Appendicitis occurs when the appendix becomes inflamed and filled with pus. Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen.

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  What is appendicitis?

  Appendicitis is an inflammation of the appendix, a finger-shaped pouch that projects from your colon on the lower right side of your abdomen.

  Appendicitis causes pain in your lower right abdomen. However, in most people, pain begins around the navel and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes severe.

  Although anyone can develop appendicitis, most often it occurs in people between the ages of 10 and 30. Standard treatment is surgical removal of the appendix.

  
  

  How does it form?

  A blockage in the lining of the appendix that results in infection is the likely cause of appendicitis. The bacteria multiply rapidly, causing the appendix to become inflamed, swollen and filled with pus. If not treated promptly, the appendix can rupture.

  
  

  Types of appendicitis

  Mainly there are two types of appendicitis

  1. Acute appendicitis
  2. Chronic appendicitis

  
  

  Causes of appendicitis

  • - Abdominal injury or trauma.
  • - Blockage at the opening where the appendix connects to the intestines.
  • - Digestive tract infection.
  • - Inflammatory bowel disease.
  • - Growths inside the appendix.
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  Symptoms of appendicitis

  • - Sudden pain that begins on the right side of the lower abdomen.
  • - Sudden pain that begins around your navel and often shifts to your lower right abdomen.
  • - Pain that worsens if you cough, walk or make other jarring movements.
  • - Nausea and vomiting.
  • - Loss of appetite.
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  Diagnosis

  Tests

  • • - Physical exam to assess your pain. Your doctor may apply gentle pressure on the painful area. When the pressure is suddenly released, appendicitis pain will often feel worse, signaling that the adjacent peritoneum is inflamed.
    • Your doctor may also look for abdominal rigidity and a tendency for you to stiffen your abdominal muscles in response to pressure over the inflamed appendix (guarding).
    • Your doctor may use a lubricated, gloved finger to examine your lower rectum (digital rectal exam). Women of childbearing age may be given a pelvic exam to check for possible gynecological problems that could be causing the pain.
    • - Blood test. This allows your doctor to check for a high white blood cell count, which may indicate an infection.
      - Urine test. Your doctor may want you to have a urinalysis to make sure that a urinary tract infection or a kidney stone isn't causing your pain.
    • - Imaging tests. Your doctor may also recommend an abdominal X-ray, an abdominal ultrasound, computerized tomography (CT) scan or magnetic resonance imaging (MRI) to help confirm appendicitis or find other causes for your pain.
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  Self-diagnosis

  Pain is usually the first symptom. The pain often starts near the belly button and moves toward the lower right side. Pain occurs rapidly and gets worse in a matter of hours. Pain is worse when you take deep breaths, cough, sneeze, or move.

  
  

  Diagnosis by doctor

  To help diagnose appendicitis, your doctor will likely take a history of your signs and symptoms and examine your abdomen. Tests and procedures used to diagnose appendicitis include: Physical exam to assess your pain. Your doctor may apply gentle pressure on the painful area.

  
  

  Severity

  A panel of acute care surgery experts reviewed the literature and developed a DSS for acute appendicitis as follows:

  - Grade 1: inflamed

  - Grade 2: gangrenous

  - Grade 3: perforated with localized free fluid

  - Grade 4: perforated with a regional abscess and

  - Grade 5:  perforated with diffuse peritonitis.

  
  

  Risks and complications

  - A ruptured appendix. A rupture spreads infection throughout your abdomen (peritonitis). Possibly life-threatening, this condition requires immediate surgery to remove the appendix and clean your abdominal cavity.

  - A pocket of pus that forms in the abdomen. If your appendix bursts, you may develop a pocket of infection (abscess). In most cases, a surgeon drains the abscess by placing a tube through your abdominal wall into the abscess. The tube is left in place for about two weeks, and you're given antibiotics to clear the infection.

  
  

  During the surgery

  - Reaction of anaesthesia: Before performing an appendix removal surgery, a person might be put under the influence of anaesthesia in order to eliminate the pain which would likely expose them to complications like difficulty in breathing during the surgery, depending upon how their body reacts to it.

  - Bleeding: If a person is suffering from severe appendicitis, it is possible that the appendix might lead to massive rectal bleeding which can be caused by severe gastrointestinal hemorrhage from an appendicle stump. However, such cases are considered to be extremely rare.

  - Inflammation caused by bursting of appendix: During an appendectomy, the appendix may burst, causing inflammation followed by redness or infection around the abdominal area.

  - Bowel Obstruction: Following an abdominal surgery, there might be subsequent bowel obstruction due to the formation of adhesions around the appendix.

  - Infection of the wound: As cuts or incisions are made in the skin while performing a surgery, it might lead to an infection around the area of the wound, causing symptoms like redness, swelling or bleeding, followed by pain and fever.

  -Injury to the nearby organs: Although least likely, a surgical procedure might cause damage to the nearby organs and tissues which can also lead to the development of a scar tissue and can possibly cause bowel obstruction.

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  If left untreated

  If appendicitis is not treated, the appendix can burst and cause potentially life-threatening infections.

  
  

  Prevention

  There's no proven way to prevent appendicitis. Eating a high-fiber diet with lots of whole grains and fresh fruits and vegetables may help, although experts can't explain why.