APPENDICITIS: SIGNS, SYMPTOMS, AND TREATMENT

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What is appendicitis?
The appendix is a 3 1/2-inch-long tube of tissue that extends from the large intestine at the right side of the abdomen. Studies suggest that appendix serves as a storehouse for useful bacteria which aid digestion and fight bacteria. However, one can live without it, without any consequences. Appendicitis is an inflammation of the appendix or appendicitis is an inflamed appendix that is filled with pus. Appendicitis mostly occurs in people between the ages of 15 and 30 years. It is more common in males than females. Appendicitis is one of the emergency medical conditions which when not treated promptly, it may cause the appendix to burst thereby becoming life-threatening. It can perforate spilling infectious materials into the abdominal cavity. Sometimes a pus can be formed outside the inflamed appendix which can explode and cause peritonitis.

CAUSES OF APPENDICITIS
An obstruction in the appendix such as faecal material can cause appendicitis. The obstruction may be either partial or complete. When there is an obstruction in the appendix,  bacteria can multiply and lead to the formation of pus inside the organ. However, there are other sources of appendix blockage. These include:

  • Irritation and ulcers in the gastrointestinal tract.
  • trauma or abdominal injury.
  • hardened stool, and parasites.
  • foreign objects

SIGNS AND SYMPTOMS
The signs and symptoms depend on the individual. However, you may experience one or more of the following symptoms.

  • dull pain near the navel or the upper abdomen that becomes sharp as it moves to the lower right abdomen. Usually, some people may feel this as the initial sign.
  • loss of appetite. 
  • abdominal swelling. 
  • nausea and vomiting.
  • constipation or diarrhoea. 
  • low-grade fever.
  • inability to pass gas.
  •  pain that worsens if you cough, walk or make jarring movements.

When you are pregnant, the pain may come from your upper abdomen because your appendix is higher during pregnancy.

DIAGNOSIS
Your physician may start by performing a physical exam. They will palpate your lower right abdomen to look for tenderness. However, bacterial infection is often correlated with appendicitis, your doctor will request for complete blood count test.
The doctor might request for other routine exam such as.

  • ultrasound- during the ultrasound, the sonographer will scan your abdomino-pelvic region especially the lower right quadrant part of your abdomen for a non-compressible, immobile, blind-ended, and tubular structure.
  •  x-ray, and CT scan.
  • urinalysis (urine test) to rule out urinary tract infection (UTI).
  • rectal exam

TREATMENT
Surgery to remove the appendix which is called an appendectomy or appendicectomy is the treatment for almost all cases of appendicitis. This surgery is done through keyhole surgery or laparoscopy, and open surgery. However, if the appendix is ruptured and has caused an abscess, open surgery will be conducted. An open surgery is a larger incision in the lower right quadrant part of the abdomen. This is done so that the area inside the abdominal cavity can be cleaned.
Keyhole or laparoscopy is a precise operation with a small incision and minimal loss of blood.

RECOVERY TIME
After the surgery, there may be pain, constipation, and bruising. In the case of keyhole surgery, the patient can usually go home within few days(24hours). Over the counter painkillers will be administered or prescribed to the patient to reduce pain. The patient will be advised to avoid solid food for few weeks after the surgery and weekly routine check-up will be advised until the stitches is removed.

It is advised that the patient should avoid strenuous activities to prevent injury to the incision area until the wound is properly healed and stitches removed.

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