KOCHI: Appendicitis is one of the many common medical conditions seen in the 10 to 30 age group. As early symptoms of appendicitis often get masked by antibiotics, diagnosis and treatment are delayed, thereby creating serious complications. While it is imperative to get a timely diagnosis, it is equally important to understand about the appendix to avoid complications which might lead to serious health conditions.
The appendix is a tubular structure located at the junction of small and large intestines. “Appendix is a vestigial organ (it no longer seems to have a purpose in the current form of an organism of the given species). It is the storage space for colonic bacteria. After a bad case of gastritis, the appendix provides the flora of the bacteria to the large intestine,” says Dr Kiran V R, the consultant paediatric surgeon at Aster Medcity.
Because it is located in the junction of the bowels, normal secretions occur daily. However, due to many reasons, the tip of the appendix gets blocked. Children with a habit of biting nails often present appendicitis.
“In children, during the bowel movements, pieces of stool may enter the appendix. In some cases, the lymph nodes in the large intestines can block the opening,” says Kiran.
The secretions will then accumulate in the appendix, causing it to distend. The distend will be felt in the umbilical cord, which is the reason for the initial pain in the area. The subsequent obstruction will cause nausea. Once the appendix is full of liquid, it gets infected. When the distended appendix touches the abdominal wall, the pain will shift to the lower right side. Then it will rupture and complications follow.
While surgery is the only known treatment for appendicitis in children, it is important to diagnose as early as possible. Early symptoms include loss of appetite, nausea and abdominal pain. “Parents should consult a paediatrician when they notice sleepless behaviour in their child, or if his/her daily activities are disrupted because of the pain. Symptoms will progress in time,” says Kiran.
Once appendicitis is confirmed after blood tests and an ultrasound scan, surgery is performed to remove the infected appendix. “This is the best-proven treatment method for children. Adults, on the other hand, can still be treated with antibiotics,” says the doctor.
While surgery may sound scary, it is pointless to delay or avoid the inevitable. In fact, it is more dangerous.
“Most of the time, general practitioners start antibiotics for abdominal pain. This mask the symptoms. But children don’t have the natural mechanism to control appendicitis. Once the infected appendix increases in size (more than 6 mm), the blood supply gradually gets blocked, it bursts and the secretions suddenly go into the abdominal cavity. A localised problem thus becomes a generalised one,” says the paediatric surgeon.
According to him, once this happens, two complicated conditions occur: Peritonitis and abscesses. In peritonitis, after the appendix burst, the lining of the organ gets infected with bacteria. In abscess, the pus gets collected around the appendix. The body will try to fight the infection by collecting pus like a mass in the small intestine. When the infection gets into the blood, it presents itself as sepsis, which is potentially life-threatening.
Appendicectomy, the surgical procedure to remove the appendix from the abdomen, is performed laparoscopically. The recovery time is less and the patient can go on with their normal lives at the earliest.