Appendicitis: The Top 10 Questions

1 Why does the appendix burst?

The appendix is a vestigial part of the gastrointestinal system, which is located in the lower part of the abdomen and is particularly connected to the colon. In cases where the appendix becomes inflamed, swollen, or filled with pus, appendicitis occurs.

The role of the appendix in the human body is not known. The organ usually gets inflamed in children and teenagers between the ages of 10 and 20 years old. However, appendicitis can affect anyone at any age. In the United States alone, it has been estimated that around 250,000 cases of appendicitis are reported each year. 

A stomach infection or an obstruction of the appendix, are considered as the underlying causes of appendicitis. If the appendix gets inflamed, abdominal pain that is specifically felt on the lower right side of the abdomen, nausea, vomiting, high fever or chills, diarrhea, constipation, or loss of appetite can be experienced. The pain usually tends to get worse and if left untreated, the appendix can burst. This condition is known as the perforation of the appendix, which is a complication of appendicitis. A perforated appendix can lead to a serious infection that can become life-threatening.

Peritonitis is the inflammation of the peritoneum, which can develop when the appendix bursts. The peritoneum is a membrane that lines the abdominal cavity and covers most of the abdominal organs. If peritonitis occurs with severe abdominal pain, high fever, and a rapid deterioration of the patient’s health, the patient can die within a couple of hours as the patient develops septic shock. Therefore, peritonitis requires immediate medical treatment.

When the appendix bursts, another complication can happen, which is the formation of an abscess. If the abscess is left untreated, it can lead to peritonitis. In general, abscesses due to a burst appendix are surgically drained. Sometimes, they are conservatively treated with antibiotics.

2 Where is your appendix located? 

The appendix is located in your lower right abdomen. It is a part of the gastrointestinal system, which is located at the junction between the small intestine and large intestine. The appendix is about four inches long and its function still remains unknown. According to one theory, the role of the appendix is to reboot the digestive system with bacteria after a diarrheal illness. However, other theories suggest that the appendix is only a useless organ from human evolution. It is not a vital organ and a person can live a normal life without it.

The appendix looks similarly to a worm. That is why the appendix is also known as the vermiform appendix due to its worm-like or “vermiform” shape., the appendix can be situated behind the colon, making it sometimes difficult to diagnose in cases of appendicitis.

Just like the other parts of the gastrointestinal system, the appendix is made of a mucosal inner layer, a muscular layer or the middle layer, and a serosa layer surrounding the other two layers.

The submucosa of the appendix contains lymphoid tissues, which play an important role in the human’s immune system.

3 How do you know if you have appendicitis?

Knowing the signs and symptoms of appendicitis is very important in order to diagnose the condition on time and receive the necessary treatment. The common signs and symptoms of appendicitis include:

• Abdominal pain - which has a gradual onset and tends to get worse with time. First, the pain is felt like a dull or cramping pain, but as the inflammation progresses, the appendix irritates the peritoneum leading to a sharp pain that can be felt on the lower right part of the abdomen. In rare cases, when the appendix is located behind the colon, the abdominal pain is located in the lower back or in the pelvic area.
• Digestive symptoms - nausea and vomiting or an alternation of diarrhea and constipation are common in appendicitis cases. You can also experience a difficulty in passing gas, which can be an indication of a partial or total bowel obstruction.
• Mild fever - can be experienced but no more than 38 degrees Celsius. Fever may also be accompanied by chills. 

If you experience any of the above-mentioned signs and symptoms, appendicitis should be suspected. Any abdominal pain that tends to get worse within a couple of hours and are associated with other signs and symptoms should be evaluated immediately. An early diagnosis of this condition will prevent the development of fatal complications. 

4 What does it feel like to have appendicitis?

Appendicitis is a medical emergency, which requires surgical treatment. In general, it all starts with an abdominal discomfort and pain around the epigastrium. This pain is first felt as a dull or aching pain that tends to get worse over a couple of hours. In rare cases, when the appendix is located behind the colon, the pain is felt in the back or in the pelvis.

Abdominal pain can also be accompanied by other digestive symptoms such as nausea and vomiting, loss of appetite, diarrhea, constipation, and inability to pass gas, among others. A mild to moderate fever is also common.

