One of the most common surgical conditions is appendicitis. Let's discuss its causes and how to treat it to prevent life-threatening complications.
The appendix is a small, sac-like part of the large intestine located at the end of the cecum. It lies indirectly at the junction of the small intestine and the large intestine. Because it is located at the edge and does not connect the two parts of the digestive tract, it is often called the "appendix."
Despite its small size, the appendix contains numerous lymph nodes that play a vital role in fighting infection and inflammation. The scientific term for the appendix is appendix. When the appendix becomes inflamed, it is called appendicitis. Appendicitis can be divided into acute and chronic conditions based on the duration of the disease and its symptoms.
Causes of Appendicitis
Appendicitis can be caused by many things, such as a blockage in the appendix due to hardened feces. This can occur in people who frequently experience constipation or difficulty passing stool, which can lead to a buildup of hardened stool. The appendix also contains lymph nodes. If these glands become inflamed, it can cause swelling and even inflammation of the appendix.
Inflammation of the appendix can also be caused by an infection. This infection can originate within the digestive tract, causing direct inflammation, or it can spread from other parts of the body. If inflammation occurs in the organs surrounding the appendix and the infection spreads, it can lead to appendicitis. A common condition is inflammation of the ovaries, which are located near the appendix. If complications arise, it can lead to appendicitis.
Symptoms of Appendicitis
When someone experiences appendicitis, depending on its location, they often experience pain in the lower right side of the abdomen. Due to the inflammation, it is usually accompanied by fever and often nausea and vomiting. In acute cases, the pain usually worsens when walking, coughing, or bending over. In chronic cases, the pain is usually tolerable and often comes and goes. Chronic appendicitis can be caused by many factors, such as partial or complete obstruction.
Because it's not a complete blockage, the inflammation doesn't progress quickly, so the symptoms aren't as pronounced. If you experience similar symptoms and they don't improve, it's highly recommended to see a doctor immediately for a thorough examination and prompt treatment. Untreated acute appendicitis can lead to complications such as a ruptured appendix, which can lead to widespread inflammation and infection, which can be life-threatening.
Risk Factors
Risk factors for appendicitis vary depending on the underlying cause. If the primary cause is a fecalith obstruction, or hardened stool, it's crucial to avoid constipation. In this condition, a risk factor is a lack of fiber in foods like fruits and vegetables. Furthermore, drinking enough water is crucial to support proper metabolism.
Regular exercise can also help improve metabolism and digestive function. If appendicitis is caused by inflammation of the lymph nodes, the underlying cause must first be determined, such as whether there are other infections present in the body. It's also important to consider whether there are other infections around the appendix to determine whether the inflammation originates within the digestive tract or from other nearby organs. Because the appendix is located relatively close to the reproductive organs, it's important to consider whether there are other risk factors in the reproductive area that could lead to infection spreading to the digestive tract, particularly the appendix.
As explained, in addition to its proximity, the appendix also contains lymph nodes, which play a role in fighting inflammation or infection in the body. Therefore, the appendix is susceptible to inflammation.
Diagnosis of Appendicitis
Anamnesis
To confirm a diagnosis of appendicitis, it is crucial to conduct a medical interview or history taking regarding the patient's symptoms and symptoms. Typical symptoms such as right lower abdominal pain accompanied by fever, nausea, and vomiting should be considered when suspecting appendicitis. The duration of symptoms is also crucial in determining whether the suspected appendicitis is acute or chronic.
By understanding this, further action can be taken more clearly, whether surgery is necessary immediately or can be postponed. It's also important to ask about the characteristics of the pain experienced to assess whether the condition is acute or chronic. Acute conditions are usually accompanied by complaints of continuous pain, while chronic conditions can be intermittent. It's also important to determine whether there are factors that aggravate or relieve the pain.
In acute appendicitis, pain is usually worsened by activities that increase pressure on the abdominal area, such as coughing, bending, or walking. In acute cases, over-the-counter pain relievers are usually unable to significantly relieve the pain. In chronic cases, medication may relieve the pain in the lower right abdomen. It's also important to ask whether the pain originated in the same location, the lower right abdomen, or whether it previously originated in other areas. Or, conversely, whether the pain in the lower right abdomen has spread to other areas of the body.
This is important to help determine whether the primary cause of the symptoms is the appendix, whether it has spread from another organ to the appendix, or whether the inflammation and infection have spread to surrounding organs. Furthermore, the intensity of the pain can also help determine whether immediate surgery is necessary. If the pain is unbearable, it is likely an acute appendicitis condition, requiring immediate surgery to prevent complications.
Physical examination
The doctor will also perform a physical examination to determine whether the diagnosis is appendicitis. Routine tests will include vital signs such as blood pressure, pulse, respiratory rate, and body temperature. When experiencing pain, the body's reaction usually causes an increase in blood pressure. In cases of acute appendicitis that have developed complications, blood pressure can drop due to shock, requiring immediate treatment to maintain stability.
