Adults with appendicitis may feel more pain when walking, coughing or moving.
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Most tummy aches pass on their own, so it is easy to blame the discomfort on something we ate, indigestion or stress.
But when the pain worsens – especially as it moves from the middle of the abdomen to the lower right side – it could be a sign of appendicitis.
Appendicitis happens when the appendix, a small pouch connected to the large intestine, becomes inflamed. Without timely treatment, the appendix may rupture and spread infection within the abdomen, says Mount Alvernia Hospital general surgeon Tan Bo Chuan.
Here, he explains the signs and treatment options.
Q: What causes appendicitis, and what symptoms should adults look out for?
Appendicitis usually begins when the opening of the appendix becomes blocked. This may be caused by hardened stool, swelling after an infection or, less commonly, a tumour.
Bacteria can then multiply inside the appendix, causing it to swell and become inflamed.
The pain often starts as a vague ache around the belly button. This is because the nerves connected to the appendix also serve other parts of the intestine, so the brain cannot pinpoint the source at first.
As the inflammation reaches the lining of the abdomen, the pain typically moves to the lower right side and becomes more distinct. It may also worsen when walking, coughing or moving.
Other symptoms include loss of appetite, nausea, vomiting and a mild fever.
However, the signs are not always typical. Older adults, pregnant women and people with diabetes or weakened immune systems may experience milder pain or little fever, even when the condition is advanced.
During pregnancy, the growing womb may push the appendix higher, causing pain further up the abdomen. In some people, its position may also cause pain in the side or back.
Q: How is appendicitis diagnosed, and when should one seek help?
The doctor will ask how the pain began, whether it has moved and what other symptoms are present. They will also gently examine the abdomen for tenderness.
Blood tests can show signs of infection or inflammation, but cannot confirm appendicitis on their own. A CT scan may therefore be needed to assess the appendix and rule out other causes of abdominal pain.
An ultrasound or MRI may be considered instead for younger patients or pregnant women to avoid radiation exposure.
Seek medical attention if abdominal pain persists, worsens over several hours or comes with fever or vomiting.
Q: How is appendicitis treated, and is surgery always needed?
Most people recover well when appendicitis is diagnosed and treated early. For the majority of patients, keyhole surgery is used to remove the appendix. The procedure is performed through several small cuts and generally leads to less pain, a shorter hospital stay and a faster recovery than open surgery.
Selected patients with mild, uncomplicated appendicitis may be treated with antibiotics alone. However, this is not suitable for everyone, and the condition may return, even after the course of antibiotics.
Source: The Straits Times © SPH Media Limited. Permission required for reproduction.
