Patient education: Appendicitis in adults (The Basics)

What is the appendix? — 

This is a long, thin pouch shaped like a finger. It hangs down from a part of the large intestine, which is also called the colon.

What is appendicitis? — 

This is when the appendix gets infected and inflamed (figure 1). When that happens, it can swell and sometimes burst. This is 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 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.

Will I need tests? — 

Probably. Your doctor will do an exam, press on your belly, and ask about your symptoms.

If the doctor thinks you might have appendicitis, they will order blood tests. They will also do a CT scan if this is available. This is a special kind of X-ray that is very good at diagnosing appendicitis. In some cases, an ultrasound, which uses sound waves to look inside the belly, is used instead.

If CT scan is not available, doctors can diagnose appendicitis based on your symptoms and the results of your blood tests.

How is appendicitis treated? — 

It is treated with surgery to remove the appendix. This can be done in 2 ways:

●Open surgery – The doctor makes a cut ("incision") in the right lower part of the belly. Then, they remove the appendix through the incision.

●Laparoscopic surgery – The doctor makes a few smaller incisions. Then, they insert long, thin tools through the incisions 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 screen to know where to cut and what to remove. Then, they use the tools to remove the appendix.

If your appendix burst, your surgery will probably be more complicated. Your doctor will need to wash away the material that spilled out when the appendix burst. As a result, your incisions 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 might be possible to treat appendicitis with just antibiotics. But, without surgery, there is a chance your appendicitis will come back again. Talk with your doctor if you wish to try to avoid surgery. They can tell you if your type of appendicitis can be treated without surgery, and if so, help you understand the chances it could come back.

If your appendix has burst, but it has been a few days 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 still need surgery later to remove your appendix. This is to make sure there is no tumor in your appendix.

What if I am pregnant? — 

If you are pregnant and think that you have signs of appendicitis, tell your doctors you are pregnant. Doctors use ultrasound or a test called an MRI to check for appendicitis in pregnant people. Laparoscopic surgery can be done during pregnancy.

More on this topic

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