get stung by a bee. But it's a different story inside the body.

Conditions such as an ectopic pregnancy, Crohn's disease,pelvic inflammatory disease, and constipation can feel similar to appendicitis. But don't guesssee a doctor.

Even if the symptoms are not traditional, doctors can do an ultrasound or a white-blood-cell count (which would be high if you have an infection) to help diagnose appendicitis, Dr. Payne says.

No symptoms at all?Dr. Payne says he has heard stories about doctors opening up patients for unrelated surgery and discovering that their appendix has ruptured and healed without treatment.

But, he says, this is an urban legend. "If your appendix bursts, you're going to know it," he says.