The appendix is a tiny pouch from your large intestine, and it's thought to likely be a remnant from our very distant ancestors. Although it’s often said to not serve any function to us now, it may in fact be helpful as a reservoir of healthy gut bacteria. It’s found in the bottom right-hand quadrant of your abdomen and is usually around 2-4 inches long. It can cause problems if it becomes inflamed and infected, in a condition called appendicitis. This can make you very unwell unless treated. It can happen at any age but is most common in people aged between 10 and 20. It seems that if you have your appendix removed you have no long-term health consequences. About 1 in 7 people get appendicitis at some time in their life.
Appendicitis usually starts in the middle of the tummy, around the belly button, and pain may initially be mild and come and go. Over several hours, the pain becomes more pronounced and specific to the lower right tummy (the right iliac fossa), becoming sharper and more intense. It’s felt worse with movement and often people want to lie down and to stay still to try to reduce pain.
This is largely unknown. It’s thought that it may be due to a small piece of poop from the intestine getting trapped in the opening of the appendix, or due to a blockage from a swollen lymph node around the opening, which infections can cause.
A common and successful surgery is an appendectomy, where the appendix is removed. This usually happens via keyhole surgery, but if there are complications, like a burst appendix or infected appendix causing sepsis, open surgery may be recommended.
We don’t need our appendix, so you can live without it perfectly well and there are no long-term repercussions of surgery.
Occasionally, appendicitis may be mild, and fluids and antibiotics are given as the treatment. You’re then closely monitored, to see if the inflammation subsides without the need for any surgery.
A serious and life-threatening complication is a burst appendix which can lead to bacteria leaking throughout the abdomen, called peritonitis. This can cause other organs to fail and requires immediate open surgery. The symptoms include severe abdominal pain and swelling, difficulty breathing and fast heart rate, vomiting and fever. This needs immediate medical attention.
If you have mild abdominal pain that's gradually worsening and moving to the right side of your tummy, it's best not to ignore this. The "watchful waiting" approach described relies on having the correct diagnosis, the right support in terms of fluids and antibiotics, and a medical team monitoring your symptoms and labs. It's not recommended you do this yourself at home.
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