Danger level: High

What is it?

Appendicitis is an inflammation of the appendix (a part of the intestine).

Who gets it?

In the US, appendicitis is the most common cause of abdominal pain which requires surgery.

It occurs in up to 7% of people in the US (it’s lower in countries where there is more dietary fiber in the diet), and occurs in about 250,000 people a year in the US. It’s 1.4 times more common in men than in women.

Appendicitis is most common in young people – it occurs mostly between ages 10 and 30, but it can happen at any age.

What causes it?

Let’s first start by explaining about the appendix. The appendix is a part of our intestines, as shown in this drawing:

The appendix is marked by a circle in this drawing.

Even though it’s part of our intestines, the appendix isn’t involved in anything related to food digestion. In fact, no one really knows what it’s there for (although there have been some suggestions in recent years).

Appendicitis occurs most commonly as a result of obstruction of the appendix. As a result, it gets filled with mucus and gets swollen, which causes pressure on the blood vessels going through it. When the blood vessels get pressured, they can’t supply the appendix with enough blood, which causes it to die. Germs see this as an opportunity for a feast, and start accumulating in the area, causing an infection. After this, the appendix can rupture, leading to an inflammation inside our abdomen, which can be life threatening.

This diagram summarizes the process to make it easier to understand -

What causes the appendix to get obstructed in the first place?

That depends on the age of the person with appendicitis:

• In young people – The cause is growth of the lymphoid tissue in the area (the lymphoid tissue is responsible for handling infections)
• In older people – It can occur as a result of a fecalith (a hard mass of feces) or because of a tumor in the area.

How does it feel?

The main thing that people feel when they have appendicitis is abdominal pain. It usually starts near the belly button, and then moves to the lower right side of the belly (but that’s not always the case and it can appear in other places as well). The pain can get worse by moving, sneezing or coughing.

Other things that can be present here are fever, loss of appetite, nausea and vomiting.

Unfortunately, all of these occur in less than half of people, which can sometimes make appendicitis hard to diagnose.

How is it discovered?

When the classic symptoms described above are present, it will be pretty clear to the doctor that this is appendicitis and no further tests need to be done, to save time.

If the doctor suspects appendicitis but is not sure, images of the abdomen using CT scan or an ultrasound may be done.

How is it treated?

The only treatment for appendicitis is surgery, in which the appendix is removed. Also antibiotics are given (since the germs in the appendix cause infection of the area).

What happens after treatment?

When the appendix is taken out on time without any complications, the disease usually goes away with it. However, if it’s not treated on time, the chance of dying from it is higher than 50%.

The bottom line – How do I avoid it?

There is no proven way to prevent appendicitis, but adding more fruit and vegetables to your diet may decrease your risk of having it.

What next?

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