What is appendicitis?
Appendicitis is an inflammation of the appendix which is a worm like organ in the gut situated just below where the small bowel opens in to the large bowel. It is caused by bacterial infection from the intestinal contents.

What is the appendix?
The appendix is a fingerlike pouch attached to the large intestine and located in the lower right area of the abdomen. Scientists are not sure what the appendix does, if anything, but removing it does not appear to affect a person’s health. The inside of the appendix is called the appendicles lumen. Mucus created by the appendix travels through the appendicle lumen and empties into the large intestine.

What causes appendicitis?
Obstruction of the appendicle lumen causes appendicitis. Mucus backs up in the appendicle lumen, causing bacteria that normally live inside the appendix to multiply. As a result, the appendix swells and becomes infected.
Sources of obstruction include;
• feces, parasites, or growths that clog the appendicle lumen
•enlarged lymph tissue in the wall of the appendix, caused by infection in the gastrointestinal tract or elsewhere in the body
• inflammatory bowel disease, including Cohn's disease and ulcerative colitis
• trauma to the abdomen
An inflamed appendix will likely burst if not removed. Bursting spreads infection throughout the abdomen—a potentially dangerous condition called peritonitis.

Who gets appendicitis?
Anyone can get appendicitis, but it is more common among people 10 to 30 years old. Appendicitis leads to more emergency abdominal surgeries than any other cause.

What are the symptoms?

Most people with appendicitis have classic symptoms around the umbilicus and soon settles in the right lower quadrant, just above the groin.a doctor can easily identify. The main symptom of appendicitis is abdominal pain.
The abdominal pain usually
• occurs suddenly, often causing a person to wake up at night
• occurs before other symptoms
• begins near the belly button and then moves lower and to the right
• is new and unlike any pain felt before
• gets worse in a matter of hours
• gets worse when moving around, taking deep breaths, coughing, or sneezing
Other symptoms of appendicitis may include
• loss of appetite
• nausea
• vomiting
• constipation or diarrhea
• inability to pass gas
• a low-grade fever that follows other symptoms
• abdominal swelling
• the feeling that passing stool will relieve discomfort
Symptoms vary and can mimic other sources of abdominal pain, including
• intestinal obstruction
• inflammatory bowel disease
• pelvic inflammatory disease and other gynecological disorders
• intestinal adhesions
• constipation

How is it diagnosed?
A doctor should be consulted immediately. The diagnosis is made by the clinical history and doctor's examination. The blood check will show a high white cell count and a raised ESR or CRP. all signs of acute infection. Ultra sound can be useful, so are other tests like X-rays. If diagnosis is delayed, a swelling forms around the area, when the organ is perforated, as a reaction of body defense. Perforation if restricted by the formation of a local mass. It becomes serious i.e. perforation, if it spreads to the whole abdomen.

Laboratory Tests;
Blood tests are used to check for signs of infection, such as a high white blood cell count. Blood tests may also show dehydration or fluid and electrolyte imbalances. Urinalysis is used to rule out a urinary tract infection. Doctors may also order a pregnancy test for women.

Imaging Tests;
Computerized tomography (CT) scans .
Ultrasonography.
An abdominal x ray .


How is it treated?
It is important that a doctor in the local hospital is consulted. Appropriate antibiotics are routinely used and when the patient settles he would need surgery, which is the corrective treatment. Surgery depends upon the seriousness of the patent’s presentation; i.e., if the patient shows signs of perforation he/she would need intensive therapy with antibiotics to help settle the condition and surgery carried out at a later date electively. Recently endoscopic surgery is being carried out at most hospital centres, but conventional procedure is still used universally.

What should people do if they think they have appendicitis?
Appendicitis is a medical emergency that requires immediate care. People who think they have appendicitis should see a doctor or go to the emergency room right away. Swift diagnosis and treatment reduce the chances the appendix will burst and improve recovery time.




 

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