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Doc Talk: Sudden abdominal pain may be an appendix in distress

  • Published Saturday, April 5, 2014, at 10:43 a.m.
  • Updated Tuesday, April 8, 2014, at 5:57 a.m.


In your lower abdomen, you have a small, finger-shaped pouch – your appendix. It doesn’t do much – in fact, doctors aren’t sure exactly what it does – and for the most part, you will never realize it’s there.

That is, you’ll never notice it unless it becomes inflamed, a condition which is called appendicitis. Then, you need immediate medical care in order to prevent a health crisis.

When appendicitis first hits, it can feel like indigestion or a side stitch. However, the pain will typically shift to your right side over several hours, and it will intensify as the swelling in your appendix grows. The pain will also frequently worsen with breathing, sneezing or coughing, and it will definitely increase with movement.

Other appendicitis symptoms include a loss of appetite, nausea, vomiting, abdominal swelling, constipation, diarrhea and fever. These symptoms may be different in children, pregnant women and the elderly, however.

Appendicitis shares several symptoms with other common medical conditions, such as kidney stones, pneumonia and urinary tract infections, which can make it difficult to diagnose. Therefore, if you experience severe abdominal pain, it is imperative to seek medical care quickly.

Typically, appendicitis affects people between the ages of 10 and 30, and it occurs slightly more often in males than females – though it can strike in anyone. In total, more than 250,000 people have their appendixes removed each year in surgeries called appendectomies.

Currently, there are no foolproof ways to prevent appendicitis, as it starts quickly and the cause is usually unknown. Your best course of action is to get medical care as soon as you experience symptoms. If you delay medical care, your appendix could swell and burst, requiring a more complex surgery and increasing your risk of infection.

When you see your doctor, he or she will ask about your symptoms and medical history. You will also undergo a physical examination, which includes abdomen and rectal checks and tests of your blood and urine. The diagnosis process can take several hours to confirm and may be extended if your physician orders a CT scan or ultrasound.

If you have appendicitis, a surgeon will perform the appendectomy as quickly as possible. Traditionally, this surgery has been performed with a single three- or four-inch incision. However, many surgeons these days opt to remove the appendix through several small incisions, which heal quicker and are less invasive than traditional surgery.

This process, called laparoscopic surgery, is further aided by robotics and other growing surgical technology.

After an uncomplicated appendectomy, you will typically go home from the hospital the next day. You may stay longer if there are any difficulties controlling pain, nausea or vomiting or if your appendix had ruptured before surgery.

Within two to three weeks after your surgery, you should be able to resume normal activity. And your missing appendix will never be a problem.

Francie Ekengren is chief medical officer and emergency physician at Wesley Medical Center.

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