Pulse and respiratory rates are typically elevated in acute appendicitis. Body temperature is also typically elevated due to inflammation and is often accompanied by infection. In chronic appendicitis, however, vital signs may be normal.
There are several specific tests that will likely yield positive results in patients with appendicitis. Typically, a test will check for tenderness in the lower right abdomen, where the appendix is located.
Additionally, an examination will be performed by bending the right knee and pushing it toward the abdomen to see if the pain worsens. Another examination may involve lying on the left side, then pulling the right leg toward the back of the body and assessing whether the pain is worsening.
You can also check for rebound tenderness or rebound pain. When you press on the lower right abdominal area and release it, check to see if you feel any pain.
Supporting investigation
In addition to primary examinations such as a history and physical examination, the doctor may also perform supporting tests. One such test is a blood test. This test will typically reveal an elevated white blood cell count due to inflammation and infection of the appendix. For sexually active women experiencing lower right abdominal pain, a urine test should also be performed to assess the possibility of an ectopic pregnancy or one in the fallopian tubes, which are located near the appendix.
This can be done to help rule out possible differential diagnoses or other diagnoses with similar symptoms, increasing confidence in further action. Other supporting tests that can be performed include abdominal ultrasound and abdominal CT scans.
This examination is also performed to determine the cause of the lower right abdominal pain. It can be due to appendicitis or something else. This examination is often performed in cases of prolonged lower right abdominal pain, but the symptoms are not typical of appendicitis. It can usually occur in cases of chronic appendicitis.
Therapy
Treatment for appendicitis is usually tailored to the patient's symptoms. For pain, pain relievers will be given to improve comfort during further examinations. However, pain relievers should be administered after the initial examination, as administering them beforehand can bias the results and complicate the diagnosis. For example, in cases of appendicitis, tenderness should be present, but due to the use of pain relievers, the test results are negative. It is highly recommended that the examiner inform the patient of any medications previously taken. For fever, antipyretics will be given to help reduce the fever. For nausea and vomiting, antiemetics will be given to address the symptoms.
If needed, antibiotics can also be given to help treat the infection. Appendicitis that is usually not responsive to medication is usually surgical. However, the urgency depends on the condition. In cases of acute appendicitis or if it has ruptured, surgery is required immediately. In cases of chronic appendicitis, regular monitoring by a doctor is required. There are many types of surgical methods available. In cases of early appendicitis, laparoscopy is usually possible.
This method requires a smaller incision and a faster recovery time. Another option is an open appendectomy. This is typically performed in cases that cannot be treated with laparoscopy alone, as it requires confirmation that the area around the appendix is free of infection. However, if the appendix has ruptured, causing widespread infection and peritonitis, a laparotomy is typically performed. This is crucial to address the infection and prevent further complications. However, the patient's condition should be assessed carefully to determine the appropriate method. The surgeon can then make a decision based on various considerations.
Prevention
Preventing recurrent appendicitis involves avoiding various risk factors. Maintaining a balanced digestive system by consuming a nutritious diet, especially one high in fiber, drinking enough water, and exercising regularly is crucial. Paying attention not only to the digestive system, but also to surrounding organs can be a risk factor for appendicitis. Maintaining the reproductive system is crucial to prevent inflammation or infection, which can increase the risk of infection spreading to the appendix. Regular medical check-ups are also highly recommended for screening before the disease and its complications develop.
Complications
Acute appendicitis, a common complication of appendicitis, is acute appendicitis. Because it is acute, it requires immediate treatment. If left untreated, the appendix can rupture, spreading the infection and often leading to sepsis, which increases the risk of death. When the appendix ruptures, inflammatory cells can leak out, causing inflammation of the surrounding area, a condition called peritonitis. When peritonitis occurs, a common symptom is a painful abdomen.
The normally soft abdomen can feel hard, like a board, when pressed. Not only can appendicitis originate from other organs, but it can also lead to complications in the form of inflammation that spreads to surrounding organs, such as the reproductive system, particularly the ovaries, which are located adjacent to the appendix.
In some cases, appendicitis becomes inflamed and surgery is delayed, causing inflammation of the reproductive system, leading to complications such as the need to remove the ovaries during the appendectomy. Furthermore, if acute appendicitis is not properly treated, it can also lead to widespread infection through the bloodstream, known as sepsis. If left untreated, this condition can lead to severe sepsis, shock, and even death.
When to See a Doctor?
If you experience symptoms typical of appendicitis, such as lower right abdominal pain, fever, nausea, and vomiting, especially if the pain is unbearable, it is highly recommended to see a doctor immediately. If necessary and the results suggest appendicitis, a referral to a surgeon will be made for further examination and appropriate therapy. Written by Dr. Valda Garcia. Reviewed by Dr. Ernest Eugene.
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