Why does appendicitis get inflamed: diagnosis and treatment

Appendicitis is a well-known and very common disease that occurs in the appendix of the cecum - the appendix. Despite the fact that this is the most common disease of the digestive organs, it is also the most dangerous. With an incorrect diagnosis or untimely medical assistance, complications of appendicitis develop rapidly and seriously threaten the patient's life. It is believed that every tenth person underwent surgery for appendicitis, half in childhood. According to statistics, most often appendicitis occurs in children from five years old and in adults aged 35-40 years, cases when the problem has arisen in people of a younger or older age are much less common. Many people are interested in why appendicitis is inflamed and whether it is possible to protect yourself and loved ones from this disease. Consider the causes, symptoms and diagnosis of the disease.

Appendicitis: what is this disease?

Inflammation of the appendix, the appendix located at the bottom of the intestine, is called appendicitis. Normally, the appendix is ​​about a centimeter long and is a small tube that side departs from the cecum, the other side does not have a through passage and gradually narrows, forming appendix.

The functions of the appendix have not been fully studied and identified. Previously, doctors believed that this is a rudimentary organ left over from a person's ancestors. Modern medicine believes that the appendix plays a serious role in the formation of intestinal microflora, is involved in immune and endocrine processes. People who have had surgery to remove their appendix often suffer from a lack of beneficial bacteria in their intestines. However, the removal of this organ does not cause proven harm to the body, and without it, the person continues to live exactly as before the operation.

It is necessary to clarify that appendicitis cannot be cured conservatively; surgical intervention is necessary in 100% of cases of the disease. As for the symptoms of appendicitis, it always gives a fairly clear picture - let's look at how the disease manifests itself.

Appendicitis: symptoms

Symptoms of appendicitis are very important for early diagnosis - it is important not to confuse the disease with other gastrointestinal disorders. The first and main signs, indeed, mask appendicitis under other, not so dangerous diseases, for example, food poisoning or gastritis. At first, the disease most often manifests itself:

• nausea and vomiting;
• an increase in body temperature;
• severe pain in the abdomen, worse with pressure.

The pain occurs abruptly, unexpectedly, more often at night or in the morning. At first, the pain manifests itself above the abdomen, then it concentrates below the navel and does not go away. In the "classic" scenario of the course of appendicitis, abdominal pain will intensify, gradually descending to the right and down. When walking, a person is uncomfortable, he pulls his right leg, when coughing, shaking (for example, in transport) and any stress, the pain increases significantly. The patient is not comfortable lying in an extended position, he seeks to tighten his right leg, it is difficult to raise it at the same time.

It is the movement of the pain focus down and to the right that is one of the most characteristic signs of appendicitis, which is called the "Kocher symptom". This migration of pain makes doctors understand that the patient has an inflamed appendix, and not another disease manifested or worsened.

As a rule, the focus of pain moves during the first few hours of the disease, the nature of pain sensations also changes: pain grows, intensifies with breathing, laughing and coughing, becomes pulsating, aching, the abdominal wall is in stress. It is easier for the patient to lie on his right side, pressing his legs to his stomach. Irridation of pain to the right leg is another characteristic symptom. If you press on the location of the pain - on the right below the navel (iliac region), the pain does not intensify, but if the patient exhales sharply and lowers his stomach, a sharp outbreak of pain is provided.

If at the above stage the person “missed the disease”, then the pain may subside for a while. In a calm state, the person practically does not hurt, but if you press on the iliac region, the pain will still be very strong. This suggests that nerve endings began to die off around and inside the appendix, and necrosis on the tissue of the organ walls is already underway. This stage of the disease is usually associated with perforation of the walls of the appendix (holes appear) through which pus comes out, which spreads throughout the peritoneum. If this happens, the pain immediately comes again, intensified many times over, it can hardly be tolerated.

In the first hours of the disease, the body temperature rises slightly - up to 37 degrees, to a maximum of 38, after a while it can drop to normal, simultaneously with a decrease in pain. But in the final stage of inflammation, before the pus from the appendix breaks into the abdominal cavity, the thermometer shows high numbers - up to 40 degrees, at the same time the pain returns. This is a dangerous situation because a person can confuse the “calm before the storm” with the cessation of symptoms and go somewhere else. You cannot do this, as well as take painkillers for any discomfort in the abdomen. The tablets will work and lubricate the symptoms, at which time you can skip the final stage of appendicitis.

Appendicitis: atypical form

In an atypical (non-standard) scenario of the course of appendicitis, diarrhea, abdominal cramps, and dizziness may be added to the picture of the disease. With appendicitis with slow development (Emipiema), there is no downward pain migration - it immediately "spreads" below, near the navel. For women, pelvic appendicitis is characteristic, when the temperature rises slightly, and the pain is localized in the pubic region.

Sometimes the pain can spread to the lumbar region, pelvic bones or under the ribs on the right, move to the pubic region. Rarely, but it happens that the appendix is ​​located on the left, respectively, the painful foci will be mirrored - on the left side of the ileum and abdomen.

