By Dr. Arief Hamid.
The word “appendicitis” is often mentioned casually, sometimes joked about as a sudden reason for emergency surgery. However, appendicitis is far from a trivial condition. It is a serious medical emergency that can turn life-threatening if not treated promptly. Understanding its warning signs, treatment, and recovery can help us to act quickly and save lives.
Appendicitis occurs when the appendix, a small finger-shaped pouch attached to the large intestine, becomes inflamed and infected. While the exact function of the appendix is not fully clear, what is known is that once it becomes blocked and swollen, it can quickly worsen. If untreated, the appendix may burst, spreading infection throughout the abdomen and causing severe complications.
How Does Appendicitis Happen?
Appendicitis usually starts when the opening of the appendix becomes blocked. This blockage can be caused by hardened stool, infection, swelling of lymph tissue, or in rare cases, a tumour. Once blocked, bacteria multiply inside the appendix, leading to inflammation, swelling, and severe pressure. As the pressure builds, blood supply may be reduced, eventually causing the appendix to rupture.
This process can happen within 24 to 72 hours, making early diagnosis crucial.
Common Signs and Symptoms
The symptoms of appendicitis often begin suddenly and worsen over time. While they may vary slightly among individuals, the most common signs include:
- Pain that starts near the belly button and moves to the lower right side of the abdomen
- Pain that worsens with movement, coughing, or walking
- Loss of appetite
- Nausea and vomiting
- Low-grade fever
- Abdominal swelling or bloating
- Constipation or diarrhoea
Children, elderly individuals, and pregnant women may show less typical symptoms, which can sometimes delay diagnosis.
When to Seek Urgent Medical Attention
Immediate medical review or referral to a specialist is needed if a person experiences:
- Severe abdominal pain, especially on the right lower side
- Pain that continues to worsen over several hours
- High fever with abdominal pain
- Inability to pass gas or stool
- Persistent vomiting
- Abdominal tenderness when touched
- Sudden relief of pain followed by worsening symptoms (possible rupture)
These symptoms should never be ignored, as a delay can lead to life-threatening complications.
How Appendicitis is Diagnosed
Doctors diagnose appendicitis based on symptoms, physical examination, and investigations.
The process usually includes:
1. Clinical Examination
The doctor will press gently on the abdomen to check for tenderness, especially on the lower right side.
2. Blood Tests
These look for signs of infection, such as a high white blood cell count.
3. Urine Test
This helps rule out urinary infections or kidney stones.
4. Imaging Tests
Modern imaging has greatly improved diagnosis accuracy:
- Ultrasound – Often used in children and pregnant women
- CT Scan – Highly accurate in confirming appendicitis and complications
Treatment Options: Old and New
Surgery (Appendicectomy)
The standard treatment for appendicitis has traditionally been removing the appendix through surgery, a procedure called appendicectomy.
There are two main methods:
- Open surgery – A single cut on the lower right abdomen
- Keyhole surgery (Laparoscopic) – Several small cuts with camera guidance
Laparoscopic surgery is now widely preferred as it causes less pain, smaller scars, faster recovery, and shorter hospital stay.
Non-Surgical Treatment
In selected mild cases, especially early appendicitis, antibiotics alone may be used. This approach is carefully monitored and may not be suitable for everyone.
Possible Complications of Appendicitis
Short-Term Complications
If not treated quickly, appendicitis can lead to:
- Ruptured appendix
- Pus collection (abscess)
- Peritonitis (widespread infection of the abdominal lining)
- Sepsis (life-threatening infection spread in the bloodstream)
These conditions require emergency care and intensive treatment.
Long-Term Complications
Some patients may experience:
- Adhesions (internal scar tissue) leading to bowel blockage
- Chronic abdominal pain
- Recurrent abdominal infections
- Fertility issues in women due to pelvic scarring
Recovery After Treatment
Recovery depends on the severity of the appendicitis and the type of treatment received.
After Laparoscopic Surgery
Most patients can:
- Go home within 1 to 3 days
- Return to light activities in 1–2 weeks
- Resume normal work in 2–3 weeks
After Open Surgery or Complicated Cases
Recovery may take longer:
- Hospital stay of 4–7 days or more
- Full recovery may take 4–6 weeks
Patients are advised to avoid heavy lifting, maintain wound hygiene, and follow up with their doctors regularly.
Life After Appendicitis
Once the appendix is removed, it does not affect daily life. The body continues to function normally without it. Most people return fully to their usual activities with no long-term problems.
However, those who had complications such as rupture or abscess may need longer follow-up and monitoring.
Conclusion
Appendicitis is a medical emergency that requires swift action. Ignoring or delaying treatment can lead to severe complications and even death. Any persistent or worsening abdominal pain, especially on the lower right side, should prompt immediate medical attention.
In many cases, early treatment leads to complete recovery and prevents dangerous outcomes. Awareness, early recognition, and prompt medical care remain the strongest tools in protecting lives.
When it comes to appendicitis, it is always better to be safe than sorry — your life may depend on it.
