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Appendix is a thin sac-like structure approximately 9 cm long. Located in the lower right side of the abdomen, this small pouch has a blind-ended structure. Its opening is connected to the large intestine. In some individuals, the size of the appendix can reach up to 35 cm. It is generally larger in children, but over time it begins to shrink and takes a shorter form in adulthood. We will also discuss which diseases can cause symptoms similar to appendicitis and how it is diagnosed, but first, let us examine the function of the appendix.
What Does the Appendix Do?
Research has been conducted for many years regarding the function of the appendix, but no definitive conclusion has been reached. It was long believed to be related to the immune system. Recent studies suggest that it may serve as a reservoir for beneficial gut flora, especially during illness. These beneficial bacteria may use the appendix as a shelter. It is also important to note that removing the appendix does not cause any known harm to the body.
What Causes Appendicitis?
Appendicitis is defined as the infection of the appendix. The exact causes are not fully known. In some cases, blockage at the entrance of the appendix by substances produced by the body or foreign materials may lead to infection. For example, fecal matter may block the opening. Additionally, swelling of lymph nodes in the intestinal wall during upper respiratory infections may cause pressure and lead to blockage. Although the exact cause is unclear, many factors may contribute to appendicitis.
Which Diseases Cause Symptoms Similar to Appendicitis?
Many diseases can be confused with appendicitis because they produce similar symptoms. These include:
- Crohn’s disease
- Gastroenteritis
- Constipation
- Bladder infection
- Urinary tract infection
- Pelvic infection
- Severe irritable bowel syndrome
In women, the following conditions may also mimic appendicitis:
- Menstruation
- Pelvic inflammatory disease (PID)
- Ectopic pregnancy
In cases of severe abdominal or groin pain, medical evaluation should be sought immediately. Pain caused by appendicitis may radiate to different areas such as the pelvic region or under the liver.
What Are the Symptoms of Appendicitis?
Common symptoms include:
- Sudden pain in the lower abdomen, usually on the right side
- Nausea
- Vomiting
- Loss of appetite
- Digestive issues such as constipation or diarrhea
- Abdominal bloating
The most characteristic symptom is sudden onset of pain.
How to Differentiate Appendicitis Pain?
Appendicitis pain typically begins in the mid-abdomen and later localizes to the lower right side. Initially intermittent, the pain becomes constant and intensifies over time. Pressing on the area, coughing, or walking increases the pain. Blockage of the appendix leads to bacterial growth and pressure, which explains the worsening pain during movement or pressure.
How Is Appendicitis Diagnosed?
Diagnosis requires taking the patient’s medical history and performing a physical examination. Blood tests and imaging methods such as ultrasound are also used. If necessary, computed tomography (CT) may be performed. In pregnant women, only ultrasound is used due to safety concerns. Diagnosis in children can be more challenging due to symptom overlap with other infections.
How Is Appendicitis Treated?
Treatment is usually surgical, involving removal of the appendix. The operation is performed under general anesthesia and can be done using open or laparoscopic methods. Today, laparoscopic surgery with small incisions (5–10 mm) is commonly preferred, allowing faster recovery.
In rare cases where the appendix has not ruptured, antibiotics may be used. However, if there is leakage or severe infection, surgery is necessary.
At What Age Does Appendicitis Occur?
Appendicitis can occur at any age after 2 years old. Although it is commonly associated with childhood, it can also occur in adults. It is rare in children under 2 years of age.
What Happens If Appendicitis Is Not Treated?
If untreated, appendicitis can become life-threatening. The appendix may rupture, causing infection to spread into the abdominal cavity. This can lead to sepsis, especially in children, and may result in death. Therefore, prompt diagnosis and treatment are essential.
