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Diseases & Conditions

Appendix

AppendixCausesMedicationsPreventionRisk FactorsSymptomsTreatment

What is Appendix?

The appendix is a small extension at the point where the large intestine begins. It is shaped like a pouch and when it becomes inflamed the affliction is called appendicitis.

Causes

The appendix can become inflamed due to several different factors. Fecal matter can pile up in the appendix causing inflammation. Occasionally, a foreign body, swallowed accidentally, can become lodged in the appendix causing appendicitis. Lymphoid hyperplasia can also lead to appendicitis. Although rare, a tumor growing in or near the appendix can lead to inflammation. Blockage of the appendix causes an increase in bacterial production and intraluminal pressure. Eventually this cuts off blood flow to and from the appendix. The appendix will necrotize and combined with the bacterial infection eventually cause severe abdominal pain.

Medications

The pain can be treated with morphine or other pain killing agents. However this is not a cure. Untreated, the infection caused by the inflamed or burst appendix will lead to death if not treated.

There are several different medications that are used to treat infections causes by appendicitis or to prevent post surgical infection. These include Flagyl, Cipro, Ampicillin, and Levaquin. Other regimens may include piperacillin, ticarcillin or imipenem. In some cases where infection is severe a therapy of alternating antibiotics is required to destroy resistant bacteria. Many patients suffering from appendicitis will also suffer from dehydration. As such, IV fluids are usually part of the treatment regimen.

Prevention

The best way to prevent appendix inflammation is to lead a healthy lifestyle. Try to maintain a diet high in antioxidants and fiber. The fiber helps foodstuffs move through the large intestine thus preventing blockage. Exercise regularly as this helps enhance gut motility and also prevents blockage. Try not to smoke and drink in moderation. Pay attention to the body's symptoms and seek medical assistance as quickly as possible when appendicitis is expected as this will help prevent a burst appendix and a septic infection called peritonitis or abscesses from forming.

Risk Factors

There are several risk factors that can lead to appendicitis:

  • Low fiber diet.
  • Diet filled with refined carbs such as white flour and white sugar.
  • Amebiasis or intestinal invasion by a uni-celled parasite.
  • Gastroenteritis caused by bacteria.
  • Adenovirus
  • Mumps
  • Coxsackievirus B-this virus can cause inflammation of the appendix.

Symptoms

While symptoms can vary there are a few consistent indications.

  • Belly button pain-the first symptom is traditionally centrally located around the navel. The pain will begin as a slight ache and become more severe over time.
  • The pain moves-as the disease progresses the pain will move toward the lower right portion of the abdomen.
  • Vague symptoms-while vomiting, fever, diarrhea and nausea can be symptomatic of several different illnesses, in conjunction with acute abdominal pain, it is likely to be appendicitis.
  • Increased pain when coughing or walking-the patient has a distinct desire to stay very still.

Treatment

The traditional treatment is surgical intervention. Typically a surgeon will go into the abdomen and remove the appendix. This surgery is called an appendectomy. In situations where the appendix has ruptured and an abscess or peritonitis has formed then treatment will first focus on clearing up the infection and then removing the appendix. A CBC blood screen is usually completed prior to surgery to determine the white blood cell count. Usually these cells are quite elevated confirming infection. Should the white blood cell count exceed a certain level than a burst appendix is a probability as the higher white blood cell count indicates abdominal infection.