When it stings in the lower abdomen, many people first think of appendicitis. In truth, however, other, less specific symptoms usually point to it. FITBOOK asked an expert what you need to know about inflammation.
Untreated appendicitis (technical term: appendicitis) can lead to serious and life-threatening complications. In the worst case, the appendix ruptures and faeces and bacteria enter the abdominal cavity. What causes appendicitis and what symptoms should you definitely see a doctor for?
What are the causes behind appendicitis?
In appendicitis, not the entire appendix, but its appendage – the so-called appendix – is inflamed. As emergency and general practitioner Dr. medical Falk Stirkat explains in the FITBOOK interview, the causes of appendicitis are not really clear. «It is assumed that clumps of faeces block the entrance to the appendix and as a result there is a relative undersupply of blood, which promotes infection with intestinal bacteria.» The appendix can become blocked relatively easily because it has no exit. What was once assumed – that cherry stones or swallowed chewing gum clog the entrance to the appendix – has now been refuted.
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What are the symptoms of appendicitis?
Unfortunately, it is also not possible to clearly define how appendicitis becomes noticeable. According to Stirkat, it is one of the most difficult diseases to diagnose. «Abdominal pain in itself is always a very diffuse sign that is often not particularly easy to classify.» Those that can indicate appendicitis usually begin in the area around the navel and migrate to the lower left abdomen.
Another indication of appendicitis is pain when lifting the leg, which is why patients should often jump if they suspect it. Typical symptoms also include fever, nausea, loss of appetite and vomiting. If the abdominal pain is accompanied by diarrhea, Stirkat says it makes appendicitis unlikely, but doesn’t rule it out entirely.
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What to do if symptoms suddenly appear?
Even if the symptoms are bearable – Stirkat urgently advises you to see a doctor if the symptoms mentioned occur. If appendicitis is not stopped, there is a risk of pus deposits in various parts of the abdomen, which can result in permanent inflammation. This can disrupt and even paralyze intestinal activity. «The inflamed intestine can rupture, which can lead to bacterial inflammation of the peritoneum and subsequent blood poisoning,» adds Stirkat, «and in the worst case, death.»
In general, acute abdominal pain should always be checked out by a doctor, “especially if it Not accompanied by diarrhea”. According to the emergency medic, they may have distracted from potentially even more serious illnesses.
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What treatment options are there?
A diagnosis of appendicitis used to mean one thing: operate, and quickly. As Stirkat reports, studies have now shown that uncomplicated appendicitis in many cases goes away without intervention. Sometimes it is just an irritation of the appendix – in some cases a preliminary stage of appendicitis, which is usually over after a few days without treatment.
In children and adolescents in particular, attempts are made to avoid an operation. And adults are also treated with antibiotics and painkillers, at least in the very acute stage, in order to alleviate the inflammation in view of an operation. If the therapy does not work, the appendix must be surgically removed.
What happens during an appendix operation?
If the appendix has not yet ruptured, many doctors prefer to do a laparoscopy. This involves less wound pain and also has the advantage (in female patients) that the condition of the genital organs can also be checked. Any malignant changes present in this area may have been masked by the symptoms of appendicitis. After a laparoscopy, you can usually leave the hospital after three days.
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After a ruptured appendix, you can no longer do without an abdominal incision. The surgeon must open the abdomen liberally and irrigate (to eliminate germs) to remove the inflamed tissue. «Fortunately, it’s a routine operation with very low risk,» says Stirkat. Possible complications are largely limited to those typical of an operation (e.g. wound healing disorders) or anesthesia. After the procedure, the patient usually has to stay in the hospital a few days longer and is on sick leave for up to two weeks. Then Scania is the order of the day!