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Appendicitis

Appendicitis

What is appendicitis?

The appendix is a small, tube-like organ attached to the first part of the large intestine. Although its exact function is unknown, the appendix does play a role in the immune system as it acts as 'storage’ for good bacteria. Be that as it may, the appendix can become inflamed, which results in appendicitis.
Appendicitis is a medical condition in Singapore that occurs when the appendix becomes blocked, which later leads to bacterial overgrowth and inflammation. There are two main types of appendicitis, namely:
  • Acute appendicitis: acute appendicitis is a sudden and severe inflammation of the appendix. It is the most common type of appendicitis and typically requires immediate medical attention.
  • Chronic appendicitis: chronic appendicitis is a milder yet recurrent form of appendicitis. The patient often experiences intermittent episodes of abdominal pain and discomfort. However, chronic appendicitis is less common compared to acute appendicitis.
    • Appendicitis is an inflammation of the appendix.

    What are the common causes of appendicitis in Singapore?

    Appendicitis happens when the appendix becomes inflamed. Even though the exact cause of the inflammation is usually unclear, it can be due to a blockage of the appendix. These blockages are often due to:

    Faecaliths:

    hardened poop, also known as appendix stones, can get stuck and block the opening of the appendix.

    Colitis:

    colitis, an inflammation of the colon, can cause appendicitis if the infection spreads to the appendix.

    Lymphoid hyperplasia:

    lymphoid hyperplasia or enlarged lymphoid tissue in the appendix can block the opening and cause an infection.

    Parasites:

    parasites such as intestinal worms can cause appendicitis in rare cases.

    Tumours:

    appendiceal tumours or tumours that grow in the appendix can block the opening of the appendix and cause appendicitis.

    What are the possible complications of appendicitis?

    When the appendix is blocked, it stimulates bacterial overgrowth, which results in an infection and inflammation. If left untreated, appendicitis can lead to potentially life-threatening complications, such as:

    Burst appendix:

    a burst appendix can cause peritonitis, a condition that refers to infection spreading throughout the abdomen.

    Abscesses formation:

    abscesses may form following a burst appendix.

    Ischaemia and necrosis:

    swelling in the appendix can cut off blood supply, a process known as ischaemia. When this happens, the appendix does not get enough blood, causing it to decay and die (necrosis).

    Gangrene and perforation:

    necrosis of the appendix can spread the infection to other tissues.
    Ischaemia and necrosis of the appendix can occur if appendicitis is left untreated.

    What are the symptoms of appendicitis?

    Some of the common symptoms of appendicitis include:

    Abdominal pain:

    the most common symptom of appendicitis is abdominal pain that begins on the right side of the lower abdomen or starts around the navel and then shifts. The pain often becomes sharper over several hours.

    Nausea and vomiting:

    other common symptoms that tend to follow abdominal pain are nausea and vomiting.

    Fever:

    individuals may also experience a low-grade fever, which is a sign that their body is fighting an infection. This may be accompanied by chills.

    Loss of appetite:

    loss of appetite is another common symptom of appendicitis.

    Bloatedness:

    individuals may be unable to pass gas, leading to bloating and abdominal swelling.

    Constipation or diarrhoea:

    gastrointestinal symptoms such as constipation or diarrhoea may occur.
    If you or someone you know is experiencing these symptoms, especially severe or worsening pain in the abdomen, seek immediate medical attention. Untreated appendicitis can lead to severe complications. Get in touch with us today (link to contact page) to schedule an appointment with our doctors.

    Who is at risk of appendicitis in Singapore?

    No one is immune to appendicitis, as it can affect anyone. However, some of the factors can increase the likelihood of developing appendicitis; these include:

    Age:

    although appendicitis can occur at any age, it often affects individuals between the ages of 10-30.

    Gender:

    males are more likely than females to develop appendicitis.

    Genetic predisposition:

    individuals with a family history of appendicitis have a higher possibility of developing appendicitis.

    Dietary factors:

    a low-fibre diet with a high amount of processed food has been linked to appendicitis.

    Gastrointestinal infections:

    gastrointestinal tract infections, such as colitis or swollen lymph nodes of the appendix, can increase the risk of developing appendicitis.
    Appendicitis is characterised by abdominal pain and a low-grade fever.

    How is appendicitis normally diagnosed in Singapore?

    Your doctor will usually start by assessing your family’s medical history, followed by a physical examination. During the physical examination, your doctor will gently press on your abdomen to check for tenderness in the lower right quadrant of the abdomen, where the appendix is located.
    Additionally, your doctor may also ask for the following diagnostic procedures to be conducted:
  • Blood tests:
    • a blood test will help determine your white blood cell count, which could indicate infection or inflammation.
  • Urine tests:
    • a urine test is often done to rule out other potential causes of pain, such as a urinary tract infection (UTI).
  • Imaging tests:
    • imaging tests such as an abdominal ultrasound, computerised tomography (CT) scan, and magnetic resonance imaging (MRI) may be conducted to provide a more accurate diagnosis of your abdominal pain. These tests allow doctors to assess the structure of the abdomen to help confirm a diagnosis or rule out other conditions.
    These risk factors increase the pressure and strain on the anus, which can cause tears in the lining, resulting in an anal fissure.

    What are the treatment options for appendicitis in Singapore?

    Since appendicitis comes with the risk of rupturing, it is considered a medical emergency. That is why, in most cases, your doctors will advise you to have your appendix removed. The appendix can be removed in two ways, depending on the severity of your symptoms and the stage of the condition.

    Open surgery:

    open surgery involves a larger incision in the lower right area of the abdomen to remove the appendix. It may be necessary if the appendix has ruptured or if there are complications, such as an abscess. In the event that the appendix has ruptured, a small shunt will be placed to drain the abscess. Your doctor will leave the shunt in for a couple of days and have it removed once the infection has cleared.

    Laparoscopic surgery:

    this is a minimally invasive surgery involving small incisions and the use of a camera and instruments to remove the appendix. It typically results in shorter recovery times and less pain after surgery.
    Beyond surgical removal, there have been cases where the appendicitis is treated with antibiotics alone. However, this is subject to your doctor’s discretion. The choice of treatment often depends on individual circumstances, including the stage of appendicitis and the overall health of the patient. In all cases, prompt medical evaluation and treatment are crucial to prevent complications such as rupture, which can lead to peritonitis (a severe, life-threatening infection of the abdominal cavity).

    Frequently Asked Questions

    Yes, appendicitis is typically quite painful. It is often described as sudden pain that begins near the navel and slowly moves to the lower right abdomen.

    The earliest sign of appendicitis is pain that begins near the navel or middle of the abdomen and progresses and moves to the lower right abdomen. Individuals may also experience a low-grade fever, loss of appetite, nausea, and bloating.

    It is impossible to prevent appendicitis. However, one of the best ways to lower the risk of appendicitis is to eat a high-fibre diet.

    Location

    Colorectal Care Specialists (CRCS)

    3 Mount Elizabeth, #14-15, Mount Elizabeth Medical Centre, Singapore 228510

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