Appendix surgery (Appendectomy)

What is appendicitis?

Appendicitis is inflammation of the appendix—a small, finger-like pouch attached to the large intestine on the lower right side of the abdomen. The appendix has no known essential function but can become blocked and infected, filling with pus. When that happens it causes severe pain and can lead to serious complications if not treated promptly. Surgery to remove the appendix (appendectomy) is the main and most effective treatment.

Causes of appendicitis

Appendicitis occurs when the appendix becomes blocked, leading to infection. When blocked, bacteria multiply inside the appendix, causing inflammation and pus, which increases pressure and pain. Common causes include:

• Fecal matter: hardened stool can lodge in the appendix and cause a blockage.
• Infection: a gastrointestinal infection can swell lymph nodes, which may compress and block the appendix.
• Foreign bodies: rarely, objects such as seeds, stones, or tumours can obstruct the appendix.
• Enlarged lymphoid follicles: sometimes the lymphoid tissue inside the appendix swells and blocks it.

Symptoms of appendicitis

Symptoms usually develop suddenly and worsen over time. They include:

• Abdominal pain: often starts around the navel and then shifts to the lower right abdomen; pain may increase with movement, coughing, or pressing on the area.
• Nausea and vomiting: often accompany the pain.
• Loss of appetite: a common early symptom.
• Fever: a mild fever may develop as the body fights the infection.
• Constipation or diarrhoea: some people have changes in bowel movements.
• Swelling and tenderness: the area around the appendix may become swollen and tender.

Diagnosis of appendicitis

Diagnosing appendicitis involves several steps:

• Physical examination: the doctor presses on the abdomen to check for tenderness, especially in the lower right side; rebound tenderness (pain when pressure is released) is a common sign.
• Blood tests: can show a high white blood cell count, suggesting infection.
• Urine tests: help rule out a urinary tract infection or kidney stones, which can mimic appendicitis.
• Imaging: ultrasound and CT scans are often used to visualise the appendix and confirm inflammation or an enlarged or ruptured appendix.

Treatment: open vs laparoscopic appendectomy

Appendectomy can be done in two main ways. Open appendectomy uses a single larger incision in the lower right abdomen to remove the appendix; it is effective and often used when the appendix has burst or there is widespread infection. Laparoscopic appendectomy uses several small incisions, a camera, and fine instruments to remove the appendix; this method usually means less pain and a quicker recovery. Both are effective; the choice depends on your condition and the surgeon’s assessment. There are no proven alternative treatments—attempting home remedies or alternative therapies can be dangerous. If you suspect appendicitis, seek medical attention immediately.

What happens if appendicitis is not treated in time?

If appendicitis is not treated promptly, the appendix can rupture, leading to peritonitis—a life-threatening infection of the abdominal cavity. This can cause widespread infection as bacteria spread through the abdomen, abscess formation (pockets of pus that may need drainage and antibiotics), and sepsis—a severe body-wide response to infection that can lead to organ failure and death if not treated urgently. Early diagnosis and treatment are crucial.

Prevention and after surgery

There is no guaranteed way to prevent appendicitis, but a high-fibre diet (plenty of fruits, vegetables, and whole grains), regular medical check-ups, and staying well hydrated may help reduce the risk. After surgery you may have some pain and will need pain relief; you will be advised to avoid strenuous activities and heavy lifting for a few weeks. Start with liquids and gradually return to your normal diet as advised. Follow-up appointments are important to ensure proper healing.