Abdominal pain from appendicitis, a dangerous symptom that must be treated urgently before infection

Appendicitis is an acute abdominal pain condition that everyone should know about because it can occur in people of all genders and ages, but it is most commonly found in people aged 12–60 years. In the early stage, patients usually have pain around the navel or cannot clearly indicate the location, but after some time, the pain point will be at the lower right abdomen. The more it is pressed, the more painful it feels. This symptom may indicate that you have appendicitis abdominal pain, therefore you should immediately see a doctor before the appendix ruptures in the abdomen, which may be life-threatening.

Key Takeaways

• Appendicitis has important indicative symptoms ได้แก่ lower right abdominal pain, nausea, loss of appetite, fever, and pain that migrates location
• If appendicitis is left untreated, it may cause the appendix to rupture, leading to severe complications such as peritonitis, which is life-threatening
• The standard treatment for appendicitis is surgery, which allows complete recovery and prevents recurrence

What is appendicitis? Is it dangerous?

Appendicitis is the most common disease in patients with severe abdominal pain requiring surgery. It is a condition in which the appendix becomes inflamed due to obstruction within the appendiceal lumen. There are many causes such as hardened fecal matter (Fecalith) falling into it, thickening of lymphoid tissue (Lymphoid tissue) in the appendiceal wall, or other foreign bodies whether parasites, fruit seeds, and tumors. These cause secretions to accumulate inside, resulting in high pressure and eventually becoming appendicitis.

If not treated promptly, the appendix will become necrotic, leading to perforation, which increases the risk of severe infection in the abdominal cavity and can be life-threatening. Therefore, when there is severe lower right abdominal pain, it should always be presumed that it may be appendicitis abdominal pain first, and promptly see a doctor for examination as soon as possible.

Is the appendix important? What is its role?

Many people may wonder whether the appendix is important and where it is located. The appendix (Appendix) is located in the lower right abdomen. It is a protrusion from the cecum (Cecum), with the appearance of a blind-ended tube, shaped like a worm, with a width of about 5–8 millimeters and a length of about 8–10 centimeters. It functions to store beneficial bacteria or probiotics that help in the digestive system and also has a role related to the immune system.

How many stages are there for appendicitis symptoms?

Appendicitis symptoms can be divided into stages according to severity and different characteristics as follows

Uncomplicated appendicitis symptoms

Appendicitis in the early stage, or the stage where obstruction begins in the appendix. The patient will have abdominal pain around the navel, or some people may have epigastric pain similar to gastritis symptoms. The pain will gradually increase continuously and may be accompanied by loss of appetite.

Complicated appendicitis symptoms, necrotic type

In the next stage, the appendix begins to swell. The pain will move clearly to the lower right abdomen and become more severe, especially when moving the body, coughing, or sneezing, to the point that the patient cannot move anywhere except lying curled and on the side to reduce suffering. In addition, there may be bloating, diarrhea, nausea, vomiting, and fatigue.

Ruptured appendix and abscess

This stage is considered very dangerous if not treated, because if the appendix ruptures, pathogens and contaminants will spread to nearby tissues within the abdominal cavity, causing peritonitis (Peritonitis), resulting in constant severe abdominal pain, high fever, chills, rapid heartbeat, abdominal distension, and possible bloodstream infection. This is a life-threatening condition.

However, in some patients, a lower abdominal abscess may form because the body creates tissue to encapsulate the ruptured appendix, causing pain at the abscess area along with fever.

Warning signs of appendicitis, what symptoms are considered?

For patients who are suffering from abdominal pain but do not know whether it is appendicitis, try to observe the key symptoms commonly found in appendicitis patients as follows

• Appendicitis often begins with acute pain around the navel or epigastrium with unclear location
• After a while, the pain will be in the lower right abdomen, pain medication does not relieve it, and it becomes more painful when moving, including coughing or sneezing
• The patient will have intermittent vomiting, loss of appetite, some may have diarrhea, constipation, or bloating as well
• There is a fever not exceeding 38 degrees Celsius. If higher than 38.3 degrees Celsius, it may be a sign of ruptured appendix. In some cases, there may be no fever if antipyretics and antibiotics have been taken beforehand

Diagnosis of appendicitis, accurate screening leads to precise treatment

For diagnosis of appendicitis, the doctor will take history, perform physical examination, and perform complete blood count (CBS) to predict appendicitis. For physical examination, the doctor will press the lower right abdomen (Mc Burney’s point) to an appropriate depth and then release quickly. If the patient has rebound tenderness (Rebound tenderness), it means there is irritation of the peritoneum.

And pressing the left lower abdomen in the iliac fossa area to push the intestines to the right. If the patient feels pain in the lower right abdomen (Rovsing's sing), it indicates a high risk that the patient has appendicitis.

In addition, there is urinalysis to differentiate other diseases such as kidney stones or urinary tract infection, and additional examination by abdominal ultrasound, but this method has low accuracy, while CT Scan or MRI examination has more than 90% accuracy in diagnosis

Surgical treatment methods for appendicitis to achieve complete cure without recurrence

When diagnosed with appendicitis, the main treatment is appendectomy to prevent rupture and severe infection. It can be done in 2 methods ได้แก่

1. Open surgery

The doctor will make an incision in the lower right abdomen, with a wound size of 3–10 cm to remove the appendix. In cases where the appendix has already ruptured, the incision may need to be extended to the mid-abdomen for convenience in cleaning the abdominal cavity, causing the patient to require a longer recovery time

2. Laparoscopic surgery

Laparoscopic appendectomy involves making an incision at the navel area to create a wound of about 0.5–1 cm, then inserting a camera to allow the doctor to clearly see internal organs without making a large incision, helping to reduce pain, recovery time, and risk of complications

Appendicitis, treat urgently before it becomes life-threatening

Appendicitis is a condition that should not be neglected, because if left until rupture, it may cause severe infection that is life-threatening. Patients can observe themselves from warning signs ได้แก่ abdominal pain around the navel that moves to the lower right abdomen, continuous pain that does not subside, vomiting, and fever

If you have these symptoms, immediately see a doctor for detailed diagnosis and receive treatment for appendicitis, or schedule an appendectomy program at Praram 9 Hospital to receive laparoscopic surgery by specialist doctors, with modern and complete equipment, to help take care of you to return to good health safely again

For more information

• Facebook : Praram 9 Hospital International & Expats
• Line : @Praram9Hospital
• Tel. 1270

Frequently asked questions about appendicitis

1. Is surgery necessary for appendicitis?

To completely treat appendicitis, only surgery can be used. It cannot be cured by medication alone. If not removed, there may be a risk of appendix rupture, leading to life-threatening complications

2. How long is the recovery period after appendicitis treatment?

After appendicitis surgery, the hospital recovery time is approximately 2–3 days, depending on the surgical method and the patient’s physical condition

References

Appendicitis. (2023, September 5). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/8095-appendicitis

Sippola, S., Haijanen, J., & Grönroos, J. (2021, January 11). Effect of oral moxifloxacin vs intravenous ertapenem plus oral levofloxacin for treatment of uncomplicated acute appendicitis: The APPAC II randomized clinical trial. JAMA Network. https://jamanetwork.com/journals/jama/fullarticle/2775227

Selänne, L., Haijanen, J., & Sippola, S. (2024, April 17). Three-year outcomes of oral antibiotics vs intravenous and oral antibiotics for uncomplicated acute appendicitis: A secondary analysis of the APPAC II randomized clinical trial. JAMA Network. https://jamanetwork.com/journals/jamasurgery/article-abstract/2817651