June 28, 2007



The appendix is a thin tail, tube or appendage growing out of the caecum, which is part of the large intestine located on the lower right side of the abdomen. The precise function of the appendix in the human body is something of a mystery, although it clearly plays a role in digestion for other animal species.

Appendicitis means inflammation of the appendix. Food or faecal matter can sometimes lodge in the narrow tube of the appendix, and the blockage becomes infected with bacteria. This is a medical emergency. If the appendix bursts, its infected contents will spread throughout the abdominal cavity. Infection of the lining of the abdominal cavity (peritonitis) can be life threatening without prompt treatment. Anyone of any age can be struck by appendicitis, but it seems to be more common during childhood and adolescence. It is less common for anyone over the age of 30 years to develop appendicitis. Treatment options include surgery.

Symptoms of appendicitis include:

Dull pain centred around the navel, which progresses to a sharp pain in the lower right side of the abdomen.
Pain in the lower back, hamstring or rectum (less commonly).
Diarrhoea or constipation.
Loss of appetite.

Causes of blockages
Food or hard faeces can clog the thin tube of the appendix. Once the impacted matter becomes infected, the appendix swells and shuts off its opening to the large intestine, virtually sealing the infection inside a self-contained pocket. Without treatment, the appendix will continue to swell with pus until it bursts. It is believed that low fibre diets may be a factor leading to appendicitis. Without sufficient fibre or 'roughage', food moves slowly through the gut and blockages may be more likely. Occasionally, a pip, seed or some other type of foreign matter becomes lodged in the appendix. Other causes of blockage include swelling of the appendix's lymphatic tissue (as occurs with some viral infections) and parasitic worms.

Perforated appendix
If pus keeps on accumulating, the appendix will eventually burst, flooding the abdominal cavity with infected matter. Bursting, or perforation, can occur 36 hours or so from the onset of infection. The signs of a perforated appendix include a severe worsening of symptoms and collapse. Infection of the lining of the abdominal cavity (peritonitis) is a life threatening complication and requires immediate emergency treatment.

Diagnosis is difficult
Appendicitis can mimic the symptoms of other disorders such as gastroenteritis, ectopic pregnancy and various infections (including those of the kidney and chest). Diagnosis methods may include a thorough physical examination and careful consideration of the symptoms. If the diagnosis is not clear, then laboratory tests and ultrasound or CT scans may be needed. Since appendicitis is potentially life threatening if left untreated, doctors will err on the side of caution and operate, even if there is no firm diagnosis.

Treatment options
Treatment for appendicitis includes an operation to remove the appendix completely. This procedure is known as an appendicectomy or appendectomy. A small incision is made in the lower abdomen. The appendix is cut away and the wound on the large intestine stitched. If the appendix has burst in the interim, the surgeon will insert a tube and drain the abdominal cavity of pus. Antibiotics are given to the patient intravenously to reduce the possibility of peritonitis.

The appendix can sometimes be removed using laparoscopic (keyhole) surgery. The surgeon will use a slender instrument (laparoscope), which is inserted through tiny incisions (cuts) in the abdomen. This eliminates the need for large abdominal incisions.

The typical hospital stay for an appendicectomy is between three and five days. Removing the appendix appears to have no effect on the workings of the digestive system, in either the short or long term.

Things to remember
Appendicitis means inflammation of the appendix, which is a small tube attached to the large intestine.
Appendicitis is a medical emergency.
Treatment includes intravenous antibiotics and surgical removal of the appendix.

Adapted from: Better Health Channel