Appendicitis: An uncommon, but potentially deadly disease

Feb 3, 2010

Appendicitis is a relatively uncommon disease, but it has serious and potentially life-threatening consequences if not treated quickly.  It will affect about 7 percent of Americans in their lifetime. 

The appendix is a long, blind pouch that is attached to the large intestine.  It is normally located in the right lower region of the abdomen.  Its formal name is the “vermiform” appendix, meaning it looks like a worm.  The size of an average appendix is about four inches in length and three-eights of an inch in diameter.
Scientists still debate the purpose of the appendix.  It has been called a vestigial organ, a structure that has lost its useful function in the human body, because a person can live normally once their appendix is taken out.  Some think it may be significant as our bodies grow during fetal development.  Others argue that it plays a role in immunity because it contains some immune or lymph tissue.  Still others maintain that it is vital for the survival of normal bacteria in the colon.

Appendicitis means the appendix is inflamed.  The presumed cause is that something has blocked its opening to the colon.  Often this is from a fecalith, or hardened stool, and less commonly, from a foreign body or a tumor.

Appendicitis is most common between the ages of 10 and 30 years, with a peak in the late teens.  Males are slightly more predisposed than females.  The very young and those over 70 years of age are more likely to die from rupture of the appendix due to a delay in diagnosis.

An individual who is developing appendicitis may begin with vague symptoms, not unlike those of a stomach bug.  These include: loss of appetite, nausea, generalized stomach pain and cramps, or pain around the belly button.  As the inflammation progresses, pressure builds up in the appendix.  There is usually more severe pain, particularly in the right lower abdomen, fever, vomiting and, at times, abdominal swelling or diarrhea. 

It is important to keep in mind that there are many other organs and body structures in the vicinity of the appendix.  This is why appendicitis is often missed.  Conditions with symptoms similar to that of appendicitis include bowel and bladder infections, kidney stones, ectopic pregnancy, ovarian cysts and muscle strains, to name just a few.    

When the physician examines the patient, there is usually a fever and tenderness in the right lower abdomen.  There may also be tensing of the abdominal muscles when pushing on the abdomen or rigidity of the abdomen.
Depending on the findings of the physical examination, the doctor may order imaging tests, such as an X-ray, ultrasound or CT scan.  A particularly useful laboratory test is the CBC, or complete blood count.  This test looks for an elevation in the white blood cells, a signal of infection in the body. 

Surgical removal of the appendix is the only treatment for acute appendicitis.  This should be done as soon as possible to prevent perforation of the appendix.  If the appendix ruptures, the infection can spread throughout the entire abdominal cavity. 

Every person is unique and not all will have symptoms that are exactly as expected.  Therefore, it is important to listen to your body and seek prompt medical attention when appropriate.  Many a normal appendix has been removed in the name of “sound medical practice.”  It’s generally better to be safe, than sorry.    

The content in this column is for informational purposes only.  Consult your physician for appropriate individual treatment.  Dr. Reynolds practices Family Medicine in Chesterfield.


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