Appendicitis

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Appendicitis is inflammation or infection of your appendix — a small, finger-shaped pouch attached to your large intestine, usually on the lower right side of your belly ¹. If not treated promptly, the appendix may burst, which is a serious, potentially life-threatening condition.

Why Does Appendicitis Happen?

Appendicitis often begins when something blocks the appendix’s opening — such as hard stool, food particles, or swelling — leading to bacterial overgrowth, inflammation, and infection ¹.

 

It can affect anyone, but is most common in children and young adults. ¹

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Symptoms

Common symptoms include:

 

  • Sudden pain near your belly button (umbilicus) that gradually shifts to the lower right side of your abdomen¹.
  • Pain that worsens when you move, cough, or press on the area; sometimes it eases briefly if you curl into a ball.
  • Feeling sick, nausea or vomiting, loss of appetite, mild fever, constipation or diarrhoea, or gas ¹.

 

Some patients don’t experience “classic” symptoms. This is more common in:

 

  • Children,
  • Older adults, and
  • Pregnant people,
    who may report vague pain, slower onset, or pain in a different location ¹.

 

If the appendix bursts (perforates), pain may briefly improve, then return more severely and spread across your abdomen. This can be accompanied by signs of infection or sepsis.

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When to Seek Help

See a doctor (or go to your nearest hospital) if you have:

  • Abdominal pain that won’t go away, is getting worse, or migrates to your lower right side.
  • Severe pain, confusion, blotchy skin, difficulty breathing — these could be signs of a ruptured appendix and infection.

Do not delay. A burst appendix requires emergency treatment.

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How Is Appendicitis Diagnosed

Medical evaluation typically involves:

  1. Physical examination — your doctor will gently press (and release) on your abdomen to check for tenderness, stiffness, and muscle guarding ².
  2. Blood tests — looking for a raised white-blood-cell count, a marker of infection ².
  3. Urine test — to rule out a urinary tract infection or kidney stones, since these can mimic appendicitis ².
  4. Imaging — an ultrasound is often used first; or sometimes a CT scan (or MRI) ².
  5. Pregnancy test, if relevant, because pregnancy can affect the location of your appendix.

Because other conditions (e.g., ovarian cysts, urinary issues) can look like appendicitis, diagnosis can be challenging. In some cases, doctors may observe symptoms for a few hours before deciding on treatment ¹,².

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Treatment

Appendectomy (Surgical Removal)

The most common treatment for appendicitis is surgery to remove your appendix (an appendectomy) — the body can function normally without it ².

  • Laparoscopic (keyhole) surgery: Several small cuts are made on the abdomen through which a camera and surgical instruments are passed to perform the operation; typically leads to faster recovery, less pain, and smaller scars ².
  • Open surgery: A larger incision, often used if the appendix has burst so that the surgeon can clean the abdominal cavity ².
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Disclaimer

This brochure is for educational purposes only and is not intended to provide a diagnosis or treatment or replace the advice of your doctor, pharmacist, primary health care nurse or other health care provider. You are advised to discuss any questions or concerns you have with your health care provider.

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  1. appendicitis in South Africa. Superscript ⁴ (ojs.sabinet.co.za)
  2. Yang E. Acute appendicitis outcomes in public vs private sectors in Cape Town. Superscript ⁵ (open.uct.ac.za)
  3. South African Journal of Surgery: Diagnostic deficits in females with suspected acute appendicitis. Superscript ⁶ (ojs.sabinet.co.za)
  4. Brits E, et al. Bacteria and antibiotic susceptibility in paediatric appendicitis in central South Africa. Superscript ⁷ (sajid.co.za)

This referenced content has been reviewed by Dr Helen Sammons, who is a qualified medical doctor with extensive experience in the private healthcare sector of South Africa, particularly in the disciplines of general practice.

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