Appendicitis is a bacterial infection of the worm-shaped appendage (appendix) of the caecum. The appendix protrudes from the first part of the caecum, is hollow on the inside and approximately ten centimeters long. It has no significant function in humans. An appendicitis usually occurs very suddenly.
The cause of appendicitis is not always clear. It often occurs after disturbances in the intestinal functions, when not excreted stool residues have become solidified and small lumps have formed. Due to the closure, the caecum cannot empty itself. As a result, bacteria can multiply there and lead to inflammation. Then the appendix is swollen and filled with pus. Appendicitis is not contagious.
The caecum is located at the transition from the small intestine to the large intestine, in the lower right abdomen. Appendicitis usually begins with a sudden, severe pain around the navel and spreads to the lower right abdomen. Because the location of the caecum may vary, the pain can also occur at a slightly different place. Sometimes, there are symptoms prior to the pain, such as decreased appetite, nausea or vomiting. The patient has almost always increased temperature and a feeling of general malaise. Many people suffer from pain when touching and releasing the abdomen and while coughing and laughing.
The doctor makes the diagnosis of appendicitis on the basis of the symptoms, in combination with several examinations:
- Physical examination of the abdomen.
- Laboratory tests of urine and blood.
- Ultrasound examination. In an ultrasound, the caecum can be made visible. Other organs may also be viewed.
- CT scan. When the caecum cannot be clearly viewed by ultrasound, a CT scan of the abdomen is usually made.
Women are sometimes difficult to diagnose, because the symptoms match the symptoms of inflammation of the ovaries. In an ultrasound is not always clear to see whether it's an appendicitis or an inflammation of the ovaries.
In case of an appendicitis, the appendix must be surgically removed. This is done under anesthesia and nowadays almost always by means of keyhole surgery (laparoscopy). In this operation, a pair of small holes (usually three) are made in the abdominal wall. The doctor inserts instruments through these holes and a small camera with light source and removes the appendix. A keyhole operation creates only a small wound and therefore recovery goes more rapidly than with a conventional operation, in which an incision is made in the lower abdomen.
When surgical intervention is done early enough, an appendicitis has a good course and the risk of a fatal ending is small. The recovery is usually rapid and complete.
When appendicitis is not treated in time, the appendix can burst. This will make the stool and pus full of bacteria flow into the abdominal cavity, causing a peritonitis. This is a serious condition, in which severe pain is felt throughout the entire abdomen. The prognosis is less favorable then. This complication was formerly fatal, but nowadays several operations and a long recovery period is required.
- Appendicitis is often caused by hard lumps of stool. These arise when the stool slowly passes through the intestines. By ensuring proper discharge of stool through the intestines, the risk of appendicitis is lower. To prevent constipation, one should drink enough, eat sufficiently high-fiber products (wholemeal bread and wholemeal pasta) and do exercises.
- Swallowed seeds of cherries, plums, etc. cannot enter the appendix, which is much too narrow. Therefore, there is no need to fear for appendicitis, due to a swallowed seed.