For the last few days, Johnny quietly suffered a throbbing pain in the area of his belly button. He had thought about staying home tonight but decided that he could just as well be miserable in a crowd of friends than sitting at home on the couch. Besides, he thought, maybe a few drinks and laughs could make things better.
After an hour at the pub, Johnny was starting to regret that choice. He felt like his abdomen was swelling, and the pain started to get worse. He thought he would throw up when someone suggested getting another plate of food.
Finally, someone noticed that he was sitting in the booth, silently grimacing and sweating. Stacy was a nurse at the local hospital and asked the normally talkative Johnny what was wrong. When he told her, she asked if she could press his abdomen Johnny reluctantly agreed.
When she did so and Johnny practically screamed, Stacy leapt into action. “We’ve got to get you to a hospital right away!” The scene became frantic as everyone leaped into action, dragging Johnny out to the parking lot and into a car.
Fortunately for Johnny, Stacy’s quick action may have saved his life. The pain was caused by appendicitis, and if he had waited much longer to seek medical attention, it could have burst, creating conditions that could have cost him his life.
What Is the Appendix?
The appendix is a closed, narrow tube that attaches to the first part of the colon, with the open central core of the appendix draining into the colon. There is no known purpose for the organ in the body’s function.
But this worm-like organ can become inflamed, causing gradually increasing pain in the lower right side of the abdomen. As it gets more and more severe, a medical emergency can ensue, creating a life-threatening situation in some cases. That’s when surgery is required.
No one knows what causes appendicitis. Theories on why it happens include blockages by feces, a foreign object or tumor. This causes pus to accumulate, leading to inflammation and pain.
The good news is that appendicitis is not contagious. The bad news is there is no way to control it, beyond eating more fiber to ensure the swift passage of materials through the colon.
Although appendicitis can strike at any age, it most frequently occurs in younger people between the ages of 10 and 30 and is the most common reason for surgery among children. Men get the condition more than women, and the National Institute of Diabetes and Digestive and Kidney Diseases estimates that about 5 percent of the American population will get appendicitis. The only treatment is surgical removal of the offending organ.
Symptoms of Appendicitis
Unlike muscle pain, appendix inflammation is a sharp, sudden pain that typically happens around the navel and then spreads. As it gets worse, acts like coughing walking or even moving become excruciatingly painful. That stage is usually followed by a loss of appetite, nausea, vomiting, a fever that can escalate, and diarrhea or constipation. Abdominal bloating is a major sign that the appendix is in trouble.
When the pain graduates from mild stages, it’s time to see the doctor. Appendicitis can pose some challenges and complications, including
- A ruptured appendix - This happens when the appendix breaks open, spreading the infection throughout the abdominal area, a condition called peritonitis. This condition is potentially life-threatening and needs immediate surgical intervention to remove the appendix and clean the infection from the abdomen.
- Pus pocket - When the appendix bursts, the pus spreads and lodges in an adjacent area, becoming a pus pocket known as an abscess. A surgeon will drain the area with a tube in the abdomen, and antibiotics will help clear the infection. Once that area is clear, surgery to remove the appendix will commence. In emergency situations, the appendix is taken out immediately.
A doctor will ask about when the symptoms of pain first appeared and will examine the abdominal area. This can be painful because the doctor will put gentle pressure on the painful areas. When that pressure is taken off, the pain will increase. This lets the physician know that the peritoneum is inflamed. While it is not a pleasant test, it is a necessary part of the diagnosis because other issues may be present.
Appendicitis indications include a rigid abdomen and a patient reacting when the appendix area is probed. The process of stiffening muscles is known as guarding.
Part of the examination may include the doctor using a digital rectal exam using a lubricated finger to check for potential tumors. Women may be checked for gynecological issues that may be the source of the pain.
To rule out other issues, doctors may also run the following tests:
- Urine test - A urinalysis will make sure that a urinary tract infection or kidney stone is not the source of pain.
- Blood test - A high white blood cell count will indicate an infection.
- Imaging tests - An x-ray, ultrasound or CT scan may be used to make sure appendicitis -- and not some other issue -- is causing the pain.
However, if the appendix has ruptured and infection has spread into the abdominal cavity, an open appendectomy may be needed to make sure that all the pockets of infection have been removed.
Recovery time is usually a day or two without complications in the hospital, and several weeks of rest and recovery at home to allow the surgery to heal. A burst appendix may require a longer recovery time because the surgery is more extensive.
While recovering, the patient should avoid strenuous activity for several days for a laparoscopic procedure and several weeks for open surgery. This is to allow time for the body to heal. The doctor will advise when it is okay to resume normal activity. During this recovery period, the abdomen is in a delicate state, and a pillow should be applied with pressure if the patient needs to cough, laugh or move. This helps ease the pressure in the area.
Doctors will usually prescribe strong pain medications to help the patient through the initial stages of surgery. This is a time for rest and recovery, so limit walking and sleep when tired. The body is recovering from trauma and needs to restore itself.
There may be some comfort in alternative therapies, such as meditation and guided imagery, both of which can contribute to pain relief. Distractions like listening to music, talking and television can distract from pain, particularly with children, who are harder to control because of their naturally restless nature.
While appendicitis is not a pleasant experience, it is fairly normal. The good news is that patients only have one appendix, so if you experience appendicitis, rest assured, it won't happen again.