What is appendicitis?

Appendicitis is inflammation of the appendix. The appendix is a thin pouch attached to a part of your large intestine (gut) on the right side of your abdomen (‘tummy’ area). It is usually about the size of a finger.

If you have appendicitis, this means that your appendix is swollen and infected. A swollen and infected appendix can sometimes burst. If this happens, the infection may spread throughout your abdomen, causing serious problems such as peritonitis (infection inside the abdomen) or an abscess (a collection of pus) around the appendix.

Appendicitis can occur at any age but it is most common in children and young adults.

What are the symptoms of appendicitis?

Pain is the most common symptom of appendicitis. It often starts near the belly button and might come and go for a while. The pain then usually moves low down to the lower right side of the abdomen and becomes more severe and more constant. It may hurt to walk or cough.

Other common symptoms of appendicitis are:

• fever
• abdominal tenderness, especially on the lower right side
• nausea or vomiting
• loss of appetite
• diarrhoea or constipation

The symptoms of appendicitis may be more subtle in young children, especially if they are not be able to tell you exactly where the pain is. Unlike gastroenteritis (‘gastro’), vomiting or diarrhoea are usually mild with appendicitis.

What causes appendicitis?

Appendicitis can be caused by an infection or a blockage in the appendix. The exact reason for this not known, but it is thought to be caused by food or faeces (poo) getting stuck in the appendix. This causes the appendix to become blocked, then inflamed, then infected.

When should I see my doctor?

If you think that you or someone in your care may have appendicitis, it is important that you see a doctor as soon as possible.

If you have significant pain that is made worse by moving or touching your abdomen, go straight to your local emergency department.

How is appendicitis diagnosed?

Your doctor will diagnose appendicitis by asking about your symptoms and examining you.

It can be difficult to diagnose appendicitis, especially in young children. Even in adults, it can be hard to tell the difference between appendicitis and other medical problems that affect your abdomen. Your doctor may monitor how your condition progresses over time to help them decide on the most likely diagnosis.

Sometimes, tests such as ultrasound, CT scan and blood tests can help your doctor diagnose appendicitis. In some cases, your doctor may recommend an operation to check the appendix even if they are not certain it is inflamed.

Because appendicitis may be life-threatening if left untreated. In some cases, your doctor may not want to take a risk of missing a problem, and may recommend you have surgery to remove the appendix, even if there is no firm diagnosis.

How is appendicitis treated?

The main treatment for appendicitis is an operation to remove the inflamed appendix, known as an appendectomy or appendicectomy. The appendix is not needed by the body, and your body can function normally without one.

You will usually receive intravenous (IV) antibiotics to treat the infection in your appendix while you wait for your operation.

There are 2 possible surgical techniques used in operations to remove the appendix:

• laparoscopic (keyhole surgery) — Your surgeon will make 3 small cuts of about 1 to 2 cm in length in different parts of your abdomen, so a camera and surgical instruments can be used.
• open — Your surgeon will make a larger cut in the bottom right side of your abdomen to remove your appendix.

Your recovery time from surgery will vary depending on many factors, including:

• your general health
• the type of surgery you have
• whether your appendix bursts

Most people recover without any complications. Sometimes, the wound gets infected. If this happens, you will need antibiotics and follow up with your doctor.

Sometimes, the appendix is removed and found to be normal (not inflamed). This usually means there is another reason for your symptoms. If you still have symptoms after having your appendix removed, your doctor may suggest other tests to find the cause of your symptoms.

After surgery, your doctor may recommend that you take it easy for a few weeks until the surgical wound heals.

Can appendicitis be prevented?

There is no proven way to prevent appendicitis.

Complications of appendicitis

Complications of appendicitis are uncommon.

If your appendix bursts due to appendicitis, this can cause peritonitis (an infection in your abdomen) or an abscess (a collection of pus) around your appendix. This can also cause a blockage of the bowel in some people whose appendix bursts.

Resources and support

For more information about the causes, symptoms, diagnosis, and treatment of appendicitis see the following websites:

• Sydney Children’s Hospital Network fact sheet offers advice relating to children as well as what happens to your child before going into the operating theatre.
• The Royal Children’s Hospital offers general information on appendicitis as well as how to tell if your child is likely to have appendicitis or gastroenteritis.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.