Appendicitis: What To Expect & How To Recover
For a world so highly driven by research and technology, the appendix has largely remained an enigma for doctors. A thin tube, located in the lower abdomen and attached to the large intestine, the functions of the appendix are still open to speculation. Some research suggests it helps our body store good bacteria to help recover from digestive illness. There are also theories about the organ being a reminder from our evolution journey from ape to man. Although the organ looks and sounds pretty trivial, any disorder related to it can have serious implications.
The most common complication related to appendix is its inflammation or infection called appendicitis. In most cases it results in emergency surgical removal of the appendix known as Appendectomy, more commonly referred to as “appendix removal”. In rare cases if left untreated, an infected appendix may also prove to be fatal.
The exact cause of Appendicitis is relatively unknown. Research suggests that people having a rich fiber diet have relatively less probability of suffering from it.
- Sharp pain starting near the belly button and moving to the lower right abdomen
- A mild fever
- Nausea and Vomiting
- Swelling near the lower abdomen
- Gas build up and loss of appetite
- Abdominal cramps and painful urination
- Some individual may also experience constipation or diarrhea
In most cases the doctors will perform a physical examination by applying gentle pressure on the affected areas. Sometimes a rectal examination may also be performed. The other tests required are:
- A blood test checking the white blood cell count to detect an infection
- A urine test to rule out the possibility of a Urinary Tract Infection (UTI) or a kidney stone , which may also cause similar pain
Based on the results of the above, the doctor may also recommend a CT scan to confirm the exact cause of the pain.
Since the appendix does not have a known important function, in most cases doctors recommend surgical removal of the organ. A minor infection can be cured through antibiotics and medication. However an untimely rupture of the appendix can prove to be fatal. Therefore in most cases surgery is viewed as the safest option.
Pre operative procedure
Appendix removal is usually an emergency surgery, however standard pre operative procedure is recommended.
The patient is advised not to eat or drink anything. If the patient experiences severe cramping, nausea, vomiting etc, related medication may be started along with IV antibiotics.
The procedure can be performed through a direct incision or a laparoscopy; both require the patient to be given general anesthesia.
The affected area is usually shaved and disinfected.
If the patient has developed an abscess, a direct incision is required. A 3-4 inch incision is made in the lower right side of the abdomen. The abscess is drained of pus and fluid and the abdominal cavity is cleaned.
If the doctor uses laparoscopy smaller incision is made and the doctor inserts small surgical tools and a camera to view and remove the appendix.
In some cases the appendix may also rupture causing bacteria and fluid to spread into the abdomen leading to serious infection peritonitis. In this situation the doctor may advise draining the fluid by placing a tube and controlling the infection first. An appendectomy may be performed only after the infection is completely cured.
A standard surgery may last around 2-3 hours and sometimes longer in case of complications.
Post Operative Care
All vital signs of the patient like temperature, breathing, heart rate etc are monitored till the anesthesia wears off, typically 6-8 hours after surgery.
Within 12 hours after surgery the patient is offered clear fluids only for some time. Solid food is introduced gradually. After the patient begins eating normally and bowel movements look fine, IV is removed and light physical activity is allowed.
Antibiotics and pain relieving medication may be administered as per the instructions from doctor. The patient is monitored typically for 2-3 hours before being discharged.
Recovery and Home Care:
The patient is given appropriate medication to be continued at home. Also the incision area must be kept clean and dry. Although normal routine can be resumed within a couple of days, heavy lifting, exercising or any strenuous activity should be avoided. However walking and limited movement are good for full recovery, typically within 4-6 weeks from surgery.
The doctor may also advise a follow up visit/check up after 2-3 weeks of surgery. The follow up visit may include a physical examination and removal of stitches/ staples from the incision area.
However it is important to contact your doctor immediately in case you experience any of the below:
- Swelling ,oozing or persistent pain around the incision area
- Fever of more than 101 degrees Fahrenheit or more
- Irregular bowel movement or loss of appetite for more than 2 days
- Vomiting , Nausea or Dizziness
- Blood in urine or vomit
Risks & Complications
Although the probability of complications is very low, it is important to be aware of the risks and take proper post operative care.
The most common complication post operation is Wound Infection. It can be prevented easily by keeping the wound clean and dry.
In rare cases an abscess may also get formed in the incision area. Another uncommon complication is Stump Appendicitis. In this condition the patient may experience inflammation of the residual appendix.
Also in some cases patients develop cases of hernia or bowel obstruction in the long term. However maintaining a healthy diet and following your doctor’s advice may prevent all of the above. To find the list of hospitals and treatment cost of appendix removal surgery in major Indian cities you may refer to www.healthprice.in.