Dr Deepak K Agarwal
The writer is senior consultant gastroenterologist, hepatologist & endoscopist and is running a successful medical Centre in Lucknow
You may never have given much thought to your appendix, the little pouch that's attached to the top of your large intestine. And you wouldn't have much reason to think about it, because it doesn't seem to do anything. But if your appendix were to become swollen and inflamed, it would probably move to the front of your mind. The pain of appendicitis can make you quickly, and unpleasantly, familiar with this organ. You can get appendicitis if your appendix becomes blocked. That blockage could be from feces, a foreign object, or, in rare cases, a tumour. When your appendix is blocked up, bacteria that normally live inside it start multiplying and cause an infection.
Appendectomy, the removal of this small pouch attached to the beginning of your large intestine when you have an acute bout of appendicitis, is one of the most common emergency abdominal surgeries. The appendix is a small, finger-shaped organ that comes out of the first part of the large intestine. It needs to be removed when it becomes swollen or infected. If the appendix is not removed, it can leak bacteria and infect your entire belly, which can be very life threatening.
So, what are the signs that you have appendicitis? Well, this condition can be fairly hard to diagnose, especially in children, older people, and women of childbearing age. Usually, the first symptom is pain around your belly button. The pain might be mild at first, but then it gets sharp and severe before not too long. The pain may then move into your right lower abdomen. You may also have nausea, vomiting, diarrhoea or constipation, a low fever and a reduced appetite. Sometimes, people think that they might be having food poisoning. Your pain may let up for a time. This relief can be misleading, though. Just when you think you're getting better, your appendix may have actually burst. If that is the case, the pain will get start to get more and more intense.
Your doctor will make a diagnosis based on your symptoms. You may also have blood tests and a CT scan or ultrasound. If you have appendicitis, the number one way to treat it is with surgery to remove your appendix. In fact, appendicitis is the number one cause of emergency abdominal surgeries. You may be treated for an infection first, before your surgery. It is important to treat the appendicitis quickly because you can develop a collection of pus called an abscess in your abdomen once your appendix bursts. Once it is clear that you have appendicitis, your doctor will probably schedule you for emergency surgery. In surgery, you will receive anaesthesia and be asleep and pain free. In fact, appendectomy is done using either spinal anaesthesia in which medicine is put into your back to make you numb below your waist and you will also get medicine to make you sleepy, or general anesthesia in which you will be asleep and not feel any pain during the surgery.
The doctor will make a small cut in the lower right side of your belly and remove your appendix. If the surgeon uses the laparoscopic technique, you will have several small cuts in your abdomen for the surgical instruments. If your appendix broke open, or a pocket of infection has formed, your doctor will wash out your belly during the surgery. A small tube may remain to help drain out fluids or pus. Once you've had an appendectomy, you will probably recover pretty quickly. It feels good to get a bad appendix out. Most patients leave the hospital one to two days after surgery. Don't worry about going through life without an appendix. People live healthy lives without it. The good news is that you'll be able to go back to all those normal activities within 2 to 4 weeks.
If you have symptoms of appendicitis, seek medical help right away. Do not use heating pads, enemas, laxatives, or other home treatments to try to relieve symptoms. Your health care provider will examine your abdomen and rectum. Other tests may be done: Blood tests, including a white blood cell count, may be done to check for infection. When the diagnosis is not clear, the provider may order a CT scan or ultrasound to make sure the appendix is the cause of the problem. There are no actual tests to confirm that you have appendicitis. Other illnesses can cause the same or similar symptoms. The goal is to remove an infected appendix before it breaks open or ruptures. After reviewing your symptoms and the results of the physical exam and medical tests, your surgeon will decide whether you need surgery. Risks of anesthesia and surgery in general include reactions to medicines, problems breathing, bleeding, blood clots, or infection. Risks of an appendectomy after a ruptured appendix include buildup of pus which may need draining and antibiotics, infection of the incision. If you had laparoscopic surgery, you will likely recover quickly. Living without an appendix causes no known health problems.