Tuesday, February 9, 2010

Appendicitis

What Is Appendicitis?
Appendicitis is an inflammation of the appendix. Once appendicitis begins, there is no effective medical therapy. Therefore, it is considered a medical emergency. When it is treated promptly, most patients recover without difficulty. However, if treatment is delayed, the appendix can burst, causing infection and even death. Although anyone can get appendicitis, it occurs most often in people between the ages of 10 and 30.

Understanding the Appendix
The appendix is a small, tube-like structure that is attached to the first part of the large intestine, also called the colon. It is located in the lower right portion of the abdomen, near where the small intestine attaches to the large intestine, and it has no known function. Removal of the appendix appears to cause no change in digestive function.

What Causes Appendicitis?
The inflammation can be caused by a blockage of the inside of the appendix, known as the lumen. Common causes of blockage include:


* Feces
* Infections that lead to swelling
* Trauma.


(Click Causes of Appendicitis for more information about what causes this condition.)

Common Symptoms
Not everyone with appendicitis has related symptoms, especially:


* People with certain medical conditions
* Women who are pregnant
* Children (see Appendicitis in Children)
* The elderly.


Pain in the abdomen can be an early symptom. The pain may first appear around the belly button and then move to the lower right area of the abdomen.

(Click Early Appendicitis Symptoms for more information.)

Other common symptoms include:


* Pain that intensifies when moving, taking deep breaths, coughing, or sneezing
* Loss of appetite
* Nausea
* Vomiting
* Constipation or diarrhea
* Inability to pass gas
* Low fever that begins after other symptoms
* Abdominal swelling
* Feeling that a bowel movement will relieve discomfort.


These symptoms can be caused by other medical conditions, however. People who have possible symptoms of appendicitis should see a qualified physician immediately.

Appendicitis Treatment: An Overview
In most cases, appendicitis treatment involves surgery. Medication may be used as an appendicitis treatment if the doctor is unsure if the patient has appendicitis. However, surgery will be needed if the patient definitely has appendicitis.

Surgery as an Appendicitis Treatment
Acute appendicitis treatment consists of surgery to remove the appendix. This operation may be performed through a standard small incision in the lower-right part of the abdomen, or it may be performed using a laparoscope, which requires three to four smaller incisions. If other conditions are suspected in addition to appendicitis, they may be identified using laparoscopy. In some patients, laparoscopy is preferable to open surgery as an appendicitis treatment because the incision is smaller, recovery time is quicker, and less pain medication is required.

Recovery from an appendectomy takes a few weeks. Doctors usually prescribe pain medication and ask patients to limit physical activity. Recovery from laparoscopic appendectomy is generally faster, but limiting strenuous activity may still be necessary for 4 to 6 weeks after surgery. Most people who are treated for appendicitis recover excellently and rarely need to make any changes in their diet, exercise, or lifestyle.

Appendicitis Treatment: Antibiotics and Other Treatments
In some cases, infections may cause the same symptoms as appendicitis. Therefore, if an appendicitis diagnosis is uncertain, people may be watched and sometimes receive antibiotics as appendicitis treatment. If the cause of the pain is an infection, symptoms should resolve with intravenous antibiotics and intravenous fluids. However, if the patient has appendicitis, the condition cannot be treated with antibiotics alone and will require surgery.

Occasionally, the body is able to control an appendiceal perforation (a hole) by forming an abscess. An abscess occurs when an infection is walled off in one part of the body. The doctor may choose to drain the abscess (as part of appendicitis treatment) and leave the drain in the abscess cavity for several weeks. An appendectomy may be scheduled after the abscess is drained.