Patient education: Appendicitis in adults (The Basics)

What is the appendix? — The appendix is a long, thin pouch shaped like a finger. It hangs down from the large intestine, which is also called the colon (figure 1).

What is appendicitis? — Appendicitis is the name for when the appendix gets infected and inflamed. If that happens, it can swell and sometimes burst. That's dangerous, because a burst appendix can cause infection in the belly.

What are the symptoms of appendicitis? — The usual symptoms include:

●Severe pain in the lower part of the belly, on the right side (for many people, the pain starts near the belly button and then moves to the lower right side)

●Loss of appetite

●Nausea and vomiting

●Fever

Some people can have different symptoms, such as:

●Stomach upset

●Having a lot of gas

●Irregular bowel movements

●Diarrhea

●Feeling ill

Should I see a doctor? — Yes. Call your doctor or nurse right away if you have the symptoms listed above.

If you do have appendicitis, get treatment as soon as possible. The risk of your appendix bursting is much higher after the first 24 hours of symptoms.

Is there a test for appendicitis? — If you have appendicitis, your doctor might be able to diagnose it just by doing an exam. They can learn a lot about your condition by pressing on your belly and talking with you about your symptoms.

If your doctor is not certain after the exam, they can do imaging tests to see what is causing your symptoms. Imaging tests create pictures of the inside of your body. They might include:

●A CT scan, which is a special kind of X-ray

●An ultrasound, which uses sound waves to look inside your belly

How is appendicitis treated? — The main treatment for appendicitis is surgery to remove the appendix. This surgery can be done in 2 ways:

●Open surgery – During an open surgery, the doctor makes a cut near the appendix that is big enough to pull the appendix through.

●Laparoscopic surgery – During laparoscopic surgery, the doctor makes a few cuts that are much smaller than those used in open surgery. Then, they insert long, thin tools into the belly. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the image on the screen to know where to cut and what to remove. Then, they use the long tools to do the surgery.

If your appendix burst, your surgery will probably be more complicated than it would be if it had not burst. Your doctor will need to wash away the material that spilled out when the appendix burst. As a result, your cuts might be larger or you might spend more time in surgery.

Can appendicitis be treated without surgery? — Yes. But your options will depend on whether or not your appendix burst.

If your appendix has not burst, it's possible to treat appendicitis with just antibiotics. But, without surgery, there is a chance that your appendicitis will come back again. So surgery is still the best treatment in most cases. But talk with your doctor if you wish to try to avoid surgery.

If your appendix has burst, but it has been a few days since this happened and you are feeling well, your doctor might decide not to do surgery right away. The body sometimes forms a wall around the appendix to block off the infection. In this case, your doctor will probably give you antibiotics and watch you carefully until you are well. But you will still need surgery later to remove your appendix. That's because at least 1 in 10 people with a burst appendix have a tumor in their appendix that can only be removed by surgery.

What if I am pregnant? — If you are pregnant and think that you have signs of appendicitis, tell your doctors that you are pregnant. Doctors use ultrasound or a test called an "MRI" to check for appendicitis in people who are pregnant.

More on this topic

Patient education: Appendicitis in children (The Basics)
Patient education: Appendectomy (The Basics)