Monday, April 4, 2011

causes of Appendicitis and Treatment

 What is appendicitis:
Appendicitis is a painful swelling and infection of the appendix.Appendicitis is the inflammation of the appendix.The symptoms are pain in the belly button area which in the end will move in the right side of the lower abdomen and will be much worse, low graded fever, nauseas and sometimes even vomiting, loss of appetite and constipation or diarrhea.
Some people might not have all these symptoms and some might not have any of them, but still have appendicitis.The appendix is a closed, narrow tube up to several centimeters in length that attaches to the cecum (the first part of the colon) like a worm.
(The anatomical name for the plant, ie vermiform, worm-like appendage.) The inner lining of the plant produces a small amount of mucus is flowing through the open center of the plant and in the appendix.The wall of the appendix contains lymphatic tissue that is part of the immune system to produce antibodies. As theRest of the colon, the wall of the annex includes a layer of muscles, but the muscle is poorly developed.

What is the appendix:
The appendix is a fingerlike pouch attached to the large intestine and located in the lower right area of the abdomen. Scientists are not sure what the appendix does, if anything, but

removing it does not appear to affect a person’s health.The inside of the appendix is called the appendiceal lumen. Mucus created by the appendix travels through the appendiceal lumen and empties into the large intestine.
  The inner lining of the appendix produces a small amount of mucus that flows through the open center of the appendix and into the cecum. The wall of the appendix contains lymphatic tissue that is part of the immune system for making antibodies.Like the rest of the colon, the wall of the appendix also contains a layer of muscle, but the layer of muscle is poorly developed.

What causes appendicitis:
Obstruction of the appendiceal lumen causes appendicitis. Mucus backs up in the appendiceal lumen, causing bacteria that normally live inside the appendix to multiply. As a result, the appendix swells and becomes infected. Sources of obstruction include
1)feces, parasites, or growths that clog the appendiceal lumen
2)enlarged lymph tissue in the wall of the appendix, caused by infection in the gastrointestinal tract or elsewhere in the body
3)inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
4)trauma to the abdomen
An inflamed appendix will likely burst if not removed. Bursting spreads infection throughout the abdomen—a potentially dangerous condition called peritonitis.

What are the symptoms of appendicitis:
Most people with appendicitis have classic symptoms that a doctor can easily identify. The main symptom of appendicitis is abdominal pain.
The abdominal pain usually
1)occurs suddenly, often causing a person to wake up at night
2)occurs before other symptoms
3)begins near the belly button and then moves lower and to the right
4)is new and unlike any pain felt before
5)gets worse in a matter of hours
6)gets worse when moving around, taking deep breaths, coughing, or sneezing
Other symptoms of appendicitis may include:
1)loss of appetite
4)constipation or diarrhea
5)inability to pass gas
6)a low-grade fever that follows other symptoms
7)abdominal swelling
8)the feeling that passing stool will relieve discomfort
Symptoms vary and can mimic other sources of abdominal pain, including
1)intestinal obstruction
2)inflammatory bowel disease
3)pelvic inflammatory disease and other gynecological disorders
4)intestinal adhesions

Diagnosis is based on patient history (symptoms) and physical examination backed by an elevation of neutrophilic white blood cells. Histories fall into two categories, typical and atypical. Typical appendicitis usually includes abdominal pain beginning in the region of the umbilicus for several hours, associated with anorexia, nausea or vomiting. The pain then "settles" into the right lower quadrant, where tenderness develops.
Atypical histories lack this typical progression and may include pain in the right lower quadrant as an initial symptom. Atypical histories often require imaging with ultrasound and/or CT scanning.
A pregnancy test is vital in all women of child bearing age, as ectopic pregnancies and appendicitis present with similar symptoms. The consequences of missing an ectopic pregnancy are serious, and potentially life threatening. Furthermore the general principles of approaching abdominal pain in women (in so much that it is different from the approach in men) should be appreciated.Blood Test Most patients suspected of having appendicitis would be asked to do a blood test. 50% of the time, the blood test may be normal, so it is not fool proof in diagnosing appendicitis.

How is appendicitis treated:
Typically, appendicitis is treated by removing the appendix. If appendicitis is suspected, a doctor will often suggest surgery without conducting extensive diagnostic testing. Prompt surgery decreases the likelihood the appendix will burst.

Surgery to remove the appendix is called appendectomy and can be done two ways. The older method, called laparotomy, removes the appendix through a single incision in the lower right area of the abdomen.
The newer method, called laparoscopic surgery, uses several smaller incisions and special surgical tools fed through the incisions to remove the appendix. Laparoscopic surgery leads to fewer complications, such as hospital-related infections, and has a shorter recovery time.Surgery occasionally reveals a normal appendix. In such cases, many surgeons will remove the healthy appendix to eliminate the future possibility of appendicitis. Occasionally, surgery reveals a different problem, which may also be corrected during surgery.

Sometimes an abscess forms around a burst appendix—called an appendiceal abscess. An abscess is a pus-filled mass that results from the body’s attempt to keep an infection from spreading. An abscess may be addressed during surgery or, more commonly, drained before surgery.
To drain an abscess, a tube is placed in the abscess through the abdominal wall. CT is used to help find the abscess. The drainage tube is left in place for about 2 weeks while antibiotics are given to treat infection.
Six to 8 weeks later, when infection and inflammation are under control, surgery is performed to remove what remains of the burst appendix.

Nonsurgical Treatment:
Nonsurgical treatment may be used if surgery is not available, if a person is not well enough to undergo surgery, or if the diagnosis is unclear. Some research suggests that appendicitis can get better without surgery.
Nonsurgical treatment includes antibiotics to treat infection and a liquid or soft diet until the infection subsides. A soft diet is low in fiber and easily breaks down in the gastrointestinal tract.

With adequate care, most people recover from appendicitis and do not need to make changes to diet, exercise, or lifestyle. Full recovery from surgery takes about 4 to 6 weeks. Limiting physical activity during this time allows tissues to heal.

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