Appendicitis

First, know this

If you think you have appendicitis, do not wait for an office appointment. It needs to be checked in an emergency department the same day, because an inflamed appendix can burst and spread infection in the abdomen.

What is appendicitis?

The appendix is a small pouch at the start of the large bowel. When it becomes inflamed, this is called appendicitis. It can happen at any age but is more common in teenagers and young adults.

What are the signs?

• Pain that often starts around the navel and moves to the lower right of the abdomen over a few hours
• Pain that gets worse with walking, coughing or pressing on the abdomen
• Loss of appetite, nausea or vomiting
• A mild fever

The signs are not always like this, especially in children, older people and pregnant women.

When should I go at once?

Abdominal pain that is getting worse, especially in the lower right, is a reason to go to the emergency department. If the pain suddenly spreads over the whole abdomen or the abdomen becomes hard, call 115. Until it is clear what is wrong, do not take strong painkillers or laxatives, and do not eat.

How is it diagnosed?

An examination, blood and urine tests and imaging such as an ultrasound or a CT scan all help. Other causes of pain, such as gynaecological problems or a urinary infection, are also checked.

Treatment

The usual treatment is surgery to remove the appendix, by laparoscopy or open surgery. In some simple cases antibiotics alone may be chosen, but the illness can come back. This decision is made in hospital with the surgeon.

After surgery

If the appendix has not burst, recovery is usually quicker. A burst appendix needs a longer hospital stay and more antibiotics. Wound care is in the patient guide.