Appendicitis: Symptoms, Diagnosis, Treatment

What is appendicitis? 

Appendicitis is an inflammation of the appendix, a small, tube-shaped pouch attached to the large intestine. It is considered a medical emergency and typically requires prompt surgical intervention to remove the appendix (appendectomy).

If left untreated, an inflamed appendix can burst, leading to serious complications such as peritonitis (infection of the abdominal lining) and abscess formation.

What are the symptoms of appendicitis?

Appendicitis usually starts with pain in the middle of your abdomen that may fluctuate in intensity. The pain typically starts around the navel (belly button) and then moves to the lower right side of the abdomen as the appendix becomes more inflamed.

Initially, the pain may be mild and intermittent, but it often progresses to become more severe and constant over several hours and worsen when you move around, cough or sneeze.

Other symptoms include:

• Loss of appetite
• Nausea and vomiting
• Fever
• Abdominal swelling
• Constipation or diarrhoea
• Inability to pass gas

What are the causes of appendicitis?

The exact cause of appendicitis is not always clear, but it can occur due to:

• Hardened stool that obstructs the opening inside the appendix.
• Infection in the digestive tract or elsewhere in the body causes the tissue in the wall of the appendix to swell, blocking it.
• Inflammatory Bowel Diseases like Crohn’s disease and ulcerative colitis can cause inflammation in the intestines, which may lead to appendicitis.

How is appendicitis diagnosed? 

Appendicitis is diagnosed through a combination of medical history, physical examinations, laboratory tests, and imaging studies.

1. Blood tests to check for an elevated white blood cell count, indicating infection or inflammation.
2. Urine tests to rule out urinary tract infections or kidney stones, which can cause similar symptoms.
3. Imaging studies:
   • Ultrasound is often used in children and pregnant women to visualise the appendix and surrounding area.
   • CT (Computed Tomography) scan is the most commonly used imaging test for diagnosing appendicitis, providing detailed images of the appendix.
   • MRI (Magnetic Resonance Imaging) scan is sometimes used as an alternative to CT scans, especially in pregnant women to avoid radiation exposure.

How is appendicitis treated?

Appendicitis is a medical emergency. If you are diagnosed with appendicitis, it is likely that your appendix will need to be removed as soon as possible.

The appendix can possibly rupture and lead to a severe, deadly infection. This reason alone is serious enough for doctors to often recommend that you have surgery to remove your appendix.

The surgery can be done in two ways:

• Open (traditional) surgery method: This surgical procedure involves making a single incision in the lower right area of the abdomen to remove the appendix. This method is more traditional but may require a slightly longer recovery time compared to laparoscopic surgery.
• Laparoscopic method: A minimally invasive approach where several small incisions are made in the abdomen. A tiny camera (laparoscope) and surgical instruments are inserted through these incisions to remove the appendix. This method often results in quicker recovery times, less pain, and smaller scars compared to open surgery.

What are the complications of appendicitis? 

Here are some complications that you may potentially develop if you have appendicitis:

• Perforation: If the appendix ruptures, bacteria and infected material can spill into the abdominal cavity, leading to a condition called peritonitis. This is a serious and potentially life-threatening complication that requires immediate medical attention.
• Peritonitis: Infection of the lining of the abdominal cavity (peritoneum) can cause severe abdominal pain, fever, nausea, and vomiting. Peritonitis requires urgent treatment with antibiotics and sometimes drainage of any abscesses that may have formed.
• Abscess formation: In some cases, a collection of pus (abscess) may form around the appendix or in the abdomen due to the spread of infection. This may require drainage either through a catheter or surgical intervention.

Is there any way to prevent appendicitis? 

Preventing appendicitis is challenging because the exact cause is often unclear and not entirely preventable. 

When should I go to the doctor for appendicitis? 

If you are showing any of the symptoms of appendicitis mentioned above, call your doctor or go to the nearest Accident & Emergency at Pantai Hospitals immediately. Appendicitis is a severe medical emergency and should be treated as promptly as possible.

Make an appointment at Pantai Hospitals

Consult our doctors if you are experiencing symptoms of appendicitis. A dedicated and expert team of general surgeons at Pantai Hospitals is available for consultation to provide the best care and assistance.

Get in touch with us to book an appointment today if you have concerns or questions regarding appendicitis. We assure you the best possible care tailored to your specific needs.

Pantai Hospitals have been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.