Appendicitis is a serious public health problem worldwide. Improving awareness of appendicitis signs and symptoms is an urgent concern. Early diagnosis of appendicitis is of the utmost importance because it can save easily preventable lives. Many people aren’t sure if appendicitis patients should visit an urgent care center or not. Newport Urgent Care is capable of diagnosing appendicitis, as are most urgent care facilities.
What Is the Appendix?
The appendix is actually a tiny, finger-like protrusion at the end of the intestine found in the lower right-hand side of your abdomen. The appendix has the interesting function of growing mucus (“lymph” like in a lymph node) that drains into the intestine—think of it like the oil-maker in your digestion engine.
This, however, is only a theory. Doctors are not really 100% sure what the appendix does, but recent findings indicate that it stores “good bacteria” to help with digestion.
So, for instance, after an incident of serious food poisoning, medical researchers speculate that the mucus produced by the appendix carries fresh digestion-aiding bacteria back into the intestine.
After being thoroughly cleaned out by a bout of vomiting and diarrhea, the digestive tract is particularly susceptible to bad bacteria taking hold—the appendix mucus supposedly helps to prevent such an occurrence. The appendix also creates lymphoid products such as the protein immunoglobulin A.
Appendicitis is the inflammation of the appendix. As mucus flows out of the appendix, it can become blocked, and this can cause it to become swollen and painful. Hardened stool and parasites can also cause the appendix to become inflamed.
As the appendix starts to fill up with mucus that it can not drain, it stretches to capacity. Unlike the bladder, that is not what it is designed to do.
If the blockage is not alleviated, the appendix can start to leak as small holes in the outer lining form (doctors say the appendix has “perforated”).
If the mucus in the appendix backs up enough, it can just completely burst. The leaked appendix mucus, when outside the appendix and intestine, can cause a deadly infection called peritonitis.
A lot of people with an inflamed appendix will not present with the usual signs. However, these are some commonly-seen appendicitis symptoms:
- Acute stomach pain—the appendix has its own blood and nerve supply, which is why the pain can be so intense. People report that the pain usually starts right by their belly buttons and ends up on the lower right side by the actual appendix. The pain can be so intense that breathing, walking, and simply moving can hurt. The pain usually intensifies quickly.
- Painful urination
- Loss of appetite
- Nausea, vomiting
Appendicitis is one of the most common emergency health problems. Despite the fact that it’s such a popular ailment, people still die from it every year, even though death is largely preventable if it is treated quickly. Here are some helpful statistics to educate you about appendicitis:
- In the United States, appendicitis affects one in 1,000 people, according to one source. Another source reveals that appendicitis affects as many as 5 out of 100 people. Yet a third source indicates that 250,000 people yearly will develop acute appendicitis. A fourth source claims 1 in 13 people will be plagued with it.
- The global occurrences of appendicitis increased by over 60% between 1990 and 2019.
- Almost half of people suffering from appendicitis experience atypical symptoms making it harder to diagnose.
- 60,000-80,000 young people require appendicitis surgery every year. It is one of the most common pediatric emergency surgeries.
- There were almost 18 million occurrences of appendicitis worldwide in 2019.
- Even with advances in laparoscopic technology, still 5-15% of people who have their appendix removed for uncomplicated appendicitis (the least serious kind) will develop at least one complication. As many as 7% of those people will experience a serious complication.
- In 2015, over 50,000 Americans died due to appendicitis.
- In a study of people who had just received antibiotics for their appendicitis, 27% developed appendicitis again within 12 months, 35% within 36 months, and 39% within 60 months.
- Appendicitis accounts for one million days of hospitalization in the US annually.
At an urgent care center or emergency room, your healthcare professional should conduct a physical exam. It will involve poking your stomach a bit, which can be quite painful if you have an enlarged and blocked appendix. Any of the following tests can be done to confirm an appendicitis diagnosis:
- Blood test
- CT scan
An urgent care center would not likely have a CT machine or ultrasound on-site.
Stages of Appendicitis
In the beginning stages of appendicitis, a blockage develops generally where the appendix attaches to the large intestine. The “valve” (lumen) of the appendix becomes irritated and fills with pus as it can no longer drain properly. The more pus that builds up, the more festered it becomes. This early stage of appendicitis is also called Simple Appendicitis or Early Appendicitis.
With the reduced ability to drain lymphatic fluid and blood, a cyst-type of growth (“appendiceal phlegmon”) can develop. An urgent care or emergency room doctor can feel this bulge in the lower right belly during a physical exam. About 1 in 10 people with Complicated Appendicitis will develop appendiceal phlegmon, mostly children. Tumors can even be a result of the appendix “valve” getting blocked. The nearby intestine walls can thicken as well.
The worse the blockage becomes, the more the blood flow to the appendix is cut off, which causes the tissue to die. Dead tissue that has lost its blood supply results in a very serious infection called gangrene. Should gangrene occur, this condition is known as “gangrenous appendicitis.” It only takes 1-3 days of restricted blood flow for holes in the appendix to develop as well (“perforated appendicitis” or “ruptured appendicitis”). Roughly 15-20% of people with appendicitis will experience perforations.
