Appendix Pain – Location, Symptoms, Causes, Diagnosis, Treatment

Appendix Location :

Appendix is seen as a small thin tube measuring about 4 inches between the small and large intestine. If you have any acute pain in the right lower abdomen it can be due to appendicitis or inflammation of appendix. Appendix does not carry out any function obviously and hence its presence is not felt unless the person develops inflammation. Appendix is located in the first part of the colon namely the cecum.

Appendix Function :

No apparent function is performed by appendix. But appendix is believed to act as a storehouse for bacteria (good) and also for recharging the digestive system after any acute diarrhea. Hence it is still a question of debate whether we need an appendix or not. It will not cause any health issues even after the removal of appendix from the body.

Appendix Pain Causes :

Sometimes the appendix become swollen and inflamed and causes acute pain. Several factors can cause inflammation of appendix. The opening of appendix can get blocked due to gradual building up of thick mucus or due to hardened stool. For some people the opening of small tube like appendix can get blocked due to thickened lymphatic tissue. Once the appendix opening gets blocked it gives room for millions of bacteria to invade it causing an infection. The immune system of the body triggers response causing inflammation of appendix which causes pain.

Normally appendix pain would not be felt by the person unless it becomes heavily swollen or ruptured. There is a chance for rupture of appendix inside emptying its contents into the abdomen. This leads to pouring in of bacteria into the colon inviting complications. If the appendix gets inflamed or ruptured it can cause sudden acute pain. Often a course of antibiotics are enough for healing of appendix and to reduce inflammation. But in severe cases surgery is necessary to remove the appendix.

Appendix Pain Symptoms :

• The symptoms of swelling of appendix are usually mild and go unnoticed. Early signs include loss of appetite and nauseated feeling occasionally. There will not be any pain in the abdomen. Gradually, the appendix develops inflammation due to deposits and blockage.
• It can cause dull pain in the abdomen and the pain is not confined to any specific area. The person may feel tired and have a general not-feeling well complex. At this stage, the pain is diffused and cannot be pinpointed. The patient may complain of dull fever and a sense of malaise and mild tenderness in the right abdomen.
• After few days, the pain gets fixed on the right lower abdomen. Now the person would not have hungry feeling and may even have vomiting feeling. The part of intestine gets blocked due to the inflammation of appendix causing such symptoms. Spells of acute sharp pain can be felt in the area between the belly button and the right hip bone.
• For some people, the inflammation becomes so severe causing unbearable pain necessitating immediate medical attention.
• If the appendix gets ruptured the pain gets reduced but the infection would now start spreading in the abdomen.

Diagnosis :

• An expert doctor can sense that something is wrong with the abdomen by gently pressing the right lower abdominal region. The pain can be increasingly felt once the doctor removes his hand withdrawing the pressure.
• Blood count level can go up indicating possibility of infection due to appendicitis. But this test cannot be valid since infection can be caused by many factors.
• Urine culture can be done to detect increased white blood cells and bacteria.
• Exact picture of the appendix can be obtained only through imaging tests like ultrasound, X-ray and CT scan.
• X-ray result can indicate the hardened area of the opening of appendix which is known as fecalith (nothing but hardened stool).
• Ultrasound test is done to identify any changes in the abdomen paying more attention to the right lower quadrant.
• In some cases diagnosing appendicitis can be confusing and difficult. Appendix can move around towards the pelvic region causing pain in the pelvic floor in women. For some people it can move to the back of the colon (retro-colic appendix) and hence can be challenging to the doctor to identify it.
• CT scan is the best test or diagnosing appendicitis and this can detect even pre-appendiceal stage also. Computerized tomography test can give exact picture of stage of inflammation and whether the appendix has ruptured inside or not.
• MRI or PET test can also be used to identify inflamed appendix.

Stump Appendix :

Once appendicitis is diagnosed it would be removed by surgery having no other option. In some cases a small piece of appendix can be left behind after surgery which can develop inflammation later. The patient may develop appendicitis again having all the symptoms like pain and loss of appetite. Such a condition is known as stump appendix which is treated very much like normal appendicitis.

Appendix Complication :

Perforation is the complication caused by inflamed appendix most of the time. Any hole formation in the appendix is dangerous. Pus can get collected inside the appendix and sometimes the contents of the appendix can get diffused spreading the infection in the lining of the abdomen. Perforation does not occur normally and only if there is inordinate delay in diagnosing and treating appendicitis it can occur. If you are delaying and postponing the treatment for appendix inflammation it can lead to perforation and various complications.

Appendicitis or inflamed appendix can block the free flow of the intestine. Pressure exerted by the appendix can compress the large intestine and block it. It can lead to gas formation gradually causing symptoms like nausea and vomiting and abdominal pain. Another complication caused by inflamed appendix is sepsis. This is the worst scenario in which the infected contents of the appendix region is emptied into the blood wherein the bacteria enters the blood traveling to the entire body causing fatal consequences. If not attended promptly it can cause death.

Appendix Pain Treatment :

For mild to moderate form of appendicitis (depending on the individual’s case) the doctor may decide on oral prescriptions like antibiotics and medications for healing of appendix. If any abscess is formed in the appendix region draining the abscess is to be done by inserting small rubber tubing through the skin of the abdomen. The entire abscess is drained off through the tube with the help of assisted camera with CT scan. Appendix will be removed surgically following this procedure after some weeks. This process is known as interval appendectomy.

• Appendectomy :

Often surgery is to be done for removing appendix which is known as appendectomy in medical terms. Before the operation, your doctor and surgeon would give complete details of the procedure. Once the patient is kept under anesthesia, the surgeon makes an incision measuring about 3 inches in length on the right lower quadrant. After opening the region, he would look for appendix and carefully examine it. Next he would gently remove the appendix from the colon relieving the mesenteric attachment behind. In case of abscess, the pus would be drained off to prevent further infection. Finally he closes the colon using sutures and abdominal incision is also closed with stitches.

The entire procedure can be made using laparoscopy involving minimal invasion. Using a video camera held on one end of the telescope the surgeon would inspect the region of appendix and makes a tiny puncture on the spot. With the aid of special instruments passing through the puncture appendix would be removed completely. The patient can get back to normal activities within a day or two since there would not be any pain after the surgery.

Even during the normal surgery, the patient can go home after few days of surgery except for perforation in the appendix. It is better to stay in the hospital for few other days to watch any infectious symptoms in the body if there is perforation in the appendix. Antibiotics are prescribed for a week or more depending on the individual’s case to prevent any infection. Removal of appendix from the body would not cause any health issues.