Appendicitis

“I recently went to a new doctor and noticed he was located in something called the Professional Building. I felt better right away.” - George Carlin

According to the Health & Science section on Time.com, “Appendicitis afflicts roughly one in 10 people during their lifetime and accounts for more emergency abdominal surgeries than any other ailment.” Yet despite its commonality, it is very difficult to diagnose. Doctors use physical exams and CT scans but are frequently wrong. Since a burst appendix can be fatal, in case of doubt, doctors will operate. In 3% to 30% of all surgeries for appendicitis, the actual cause of abdominal pain is found to be constipation, gastroenteritis or ovarian cysts, for example. Also shockingly, while waiting for test results, as many as 45% of surgeries happen too late, after the appendix has already ruptured. The Time article then goes on to describe a new urine test to detect appendicitis but it’s in clinical trials and may be three years away from general practice.

According to eMedicineHealth.com,

Appendicitis typically begins with a vague pain in the middle of the abdomen often near the navel or "belly button" (umbilicus). The pain slowly moves to the right lower abdomen (toward the right hip) over the next 24 hours. In the classic description, abdominal pain is accompanied with nausea, vomiting, lack of appetite, and fever. All of these symptoms, however, occur in fewer than half of people who develop appendicitis. More commonly, people with appendicitis have any combination of these symptoms. … Children and the elderly often have fewer symptoms, which makes their diagnosis less obvious and the incidence of complications more frequent.

Another possible sign is abdominal pain that gets worse if you move, walk, or cough.

Since appendicitis advances so rapidly it is vital to see a doctor or emergency room if there are acute symptoms of middle/lower or right/lower abdominal pain with fever and/or vomiting that lasts for more than four hours.

If you suspect appendicitis, do not eat or drink, this may complicate surgery. If thirsty rinse your mouth with water but don’t swallow. Do not take laxatives, antibiotics or pain medications as these may mask the symptoms and delay a proper diagnosis resulting in rupture. I once had back surgery postponed because I was NOT in pain during the pre-surgery doctor visit. I had visited a massage specialist the day before and all sciatic pain was gone for about 24 hours. So no pain, no operation.

After an uncomplicated appendectomy, the patient may gradually resume a normal diet with a restriction in physical activity for at least two to four weeks. The doctor will check the incision the following week to look for possible wound infection. [eMedicineHealth]

Bottom Line

Many people who have had appendicitis say the pain is hard to describe. It may not feel like any pain you have had before. It may not even be a very bad pain, but you may feel like something is wrong. If you have moderate belly pain that does not go away after 4 hours, call your doctor. If you have severe belly pain, call your doctor right away. [WebMD]