Appendicitis: Causes and Treatment

Appendix is a small sac like structure that is found attached to the right side of the colon or large intestine. Its actual name is vermiform appendix, which means worm-like appendage. The exact function of appendix is not known till now, however, its removal has not been found to cause any problem. A small amount of mucus is produced by the inner lining of the appendix, which empties into the large intestine. Appendicitis is the result of the inflammation of this appendix, and is a common disease affecting almost 7% of the population according to American Academy of Family Physicians.

Causes
Inflammation of the appendix can occur due to many factors like blockage of the appendix, development of ulcers, or bacterial infection etc. However, the exact causes of appendicitis have not been determined. Sometimes, foods or waste material like feces can enter the appendix and block it. Sometimes, swelling of the lymphatic tissues of the wall of appendix can also cause blockage. Blockage of the appendix creates a favorable condition for bacterial growth leading to infection and the consequent inflammation, which is the body's response to any kind of infection. Besides bacteria, fungi, virus and parasites can also be responsible for causing infection. As a result of infection, the appendix inflates and is filled with pus. Inflammatory bowel diseases like Crohn's disease and ulcerative colitis are also thought to be a possible cause of inflammation of the appendix.

Symptoms
The most common symptom of appendicitis is abdominal pain, which can be initially felt in the middle abdomen and then in the right lower abdomen. It can produce some other symptoms like loss of appetite, nausea, vomiting and fever. Sometimes, patients of appendicitis can also experience constipation and diarrhea.

Diagnosis and Treatment
Diagnosis of appendicitis usually begins with evaluation of medical history and physical examination. The physician usually looks for tenderness in the right lower abdomen by gently pushing there. Spreading of the infection to peritoneum can cause rebound tenderness. Rebound tenderness refers to the pain felt when the doctor releases his hand after pushing the abdomen. In addition to these, the patients of appendicitis can have high body temperature. Besides, blood test is carried out to find out the count of white blood cells, as any kind of infection involves an elevated level of white blood cells in the blood. Sometimes other tests like CT scan, abdominal X-ray, urinalysis and ultrasound can be required for proper diagnosis of the disease.

Treatment of appendicitis usually involves the surgical removal of the appendix from the body, as its rupture or bursting may result in spread of the infection causing bacteria and waste material to the other parts of the body. This can cause infection in the abdomen and peritoneum, which can lead to really grave situations. The appendix can be removed by open surgery or laparoscopic surgery.

Laparoscopy involves a small incision in the abdomen to insert laparoscope. The video camera present in the laparoscope gives a magnified image of the inside of the abdomen to carry out the surgery. For removing the appendix, some tiny surgical instruments are inserted through the incisions made on the abdomen. The advantage of such a surgery is that it ensures faster recovery and healing. But, rupture of the appendix and the consequent spreading of infection to the other parts of abdomen may necessitate open surgery. In open surgery, a large abdominal incision is required to remove the appendix.