As the inflammation progresses, the signs and symptoms get worse, until the appendix bursts. Once the appendix bursts, an immediate relief from the pain is felt but does not last for a long period of time. As the infection spreads in the peritoneum, peritonitis develops, leading to a rapid worsening of the patient’s health.

5 What is the recovery time after an appendectomy?

In the United States, more than 300,000 appendectomies are performed each year. However, just like any other surgical procedure, appendectomy has its own risks and possible complications. The possible risks and complications of appendectomies include wound infections, the formation of an abscess in the area where the appendix was removed, peritonitis, and bowel obstruction.

Usually, patients who had an unruptured appendix can go back to their normal daily activities within a week after the surgery. The next morning, after the surgery, clear liquids are given, and then progresses gradually to solid food. Most patient can get up the same day or the next day after their surgery, while painkillers are often needed to relieve the discomfort from their incision site. The recovery time is faster with lesser discomforts in cases of a laparoscopic surgery, compared to an open appendectomy. Patients can leave the hospital about two days after the surgery. Once at home, patients should have a closer look at their incision site for the early identification of any signs of wound infection. However, in most cases, patients can return to their normal life within a couple of days. A full recovery is expected after a period of 4-6 weeks. Lifting heavy things should be avoided while recovering from the operation.

However, when patients develop certain complications after the procedure, their recovery time is prolonged. In a ruptured appendix, patients are hospitalized for about a week, or sometimes, even longer. A drainage at the incision site is maintained to quickly drain the pus. Intravenous antibiotics are administrated to prevent peritonitis from developing. Once the infection has resolved, the drain is removed. After being discharged, patients should take good care of their incision site, looking closely for any changes that can signal an infection. 

6 What does the appendix do?

Many scientists believe that the appendix is a vestigial organ with no function in the human body. However, according to some recent studies, the appendix is full of bacteria needed for digestion. In various diseases of the gastrointestinal system, the normal bacterial flora of the intestines is destroyed. In such situations, the appendix plays an important role in recolonizing the intestines.

Other studies suggest that the appendix might play an important role in the development of the human’s immune system as its submucosa contains lymphatic tissues. It has also been suggested that the appendix helps the immune system by producing antibodies that fight off harmful foreign substances.

7 Can you live without your appendix?

Yes, you can live without your appendix. If the appendix is removed due to inflammation, no significant health consequences will occur. New studies have shown that the appendix might still have a function in the body's gastrointestinal and immune systems.

8 What does the appendix look like?

The appendix is a tube-shaped sac, which is located in the lower right part of the abdomen. It is connected to the large intestine and has the shape of a worm. For many years, it was believed that the appendix was a rudimentary organ located in our body from our evolutionary past. However, recent studies have suggested that the appendix might play an important role in the development of our immune system and for the healthy functioning of the intestine's normal flora.

9 Why is the appendix a vestigial organ?

A great debate sparks among scientists whether the human appendix is a vestigial organ or not. Many scientists believe that the appendix is a vestigial organ from our evolutionary past. On the other hand, some scientists believe that the appendix does have some significant functions in the human body. Recent studies revealed that the appendix can have an important role in the development of the immune system, as it plays a role in the production of antibodies and in the maturation process of B lymphocytes. Other experts also believe that the appendix plays a role in the normal functioning of the gastrointestinal system, by contributing in the normal gastrointestinal flora, especially after a gastrointestinal tract disease.

Yes, the appendix may have a function, but it is still a vestigial organ in the human body and a great evidence of our evolution. Most people live a normal life after the surgical removal of their appendix with no negative consequences on their health. 

10 Can you get your appendix removed for no reason?

The appendix is usually removed in cases of appendicitis. Appendicitis is a medical emergency that requires immediate medical treatment to prevent the development of life-threatening complications such as peritonitis.

Removing your appendix for no reason seems pretty extreme. Normally, the benefits of a medical treatment need to outweigh its risks. Having an appendectomy for no reason increases your risk of developing various complications that can be fatal. However, in appendicitis cases, the benefits of the surgical treatment outweigh the risks.

There is always a possibility of having your appendix removed in cases when you're undergoing another type of abdominal surgery for other medical conditions such as cholecystitis (inflammation of the gallbladder). In such cases, since you are already having a surgery, removing your appendix at this point doesn’t present any additional risks to your health. This method of appendix removal is also less likely to happen as doctors tend to perform minimal surgical procedures as much as possible.