You seem to hear about appendicitis all the time, but only about 5% of people get it.
It’s most common in children, ages 10 to 19. It’s not hereditary or preventable. But when an appendix gets infected or bursts — causing appendicitis — you’re in trouble, because it’s a life-threatening emergency that you shouldn't ignore.
The appendix is an appendage that hangs off the beginning of the colon, or large intestine. It doesn’t have a function, and we all can live without it. If you take a balloon and poke your finger through it, that’s what the appendix looks like. It’s about the size of your little finger.
How an appendix gets infected or bursts
An appendix gets infected when there’s an obstruction in your large intestine. It gets blocked up, and an infection can occur. We don’t always know what causes it. In some cases, it’s due to feces getting into the appendix, which is located near where your feces transitions from a liquid to a solid, causing bacteria to multiply.
Appendicitis happens quickly — in some cases, several hours after the obstruction occurs. The earlier it’s treated, the better the outcome. If you get it treated quickly (within 12 hours), you’ll be in and out of the hospital within a day.
Warning signs of appendicitis
Because the appendix can rupture without treatment, everyone needs to recognize the warning signs of appendicitis, progressing from first to last:
- Sudden pain around the belly button or the upper abdomen — a gnawing, aching pain unlike anything you’ve ever felt
- Pain that intensifies over a couple of hours and migrates to the lower right abdomen (the area around right hip bone)
- A lack of energy and loss of appetite
- The condition progressively worsens, perhaps leading to nausea
- Constipation, inability to pass gas, or diarrhea
- A fever of 99-102 degrees
If the pain goes away, it’s likely not appendicitis. If not, and you find yourself at or near the bottom of the symptoms list, get to the hospital.
Treatment for appendicitis
Surgery to remove the appendix
- Standard surgery: This surgery is called an appendectomy. It’s often performed to prevent the appendix from rupturing. After giving the patient antibiotics, the surgeon removes the appendix through three half-inch incisions.
- Laparoscopy: Surgery is done using a fiber-optic instrument that’s used for viewing inside the abdomen and permitting a surgical procedure. The incision is smaller that way, and the recovery is faster.
Antibiotics instead of surgery
This is being tested at Ohio State as an alternative to surgery. Within a day, patients can get up and move around. They can resume normal activities in a couple of weeks.
What happens if your appendix bursts?
There’s a real problem in waiting too long to treat appendicitis. Your symptoms might be severe, then you’ll suddenly feel better. This could occur when the appendix actually ruptures. About three hours later, you’ll get really sick, because infection is freely floating around the belly.
This situation can lead to sepsis, a possibly life-threatening condition caused by the body’s response to an infection. Care becomes much more complicated, and you might find yourself being rushed to the hospital in an ambulance.
In this situation, an abscess forms where the appendix was, or the appendix freely ruptures in the abdomen. We’ll put a drain by the appendix to remove toxins. We don’t remove the appendix, because that can cause more harm at this point. Patients might find themselves in the hospital for weeks.
We find the abscess, drain it and eventually send home patients on antibiotics.
Surgery after an appendix bursts
Eventually, about six months after an appendix bursts, we’ll perform a laparoscopic appendectomy or a surgery called an interval appendectomy.
Again, we administer antibiotics to fight possible peritonitis, or the infection of the abdominal cavity’s lining. General anesthesia is given, and the appendix is removed through a short incision in the right lower quadrant of the abdomen.
The bottom line: You don’t want to be in this situation. Don’t wait to get medical care if you notice potential signs of appendicitis.
When an emergency strikes, turn to The Ohio State University Wexner Medical Center’s full-service, state-of-the-art emergency departments
Our facilities are equipped to handle any medical emergency.
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