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It can be easy to blame your abdominal pain on indigestion or stress. But sometimes the pain is more serious, and you'll need to see a doctor to diagnose appendicitis or any other abdominal conditions. Here's what you should know about appendicitis in order to start feeling better soon.
What Is Appendicitis?
Appendicitis is the inflammation or an infection of the appendix, a small extension of the large intestine. The most recognizable symptom of appendicitis is the development of abdominal pain, according to John M. Martinez, MD, clinical director of urgent care and occupational medicine at Dignity Health Medical Foundation - Woodland.
That pain usually starts in the middle part of the abdomen, around the belly button, and moves slowly toward the lower-right part of the abdomen over 12 to 24 hours. Other symptoms of appendicitis might include fever, nausea, vomiting, diarrhea, constipation, or loss of appetite, according to the American College of Surgeons.
A common question is when to visit the emergency room or urgent care center. Dr. Martinez suggests a professional evaluation if your symptoms, particularly the abdominal pain, vomiting, or fever, continue to worsen and over-the-counter medications have not helped.
How a Doctor Will Diagnose Appendicitis
Your doctor will perform a series of standard tests and procedures to determine whether you have appendicitis or something else.
Diagnostic tests to help confirm appendicitis or other conditions may include:
- Taking vital signs, such as body temperature and blood pressure
- Physical exam, such as checking for rebound tenderness, the pain felt after the doctor presses down on the lower right quadrant of your abdomen
- Lab or blood tests, such as a white blood cell count
- Imaging tests, such as an ultrasound or CT scan to detect any inflammation of the appendix
- Urine test to check for bladder or kidney infections, or kidney stones
- Pregnancy test, in case of ectopic pregnancy
Your doctor will also ask you questions about your basic medical and surgical history, any medications you currently take, and any medication allergies you have.
Be prepared to provide detailed answers to questions about the onset and progression of your current symptoms. For example, in response to questions about when your abdominal pain started, a specific answer such as "12 hours ago" or "three days ago" is most helpful.
"Trying to be accurate on the time frame of the progression of symptoms really helps the physician accurately and quickly diagnose appendicitis," said Dr. Martinez. "We're looking for very specific time lines."
How to Treat Appendicitis
In many cases, the standard of care includes an appendectomy, or surgical removal of the appendix. Your surgeon may perform an open appendectomy with one larger incision, or a laparoscopic appendectomy with multiple small incisions. Both surgeries have comparable durations and recovery periods, and you usually can go home one or two days after either procedure.
Nonoperative treatment of appendicitis may be an option for some children with early onset of symptoms and no concerns of rupture or blockage of the appendix.
In some cases, particularly if a doctor catches the infection early on, you may be able to treat and manage the infection or inflammation and its symptoms without surgery, using antibiotics alone. Recent studies show that more patients in the U.S. are opting for nonoperative treatment if the appendix has not yet burst. However, patients and experts still question short- and long-term risks and outcomes of antibiotic-first treatment for appendicitis.
Opting out of surgery could mean risking future infections and the potential bursting or rupture of the appendix. A burst appendix can release fecal matter into the abdomen, causing an abdominal infection called peritonitis.
Why You Should See a Doctor
Because of the emergency risk associated with a burst appendix, you should visit the nearest emergency room or urgent care clinic if you suspect you have appendicitis.
"Even if it's not appendicitis, it could still be a serious medical condition," said Dr. Martinez. "I think some people think it's either appendicitis or nothing. From a medical standpoint, there's a list of 10 or more things that are serious that we're trying to rule out, not just the appendicitis."
Per the American Pediatric Surgical Association, conditions with symptoms that mimic appendicitis could include stomach flu, constipation, ovarian cyst or torsion (twisting), ectopic pregnancy, urinary tract infection, or kidney diseases, among others.
The potential seriousness of many of these conditions warrants a trip to the emergency room or urgent care center without hesitation. While easily treatable, it's important to diagnose appendicitis and begin treatment as soon as possible for a better outcome and quality of life.