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Appendicitis 101

Updated on August 28, 2015

The ABCs of Appendicitis

The Appendix

The appendix or rather the vermiform process is a 2-4 inch pouch like tissue that extends downward from the place where the small intestine meets the large intestine (ileo-cecal joint)

The Appendix is covered by a serous membrane outward where it gets into contact with the peritoneal walls. Inwardly from the serous membrane we find the muscular layer, submucosal and mucosal layers in that order.

Its contents

The appendix is known to harbour useful bacteria that helps in the cleansing of the digestive tract after the emptying of the bowels. This bacteria rejuvenates the gut after the bad bacteria has been ejected out. This function is far more often neglected as it sadly happens that the appendix is considered a useless organ by many. This is due to the notion ''anything that contains bacteria is harmful to us. Some people if given a chance would rather have it surgically removed whether or not it is inflamed.

Note: The appendix can also be considered as a hub for immunity to the body since it contains numerous masses of lymphoid tissue alongside its immediate counterpart the digestive tract.

Note: However, doctors would justify its removal especially when perfoming surgeries like hysterectomies or if it is becomes resistant to an antibiotic treatment in a bid to prevent its inflammation so they would rather do away with it

Appendicitis and its relations

As now known, it is the inflammation of the appendix,

It may vary from individual to individual due to different reasons. In some it may be caused Primarily whereas to some it may be chained to other conditions rendering it Secondary. I.e. When an individual has an autoimmune disorder such as Systemic Erythematous Lupus Syndrome: where the human immune system becomes hyperactive and starts attacking its own self especially tissues. This may results Into appendicitis since the Appendix will be highly susceptible to this condition.

Appendicitis as well can aggravate to cause other diseases such as Crohn's disease which is an inflammation of the Intestines especially the colon and some parts of the ileum often associated with ulcers and fistulae.

Note: Due to the chronology of the diseases that are often associated with appendicitis: In worst case scenario Colon cancer may occur in such individuals due to the manifestation of Crohn's disease earlier in an individual. At this stage usually the immune system is rather weakened drastically due to the relation of the immune system with the Appendix; where we earlier said contains masses of lymphoid tissues that aid to boost general human immunity alongside the Digestive tract that also provides human immunity.

Note: Colon cancer in most cases is acquired after a series of diseases such as Crohn's disease But in some cases we find that its acquired hereditarily. That is why it is advisable to go for a colon screening examination if you suspect or found out that one of your close relatives has been diagnosed with the disease. Other diseases such as Stomach cancer and Liver cancer may occur due to multiple refluxes from infected parts into this Organs but the possibility is minimal.

Note: The gut microbiota that is found in the walls of the digestive tract plays a key role in providing essential health benefits to us. Mainly because it regulates Immune homeostasis.

Symptoms

1. Usually one complains of a searing pain especially around the belly button are. The pain is often described as unbearable which increases when one coughs, sneezes, belches or moves. Pregnant women may experience the pain at slightly different locations on their right side.

2. The earlier searing pain becomes consistent and can result into headaches and at worst cases migraines.

3. Chills and fever may be at peak, with temperature of up to 40 degrees Celsius.

4. Anorexia or lack of appetite

5. Difficulty during opening of bowels (constipation)

6. Diarrhoea often with mucus may be noticed

Note: when you experience such symptoms consult your doctor immediately.

Can it be Asymptomatic ?

In some minor cases especially during surgeries like hysterectomies, surgeons have found out that the appendix ruptured and healed all by itself. This means that the patient did not experience any symptoms related to it appendicitis. For such, it's an exemption but in most cases the symptoms above are manifested.

Diagnosis

1.
The common traditional mode of diagnosis is by palpation by the doctor on your abdomen. This is significant because the Rovsing's sign is used to narrow down to appendicitis diagnosis. It involves pushing on the abdomen on the left lower quadrant which is unusually far away from the primary site of the appendix. When the doctor manoeuvres this region, it stretches the peritoneal lining to enable the right lower quadrant to rub onto the inflamed tissues of organs of the right side. However, this does not entirely conclude that it is Appendicitis because in this region: there are other organs that have the same pathologic etiology as appendicitis. Such organs include the bladder most common, So the doctor may carry out other diagnostic examinations to rule out any other doubts even though the Rovsing's sign may be positive.

2. Imaging processes such as conducting ultrasound scans and CT scans on your patient may give more precise diagnosis. Because inflamed organs within the peritoneum are flared with bright colour that suggest inflammation on this areas.

3. Blood tests may be carried out to check for the white blood cell count which will be abnormally high confirming an infection.

4. Urine tests may be carried out to rule out the possibility of bladder infections.

Prognosis, Treatment, Recovery Rates and Its Mortality Rate

Its prognosis is that it can result to further complications if left untreated or if treated with antibiotics and proves to be resistance to them. At such a stage it is recommended that it is surgically removed: rather by open surgeries or laparoscopic surgeries which are mostly used nowadays.

However, the most common way that doctors and most patients prefer is having antibiotic to treat appendicitis. This method has been successful for its treatment with a high percentage of patients recovering from it without having to undergo surgery; if the doctor recommends a surgical procedure on the patient, it means that the condition is way out of hand.

When it comes to surgery: Surgical procedures especially Laparoscopic appendectomy are more often used nowadays as earlier said since it is less invasive compared to the traditional open table surgery for appendectomy. Recovery time is often up to 3 weeks.

Complications such as formation of an abscess may occur during the healing process due to infections that they may incur at the time but it is quite uncommon.

Mortality rates are almost at 1% rate for appendicitis: If a death case occurs during surgeries to a patient, it is often associated with the age of the individual.

Raynold Grahams Omondi

R.G.O





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    • RaynoldGrahamsooo profile image
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      Raynold Grahams Omondi 2 years ago from Luton, UK, England.

      Thank you Doc! I am truly honoured and humbled indeed!

    • Dr Pran Rangan profile image

      Dr Pran Rangan 2 years ago from Kanpur (UP), India

      Thanks for sharing a well written hub on Appendicitis.

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