Wright State University Sports Medicine Blog


A real pain in the Abs

IMG_0472 Do you have pain in the stomach? There are many things that it could be and one of those things is appendicitis. Appendicitis is an inflammation of the appendix. The appendix is a small tube of tissue about 3 ½ inches long that attaches/extends from the large intestine.

With current medical knowledge, there appears to be no specific function that appendix serves. We do know however, that a person can live without an appendix. Appendicitis is not an injury that is preventable although studies show that people who eat foods high in fiber are less likely to have appendicitis. In the United States, 1 in 15 people will get appendicitis and it is most common between the ages of 10 and 30.

Appendicitis can be caused by a blockage of some kind in the gastrointestinal tract. These blockages can include feces, a foreign object, or a tumor. Signs and symptoms of appendicitis can vary from person to person but the most universal symptoms include: pain around the belly button, reduction in appetite, nausea, vomiting, and a low fever. The pain may be minor at first, growing more sharp and severe as time goes on. Patients typically complain of increased pain with walking and coughing but symptoms reduce when lying flat and immobile. Other signs/symptoms are: chills, constipation, diarrhea, fever, abdominal swelling, inability to pass gas, painful urination, severe cramps, and shaking. If the appendicitis continues untreated and undiagnosed, at about 12 to 24 hours the pain typically radiates to the lower right quadrant of the abdomen to a location referred to as McBurney’s Point. Seek medical attention if the patient has these signs and symptoms. Also make sure not to drink, eat, or take any medications due to the increased risk of rupture and they increase in the chance for surgical intervention.

There are two things that can happen as a result of an inflamed appendix. First an abscess can form outside the inflamed appendix. The abdominal cavity will form a wall of scar tissue around the abscess as a mode of self-defense. This keeps the infection secluded to one place preventing it from seeping throughout the abdominal cavity. Unfortunately, an abscess can’t be identified without surgery, but an abscess is typically not as severe as a ruptured appendix. If the appendix becomes so inflamed that it ruptures, there are a few things that may happen. The pain may lessen for a short amount of time and the symptoms may completely resolve. This is not to be taken lightly. If the appendix ruptures, infectious material that the appendix holds can spill out into the abdominal cavity. Once the lining of the abdominal cavity becomes infected (called peritonitis) the pain gets much worse and the patient becomes sick again. If this happens it can be fatal unless treated with strong antibiotics.

How do you tell if it is appendicitis, an ovarian cyst, the flu, Chron’s disease, bladder or urinary tract infection(UTI), gastritis, intestinal infection, or food poisoning? The medical tests that confirm appendicitis are: abdominal exam, urine analysis, rectal exam, blood test, and/or an abdominal CT/Ultrasound. Once appendicitis has been diagnosed there is only one form of treatment; appendectomy. An appendectomy is where a Physician surgically goes in and removes the appendix. Since appendicitis is difficult to diagnose, if a Physician does go in to remove the appendix and it is not inflamed the Physician will usually still remove the appendix for good measure. If the Physician finds an abscess upon surgery, then it becomes a two-step process to remove the appendix. First the abscess must be drained to release the infection surrounding the appendix and then the appendix is removed. This is to ensure that during surgery the body does not absorb any of the infection from the abscess.

After an appendectomy, recovery time is fairly quick. Within 12 hours post-surgery the patient is up and moving around. Usually if everything goes well, return to full activity is within two or three weeks. If the surgery is done by laparoscope, the incision is smaller and recovery can be faster. If however, after surgery the patient has uncontrolled vomiting, increased pain in the abdomen, dizziness, blood in vomit or urine, redness in or around the incision, fever, or purulent in or around the incision, refer back to the Physician immediately.

The main thing to remember in the treatment of appendicitis is early recognition of the signs and symptoms and referral time. A Physician should see other conditions that can mimic appendicitis; there is no reason to wait, for it is better to be safe than sorry.

Resources:

http://appendicitis-symptoms.com

http://www.youtube.com/watch?v=MAppEy9Umcg

http://www.meddean.luc.edu/lumen/MedEd/Radio/curriculum/Surgery/appendicitis1.htm

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