Here are a few different treatment options your doctor will explore with you if you are diagnosed with appendicitis:
- Antibiotics – Again, appendicitis will most certainly return if you are only treated with antibiotics and nothing else. Because it is the blockage that causes the infection, unless the blockage is treated, the antibiotics alone can only be so effective.Antibiotics alone as a treatment would only be considered if the appendix has not burst. If you do get an appendix operation, you will also be given antibiotics. Only if your appendix burst would you continue to receive antibiotics after surgery.
- Appendectomy – Appendectomy means having surgery to remove the appendix. This is the most common treatment for any problem with the appendix because the appendix is not necessary to sustain life or function.The majority of children with appendicitis will require an appendectomy. There are three ways to do an appendectomy: an incision at the belly button (only in cases with an intact appendix), three incisions at various points in the stomach region, or with the entire stomach open (when the appendix has burst and a peritonitis infection has spread throughout the large intestine).
An “interval appendectomy” is another option. If the appendix burst days prior, the primary focus will be on treating the infection.
With an interval appendectomy, you will receive antibiotics for 6-8 weeks at home. Once any potential infection is treated, then you’ll come in and have your burst appendix removed.
Regardless of which type of appendectomy is performed, your surgeon will give you a shot of pain medicine at your incision site to help reduce your post-op pain.
Appendicitis in Children
Having an inflamed appendix is, again, the most common reason for emergency belly surgery in children, unfortunately.
Boys develop appendicitis more than girls. Pediatric appendicitis happens most often in youngsters aged 8-16 years. Appendicitis can occur in kids as young as 5 (or even younger).
The younger the child, the more likely they are to have their appendix burst, as they often can’t find the right words to accurately describe their symptoms.
Also, for this reason, it is more likely that a child will experience an appendix perforation or rupture.
The good news, though, is that appendicitis is statistically less likely to be lethal in young people.
Having Appendix Surgery
Having your appendix removed is the most common treatment for appendicitis, so, more than likely, if you have an inflamed appendix, you can anticipate a hospital stay of 12 hours to one week.
If your appendix did not burst, once you can drink water and urinate OK, you can typically be discharged.
If your appendix did burst, expect to be in the hospital for at least a few days. A ruptured appendix is very serious. After the surgery, your stomach will go dormant, sort of shutting down.
Because of this, something called an NG tube will be placed through your nose going down to your stomach.
This tube helps keep your stomach empty until your stomach starts functioning again.
When that happens, you’ll most likely have some nausea and/or diarrhea that may discourage you from eating even longer.
You’ll start slowly with ice chips, then water, then soft foods, and so on.
Because of your appendix bursting, you’ll also be on antibiotics throughout this time, which can also cause an upset stomach.
Even upon being released, you will most likely need to continue taking antibiotics.
In order to be sent home after a ruptured appendix and appendectomy, these three things need to happen:
- You don’t have a fever
- Your nausea has subsided
- You are eating solid food
After Appendix Surgery
When you get back home after having your appendix removed, there should be no need for any type of addictive painkiller—just over-the-counter brands like Motrin.
Over-the-counter medications are usually not covered by health insurers. Remember not to mix or combine acetaminophen painkillers and ibuprofen painkillers. Use one or the other.
Here is a progression of what to expect in regard to your care and condition:
- Day 1-2: Ensure that your surgery incision stays dry (no bathing). Leave the dressing on. Go for a walk every day but don’t do anything strenuous (no lifting, no gym).The more you can move around, the better you will feel—if you can walk for a whole hour, go for it. Even just talking and sitting up is great. Take your pain medication as directed by your doctor.
- Day 3-6: After removing your dressing per the doctor’s orders, don’t disturb any surgical glue on your incision—leave it be.Showering is OK, but avoid baths and swimming. Clean your incision with mild soap, then pat it dry. If you have an office job, you’ll most likely be authorized to return to work.
Children should be able to return to school. Take pain medication only if you feel pain. Doctors will normally recommend something over-the-counter at this point, like Tylenol, Motrin, or Advil.
- Day 7-13: Continue to leave any surgical glue at your incision site alone—it will slowly loosen up and come off on its own.Taking a bath is OK. Only swim in chlorinated water (no ocean, lake, or river submerging). You still need to avoid lifting anything over 20 pounds (For older kids, this generally means they should not be lifting their school backpacks).
No contact sports or gym sessions. If you are still experiencing any pain at this point, consult your doctor immediately.
- Day 14: Usually, by now, the surgical glue at your incision site is gone. If some of it is still there, you can gently rub it off with a warm, damp washcloth.You’re OK to swim in freshwater or ocean water now, as well as lift things heavier than 20 pounds.
Diagnose Appendicitis at Newport Urgent Care
Appendicitis is a medical emergency at any stage! The sooner you can get to Newport Urgent Care, the better. Every hour counts. Find us at 1000 Bristol Street North #1B, Newport Beach, CA, 92660. There is no need to make an appointment or call ahead; you can just walk in.