Do you still have your appendix? Do you know where your appendix is in your body? Do you know what it does and if you have a problem with it, what can happen? Although lower right abdominal pain in women and men may be fairly common in the U.S. and is usually short lived pain due to indigestion, it can be much more serious. Pain in the right lower abdomen is often suspected to be appendicitis, however, most people do not know what appendicitis is, how it happens, and what risks it poses.
Each minute of every day a new person has a case of acute (requiring immediate care) appendicitis in the U.S. More worrisome is that another person dies from complications associated with acute appendicitis every day. One cause of this death rate is that patients avoid treatment for abdominal pain, but another is that appendicitis is sometimes misdiagnosed in the ER setting. As a matter of fact, misdiagnosis of appendicitis is the third leading cause of malpractice suites in hospitals and health care centers.
Find out what the appendix is, what it does, and what risks a ruptured appendix can pose in the abdomen. Also learn how other abdominal pains differ from pain in appendicitis, even if it is sharp lower abdominal pain.
What Is The Appendix?
The appendix, or Vermiform Appendix, is located at the beginning of the colon, or large intestine, and is a short, finger-like appendage. From the outside of the body, the appendix's location is referred to by medical personnel as McBurney's Point. This is located halfway between one's bellybutton and the front of their illiac crest (hip bone).
For many years, doctors thought that the appendix was a useless part of the GI tract that was better off removed routinely any time any abdominal surgery had to be performed. Recently, though, doctors have stopped routinely removing the appendix for two main reasons: possible reasons for the appendix's existence and new uses for the appendix in the body. Many doctors are now finding correlations between the appendix and the lymph and immune systems. They have found that it contains high amounts of lymphoid cells, and that it may assist in "training" the body's immune system by introducing antigens to the body.
While appendectomies are still quite common, due to new research they do not happen routinely unless a person's appendix is infected or inflamed.
Classic Signs And Symptoms Of Appendicitis
Although many think of right side abdomen pain when considering appendicitis, the initial pain at onset of acute appendicitis is often felt around the bellybutton. The reason for this is that the center of the abdomen is where the appendix is located during gestation, therefore the nerves that are associated with the appendix refer pain to this area.
Once the appendix is inflamed it begins to aggravate and inflame the peritoneum (lining of the abdomen) at the location of the appendix. This, in turn, causes the sharp lower abdominal pain, in the right lower quadrant, that many associate with appendicitis.
Although there is acute pain in this area, one confirmation of the possibility of appendicitis in the field is if the patient has rebound tenderness. What this means is that a medical professional will press a couple fingers into the right abdomen at or around McBurneys' point and quickly remove the pressure. This release of pressure will cause sharp pain to the patient. Many things can cause pain to the abdomen, and most of them will cause tenderness on palpation, but few will cause that pain to worsen sharply when the palpation is removed. Another confirmation is to give a quick bump to the heel of the patients straightened leg. If the patient has peritonitis (often caused by appendicitis) they will feel excruciating pain.
Some patients may experience "silent appendicitis." This occurs when there is no added pain from palpation or rebound tenderness. This can be due to anatomy and other issues, but if the infection progresses, peritonitis will occur and will cause severe abdominal pain.
Another key to identifying appendicitis or peritonitis is to look for fever and/or swollen lymph glands. This often happens due to the actual infection of the organ.
Risks Of Appendix Rupture
As with any other medical emergency, one of the biggest reasons for mortality from acute appendicitis is the reluctance to seek emergency medical care. Many people simply attempt to ignore the pain, often writing it off as gas, especially in cases of "silent appendicitis" where the pain may be dull. However, if a person does not, at some point, seek medical care for acute appendicitis, death is almost certain.
If the appendicitis is allowed to go untreated, or removed, it will most certainly rupture. The rupture of the organ will spread the infected body fluids throughout the abdominal cavity. The aggravation from this fluid in the abdominal cavity will lead to widespread peritonitis and inflamed bowels. After the peritoneum and other abdominal organs become inflamed, a patient is at high risk of septic shock which can snowball rapidly into hypovolemia and death.
Although many patients with appendicitis do not experience organ rupture, many cases do happen. Most of those patients are rushed into an emergency appendectomy. If appendix rupture happens away from the hospital, transport by ambulance and treatment by paramedics en route is imperative.
Treatment Of Appendicitis And Appendix Rupture
As with any acute pain of unknown origin that is persistent and debilitating, you should call 911 to be transported by ambulance to the hospital. If you are near the hospital and feeling well enough, you can be transported in a personal vehicle by a family member or friend. If you are taken by ambulance, you are not likely to receive pain medication due to the necessity for a doctor to be able to assess your sharp lower abdominal pain on arrival at the ER. You are, however, going to have an IV established and may have a blood draw done to make your ER care seem a bit quicker.
The most widely held cure for appendicitis today is removal of the inflamed organ. In most cases, appendectomy is performed and the patient generally is released from the hospital in a couple days without any complications. In some places, mostly those that are remote and do not have surgical capability, a patient is given antibiotics to fight off the infection in the appendix and its surroundings. This treatment has been known to provide complete cure, but in many cases, the appendix is still removed either due to lingering inflammation or possibility of recurrence of appendicitis.
Not All Appendix Pain Is The Same..
For almost everyone, pain from an inflamed or ruptured appendix occurs on the right side, in the Right Lower Quadrant of the abdomen. There are, however, cases when appendix pain occurs elsewhere.
About 0.01% of the population are born with all of their organs on the opposite side of their body. That means that their colon runs the begins on the left side and therefore, their vermiform appendix is in the Left Lower Quadrant of the abdomen. So don't necessarily discount that Left Side Pain as not appendicitis.
Mario on December 27, 2012:
I am having al the symptoms you have described for years except fever (acctually I've never checked it). It happens 2-3 times per year.
I went to hospital after the event twice but they took my blood sample and made X rey to my belly and every time they rulled out Appendicitis.
After reading your article I am positive that I am having problems with Appendix.
Joseph Davis (author) from Florida on December 02, 2011:
Please post the questions if you can. If I can't answer them I will definitely find the answer.
Michaela on December 02, 2011:
I have read over your article. There are stills some questions unanswered but I think i'll cope. Thank you for the useful information.