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Do I Have Appendicitis? Do I Need Surgery?

The first thing we need to understand is that appendicitis is a surgical emergency. When treated appropriately, complications are very few.

What are the symptoms of appendicitis?

A person suffering from appendicitis might experience dull aching pain around the umbilicus. The pain slowly localizes to lower right side. It is associated with vomiting and anorexia (the patient does not feel hungry). If ignored, it might result in high temperature and high heart rate (tachycardia).

How is appendicitis diagnosed? 

It’s based on history and clinical examination. Blood tests will reveal the presence of an infection (increased WBC and CRP). Ultrasound of abdomen might help to confirm the diagnosis, but a negative ultrasound scan does not rule out the possibility of appendicitis. Ultrasound is more important in females as problems in ovaries, fallopian tube and uterus might be present. Ultrasound helps to rule out those possibilities.

What is the treatment for appendicitis?  

Treatment of appendicitis is immediate surgery. If not tended to immediately, it might lead to serious complications.

Now a days, surgery is done laparoscopically (key hole) and involves three small cuts, which will be barely visible with time. Most patients go home 24 hours later, being able to do regular activities. There will be no food restrictions. Only, the patient should avoid lifting weights for 1 month.

Can appendicitis be treated with medicines? If so, what are the complications?

There are times when patients want antibiotics and not surgery. While this is proven treatment, it is logistically difficult to apply in Indian settings unless patients can afford it and are ready to take risks.

Medical proof so far tells us to treat appendicitis with antibiotics. But, first, we need to do a CT scan and prove that there is no collection of pus inside the abdomen. Once this is done, the patient needs to be admitted for intravenous antibiotics (IV) for 48 hours. The doctor must regularly monitor the patient to make sure that the infection is not spreading. If the infection does not settle down or if the patient suffers from some complication, then a complicated surgery needs to be done, with more risks involved.

Young females with untreated or poorly treated appendicitis might face fertility issues in the future as it can affect the movements of the fallopian tubes.

In all patients treated with antibiotics, there is small risk of long-term abdominal pain. Very rarely, appendicitis might recur, needing immediate surgery.