In patients, symptoms of appendicitis can be: nausea, vomiting, diarrhea, after which there is no relief. When the appendix is ​​located outside the norm, on the contrary, there may be a delay in urination and stool, dry mouth, tachycardia (about one hundred beats per minute).

Diagnosis of the disease is difficult in children under five years of age and elderly people. The child cannot explain the nature of the pain, it is often not localized in the ileum, and upon palpation, the baby does not express much concern. Parents confuse appendicitis with indigestion and begin giving medications for this ailment. To avoid confusion, you should pay attention to diarrhea, fever, plaque on the tongue.

Appendicitis in the elderly is even more difficult to diagnose. There may not be a rise in temperature, nausea is not too bothersome, and the pains are dull and aching in nature, without sharp outbreaks. Moreover, it is in elderly patients that complications of the disease are more often observed, some of them occur due to late admission to the hospital and untimely diagnosis.

Why does appendicitis get inflamed?

We mentioned that the appendix itself is not fully understood, therefore, the causes of its inflammation are controversial. It is believed that harmful bacteria fill the lumen of the epididymis and lead to disease. Bacteria are in the organ and are normal, but their number is small, and the process itself is protected from their influence by functional lymphoid tissue and mucous membranes.

But in a number of situations, the protective tissue and membrane weaken, foreign microorganisms and bacteria still penetrate into the appendix, and inflammation occurs. Appendicitis can be a complication of other diseases: problems with the intestinal microflora, systemic vasculitis (destruction of the walls of blood vessels), infectious diseases (tuberculosis, typhoid fever). There are other reasons, which we will consider in the form of a table.

Table 1. Reasons why protection is violated

Blood flow is impaired	Improper nutrition	Allergic reactions	Blockage of the appendix	Frequent constipation
The arteries and vessels that feed the appendix can be blocked by a blood clot, leaving the walls of the appendix lacking nutrients and suffering.	Violation of the diet, food scarcity can lead to stagnation of feces in the intestines, and fragments of fecal stones can get from the intestines into the appendix and provoke inflammation.	Since the appendix is ​​classified as an organ of the immune system, the hyperfunction of immune cells leads to an allergic reaction, due to which the organ's defense is weakened.	Parasites, fecal stones, foreign bodies, food debris and the like can lead to blockage of the appendix. Since it is not end-to-end, stagnation of any character provokes an inflammatory process.	The tendency to constipation is characterized by the slow movement of feces through the intestines, their compaction and slow evacuation, during which they enter the appendix.

Also, appendicitis can be caused by a seasonal decrease in immunity (in spring or during periods of winter quarantine) or a chronic focus of inflammation in the body (adenoids, caries, severe tonsillitis).

What to do if appendicitis is suspected?

Constant pain in the abdomen of any strength that does not pass within six hours is a reason to call a doctor, and at night - an ambulance. While you are waiting for an examination, you do not need to take analgesics or antispasmodics, as they complicate the diagnosis, distorting the clinical picture. Do not take laxatives or antibiotics, use a heating pad, go to the bathroom, or eat.

The best option is bed rest until the doctor arrives. Remember the time when the pain began, try to remember all the little things that could lead to the disease. Measure the temperature to inform the doctor about the dynamics of its change or lack thereof. If you are taking any pharmaceutical drugs, suffer from chronic diseases, especially if they are related to the gastrointestinal tract, do not forget to talk about it.

Appendicitis diagnosis and treatment

First of all, the physician will conduct a visual examination of the abdomen, ask the patient about the symptoms and complaints, and palpate the painful area. On palpation, the doctor should note an increase in pain in the lower right side, tension in the abdominal wall. If these symptoms are accompanied by those that we have indicated above, this is an indication for hospitalization.

At the hospital, urine and blood tests will be taken from the patient, paying attention to the level of leukocytes. If this indicator is increased, it characterizes appendicitis. The most common diagnostic method is abdominal ultrasound; if indicated, MPT, computed tomography, or even laparoscopic examination can be prescribed.

If appendicitis is confirmed by diagnosis, the patient is prepared for an operation to remove the appendix. Surgical intervention is carried out either by the method laparoscopy (through a small hole), or the classical open method through an incision. Within twelve hours after the operation, the patient is under observation, activity and food intake are excluded. The recovery period usually lasts a week and a half, if necessary, additional antibiotic therapy is prescribed.

Video - How to distinguish appendicitis from other abdominal pain

Summing up

Most doctors are inclined to believe that appendicitis occurs due to an excessive amount of harmful bacteria that occurs in the appendage - the appendix. To avoid problems, the first rule that every person must follow is to make a thoughtful and balanced diet. In fact, the appendix belongs to the gastrointestinal tract system, so the correct selection of nutrition will be the best prevention of the disease.

The second follows from the first - a person must carefully monitor his entire body, including its cleansing functions. Simply put, you need to pay attention to the frequency and quality of stools, and in case of negative changes, reconsider the diet or consult a doctor.

It is enough to solve digestive problems, cure all diseases, undergo regular medical examinations and not abuse harmful products, alcohol and smoking. In this case, it can be assumed that a disease such as appendicitis, if it occurs, will be under the influence of other factors that cannot be influenced.