What does appendicitis feel like?

Appendicitis is a condition characterized by inflammation and swelling of the appendix. The appendix is a pouch-like, finger shaped organ that extends from the colon towards the bottom right side of the abdominal cavity. Doctors are not yet aware about the function or purpose of the appendix.

People with appendicitis will experience pain in the lower right half of the abdomen. It may however be noted that most patients suffer from pain that commences from near the belly button and then migrates to other areas. Pain associated with appendicitis can be acute or chronic; it becomes worse with an increase in the level of appendix inflammation, ultimately becoming a severe form of appendicitis.

People of all age groups can develop appendicitis, but the condition is more common in individuals aged between 10 and 30 years. Appendicitis pain is usually treated via surgical excision of the organ.

What does appendicitis feel like?

Patients affected by appendicitis may feel the following signs and symptoms:

• Sudden throbbing that commences near the belly button area and later typically migrates to the bottom right side of the abdomen.
• Sudden throbbing pain that originates on the lower right side of the abdominal cavity.
• Pain which aggravates if the patient makes movements that vibrate/shake the body. Some examples of jarring movements are coughing and walking briskly.
• If appendicitis remains untreated, the associated pain will keep becoming more intense or severe.
• Vomiting and nausea
• The affected area, i.e., the right side of lower abdomen, will experience tenderness if pressure is exerted on it.
• Rebound tenderness, i.e., occurrence of severe pain after application of pressure on the affected region and subsequent equally rapid easing of pain after pressure is released, is also evident.
• Mild fever which can worsen along with deterioration of appendicitis.
• Appetite loss
• Abdominal bloating
• Diarrhea or constipation
• Indigestion
• Reduced ability to pass out gas

The area of appendicitispain may differ as per the location of the appendix and the age of the patient. Expectant women may feel the pain in the upper abdominal region as the organ shifts upwards during pregnancy.

Complications

Appendicitis can result in some severe medical complications as listed below:

• A burst appendix: When the appendix ruptures it causes the infection to spread all over the abdomen resulting in a condition called peritonitis. It is a dangerous condition and can prove to be fatal. Hence, immediate surgical removal of the organ as well as cleaning of the abdomen is required.
• Formation of a ‘pus-pocket’ in the abdominal cavity: Rupture of the appendix can result in an abscess, i.e., formation of an infected pocket/area. Surgeons usually treat this complication by draining the abscess via a tube inserted into the abscess through the abdominal wall. Antibiotics are given to treat the infection. The tube remains intact for about 2 weeks.

Doctors will opt for surgical removal of the organ only after the infection has been cleared. Sometimes, doctors will perform the surgery immediately after draining the abscess.

Causes of appendicitis

• Any kind of obstruction in the appendix lining that leads to infection carries the possibility of eventually causing appendicitis. The pathogens rapidly multiply and cause inflammation, swelling, and buildup of pus in the appendix.
• Any delay in treatment can cause the organ to burst open.

Diagnosis

Diagnosis of appendicitis includes:

• Verification of the signs and symptoms and its history.
• A physical examination to verify the area and intensity of pain.
• The doctor may search for rigid spots on the abdomen. He/she will also verify whether the patient stiffens the muscles of the abdomen upon application of pressure on the affected region.
• Blood tests to check for any signs of infection.
• Imaging tests such as an ultrasound, X-ray, or a CT scan of the abdomen to confirm a diagnosis of appendicitis.
• A rectal and gynecological exam as well as a urinalysis may be carried out to rule out the possibility of other pain-causing conditions, such as kidney stones, UTIs, etc.

Treatment of appendicitis

Appendicitis is typically treated by surgical removal of the swollen appendix. Doctors may give a dose of antibiotics before surgery to prevent infection.

Appendectomy or surgical removal of the appendix

• Surgeons may go for an open surgery to remove the appendix. In this procedure, a 2 to 4 inches long incision is made in the abdomen. Doctors may also opt for laparoscopic surgery, wherein many tiny incisions are made in the abdomen. The surgeon will then insert a video camera and surgical instruments through these incisions to cut out the appendix and remove it.
• Laparoscopic surgery usually causes less pain during healing, has a faster recovery period, and causes minimal scarring. In case the appendix has burst and the infection has migrated to other areas along with the formation of an abscess, then doctors will perform an open surgeon so as to have better access to the abdominal cavity so as to easily and thoroughly clean the abscess.
• Patients may need to spend 1 or 2 days at the hospital after either kind of surgery to remove the appendix.

Draining of abscess before appendectomy

• In case an abscess has developed due to rupture of the appendix, then surgeons will first drain it by inserting a tube into the abscess via the skin. Once the infection is controlled, which may take some weeks, the surgeon will carry out the appendectomy.

The recovery period

Patients who have undergone a surgery to remove the appendix will take a few weeks to recover completely. Patients with a ruptured appendix and subsequent infection may take longer to recover post-surgery.

The following self-care guidelines need to be adhered to during the recovery period:

• Make sure to support the abdomen before you start coughing.
• Contact the doctor if the medications do not help ease pain.
• Restrict all types of physical activity for some weeks post-surgery.
• Patients may begin walking only if they feel strong enough. Till then, lots of bed rest is advised.
• Visit the doctor before resuming your daily life.