Appendicitis happens when your appendix, a small finger-shaped structure that sticks out from your large intestine on the right side, gets inflamed and filled with pus. The inflammation is usually caused by a blockage, but may be caused by an infection. Without treatment, an inflamed appendix can rupture, infecting the lining of the abdomen. Rupture is most common among infants, occurring in up to 95% of cases. That can be a life-threatening condition. Appendicitis is one of the most common causes of emergency abdominal surgery. Signs and SymptomsThe following signs and symptoms may accompany appendicitis:
What Causes It?Appendicitis usually happens after an infection in the digestive tract, or when the tube connecting the intestine to the appendix is blocked by trapped feces or food. Both situations cause inflammation, which can lead to infection or rupture of the appendix. Who's Most At Risk?The following factors can put you at higher risk for developing appendicitis:
What to Expect at Your Provider's OfficeAppendicitis is an emergency, because the appendix could rupture. If you have appendicitis symptoms, you should go to an emergency room. The doctor will ask about your symptoms and your medical history, do a physical exam to check for abdominal tenderness, and may order blood and urine tests. Some health care providers use ultrasound to check whether the appendix is inflamed, and to rule out ovarian cysts or ectopic pregnancy in women. You may also have a computed tomography (CT) scan. Treatment OptionsPreventionThere is no sure way to prevent appendicitis. However, eating a diet that includes fresh vegetables and fruit may lower your risk. Treatment PlanAppendicitis is usually treated with surgery and antibiotics. Along with antibiotics, you may get intravenous (IV) fluids and medication to control vomiting. If your doctor can't tell from the CT scan or ultrasound whether you have appendicitis, you may have exploratory surgery. If you do have appendicitis, your appendix will be removed (appendectomy), though doctors are increasingly treating appendicitis with antibiotics only. Drug TherapiesYour health care provider may prescribe the following medications:
Surgical and Other ProceduresAn appendectomy is the surgical removal of the appendix through an incision in your abdomen that can be several inches long. A laparoscopic appendectomy involves making a few tiny cuts in the abdomen and inserting a tiny camera and surgical instruments. The surgeon then removes the appendix through one of the small incisions. Recovery from a laparoscopic appendectomy is usually faster than with traditional surgery, and the scars are smaller. However, not everyone is a candidate for a laparoscopic appendectomy. Complementary and Alternative TherapiesAcute appendicitis is an emergency, and you should get medical help immediately. Never try to treat appendicitis with alternative therapies alone. Some studies show that certain herbs and supplements may help to prevent appendicitis, strengthen your immune system, or help you recover faster from surgery. NutritionIn England and Wales, a study reviewed whether a diet that was low in fiber and high in sugar and meat had any effect on people getting appendicitis. No specific link was found with sugar or meat. But the study did suggest that the more fresh and frozen green vegetables and fresh and processed tomatoes people ate, the less likely they were to get appendicitis. Eating green vegetables -- particularly cabbage, cauliflower, peas, beans, Brussels sprouts and maybe tomatoes -- may protect against appendicitis. HerbsAppendicitis should be treated with surgery. Some herbs may help you recover faster from surgery. Ask your doctor for more information. Prognosis and Possible ComplicationsWith treatment, people usually make a complete recovery from appendicitis, especially if the appendix does not rupture. In cases where the appendix ruptures, the death rate is higher, especially among the elderly. The death rate after appendectoy is less than 1%. Complications may include recurring appendicitis, inflammation of the abdominal lining, abscess (pus-filled inflamed area), sepsis or "blood poisoning," blocking of a fallopian tube, infertility, and wound infection. Appendicitis happens in only about 1 in 1,000 pregnancies. Following UpIf you have surgery, you will need to see your health care provider 2 weeks after the operation, and again at 6 weeks. Supporting ResearchAli A, Moser MA. Recent experience with laparoscopic appendectomy in a Canadian teaching centre. Can J Surg. 2008;51(1):51-55. PMID: 18248706 www.ncbi.nlm.nih.gov/pubmed/18248706. Barker DJ, Morris J, Nelson M. Vegetable consumption and acute appendicitis in 59 areas in England and Wales. Br Med J (Clin Res Ed). 1986;292(6525):927-930. PMID: 3008904 www.ncbi.nlm.nih.gov/pubmed/3008904. Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:101-102. 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PMID: 483837 www.ncbi.nlm.nih.gov/pubmed/483837. Marx J, Hockberger R, Walls R, eds. Rosen's Emergency Medicine - Concepts and Clinical Practice. 8th ed. Philadelphia, PA; Elsevier Saunders; 2014. McKinney PE. Elemental mercury in the appendix: an unusual complication of a Mexican-American folk remedy. J Toxicol Clin Toxicol. 1999;37(1):103-107. PMID: 10078167 www.ncbi.nlm.nih.gov/pubmed/10078167. No author listed. Combined traditional Chinese and Western medicine in acute appendicitis. Chin Med J (Engl). 1977;3(4):266-269. PMID: 410610 www.ncbi.nlm.nih.gov/pubmed/410610. No author listed. Treatment of acute abdominal diseases by combined traditional Chinese and Western medicine. World J Surg. 1979;3(1):91-94. PMID: 483837 www.ncbi.nlm.nih.gov/pubmed/483837. No author listed. Treatment of acute appendicitis in children with combined traditional Chinese and Western medicine. Chin Med J (Engl). 1977;3(6):373-378. PMID: 414892 www.ncbi.nlm.nih.gov/pubmed/414892. Pisacane A, de Luca U, Impagliazzo N, Russo M, De Caprio C, Caracciolo G. Breast feeding and acute appendicitis. BMJ. 1995;310(6983):836-837. PMID: 7711621 www.ncbi.nlm.nih.gov/pubmed/7711621. Rao PM, Rhea JT, Novelline RA, Mostafavi AA, McCabe CJ. Effect of computed tomography of the appendix on treatment of patients and use of hospital resources. N Engl J Med. 1998;338(3):141-146. PMID: 9428814 www.ncbi.nlm.nih.gov/pubmed/9428814. Townsend CM, Beauchamp D, Evers M, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017. Tsai HM, Shan YS, Lin PW, Lin XZ, Chen CY. Clinical analysis of the predictive factors for recurrent appendicitis after initial nonoperative treatment of perforated appendicitis. Am J Surg. 2006;192(3):311-316. PMID: 16920424 www.ncbi.nlm.nih.gov/pubmed/16920424. Tulin-Silver S, Babb J, Pinkney L, et al. The challenging ultrasound diagnosis of perforated appendicitis in children: constellations of sonographic findings improve specificity. Pediatr Radiol. 2014;45(6):820-830. PMID: 25471754 www.ncbi.nlm.nih.gov/pubmed/25471754. Zheng XL, Chen C, Wu XZ. Acupuncture therapy in acute abdomen. Am J Chin Med. 1985;13(1-4):127-131. PMID: 4025207 www.ncbi.nlm.nih.gov/pubmed/4025207.
Review Date:
11/19/2016 Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network. Also reviewed by the A.D.A.M Editorial team.
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