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Appendicitis

Published by Bupa's health information team, July 2009.

This factsheet is for people who have appendicitis, or who would like information about it.

Appendicitis is the swelling (inflammation) of the appendix. The appendix is a small 'blind-ended' tube attached to the large bowel (colon) and located in the lower right side of your abdomen.

• About appendicitis
• Symptoms of appendicitis
• Complications of appendicitis
• Causes of appendicitis
• Diagnosis of appendicitis
• Treatment for appendicitis
• Questions and answers
• Related topics
• Sources

About appendicitis

The appendix is a small pouch attached to the end of the large intestine. At present the appendix has no known function in humans.

The appendix can become swollen as a result of infection or blockage (obstruction), and this is called appendicitis. Appendicitis needs prompt treatment in hospital to remove the appendix (the surgery is known as appendicectomy).

Appendicitis is most common in people aged between 10 and 30, but you can get it at any age. Men are slightly more likely to have appendicitis than women.

In the UK, each year around 35,000 people get appendicitis. It's the most common reason for people to have to go to hospital for emergency treatment for a problem with the abdomen (tummy). It's also the most common surgical emergency in children. About one in seven people will need to have their appendix removed.

Symptoms of appendicitis

Symptoms of appendicitis include:

• pain in the abdomen - this usually starts in the centre and then moves to the lower right side of the abdomen
• pain when you walk
• high temperature
• feeling sick or vomiting
• loss of appetite
• constipation or diarrhoea
• testicular pain in men

These symptoms aren't always due to appendicitis, but if you have them, see your GP.

Complications of appendicitis

If appendicitis isn't treated promptly, the appendix can burst (perforate), causing problems such as a severe bowel infection (peritonitis). An abscess (containing pus) might also form within the abdomen and could need draining.

If you're pregnant

If you have appendicitis while you're pregnant, your symptoms may be different from those listed above - for example the pain in your abdomen may be higher than it usually is for appendicitis. It's important that you see your GP if you're concerned about your symptoms.

Causes of appendicitis

The cause of appendicitis isn't known, although there are various theories. It's thought that it may be caused by a blockage (obstruction), which causes the pressure to rise within the appendix and makes inflammation more likely. Possible causes for the obstruction are:

• constipation
• cancer of the caecum (the point where the large intestine and the small intestine join)
• a condition in which normal cells that resemble lymph tissue grow rapidly (this is known as lymphoid hyperplasia)
• diet - studies have shown that appendicitis may be less common in people with high-fibre diets

Diagnosis of appendicitis

Your GP will ask you about your symptoms and examine you. This will usually involve feeling your abdomen to find out where the painful areas are. He or she may also ask you about your medical history.

There is no single test for diagnosing appendicitis. However, to help make a diagnosis, your doctor may do some tests including:

• urine tests
• blood tests
• a CT scan, which uses X-rays to make a three-dimensional image of the body
• an ultrasound scan, which uses sound waves to produce an image of the inside of your body
• for women, a pregnancy test to check whether you're pregnant

Treatment for appendicitis

If appendicitis is suspected by your GP, you will usually need to go to hospital as soon as possible.

The doctors at the hospital will review you and your tests and if it is felt that your symptoms indicate that you have appendicitis you will need an operation.

The operation to remove your appendix is called an appendicectomy. It's done under general anaesthesia, which means you will be asleep during the operation. Nowadays this is usually done by keyhole surgery (laparoscopy). You will usually be able to go home after a few days in hospital and recover at home.

If you have a more traditional operation, a larger cut will be made in your lower abdomen (tummy) and the appendix removed through the operation site. This may result in a longer recovery period in hospital.

Very occasionally you may just be put on a course of antibiotics and observed.

It's possible that once your appendix has been removed and your doctor has examined it, you will find out that the cause of your symptoms wasn't appendicitis after all. However, because the risks of complications if treatment for appendicitis is delayed, the benefits of having the surgery outweigh the risks or inconvenience.

Related topics

• Appendix removal (appendicectomy)
• General anaesthesia

Sources

• Appendicitis. GP Notebook. www.gpnotebook.co.uk, accessed 3 April 2009
• Humes DJ, Simpson J. Acute appendicitis. BMJ 2006; 333:530-4
• Appendicitis. About this condition. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 26 March 2009
• Simon C, Everitt H, Kendrick T. Oxford handbook of general practice. 2nd ed. Oxford: Oxford University Press, 2006:464
• Bundy DG, Byerley JS, Liles EA, et al. Does this child have appendicitis? JAMA 2007; 298:438-51
• Brender JD, Weiss NS, Koepsell TD, et al. Fiber intake and childhood appendicitis. American Journal of Public Health. 1985; 75(4):399-400
• Personal communication, Dr Wendy Simpson, General Practitioner, 7 April 2009

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: July 2009