Medicines for Appendicitis

What it is

Appendicitis is a painful swelling (inflammation) of the appendix — a small, finger-shaped pouch attached to the large intestine on the lower right side of the tummy. It is a common cause of sudden, severe tummy pain and is one of the most common reasons for emergency abdominal surgery. It can affect people of any age but is most common in children, teenagers, and young adults. Appendicitis usually develops when the appendix becomes blocked and then inflamed and infected. The classic pattern of pain is distinctive and important to recognise: the pain often begins in the middle of the tummy (around the navel) and comes and goes, then over a number of hours moves to the lower right-hand side, where it becomes constant, severe, and worse with movement, coughing, or pressing. Other symptoms can include feeling sick or being sick, loss of appetite, a raised temperature, constipation or diarrhoea, and generally feeling unwell. The presentation can be less typical, particularly in young children, older people, and during pregnancy, which can make it harder to recognise. Appendicitis is a medical emergency: if the inflamed appendix is not treated, it can burst (perforate), which spreads infection into the tummy (peritonitis) and is serious. The main treatment is usually an operation to remove the appendix (appendicectomy), which is a common and generally very effective procedure. Because of the risk of the appendix bursting, it is important to seek urgent medical help for the typical pattern of worsening tummy pain — and not to take painkillers or wait, as prompt assessment and treatment are important.

How it is treated

Appendicitis is a medical emergency and is managed in hospital, with the priority being prompt assessment and treatment before the appendix can burst. If appendicitis is suspected — particularly tummy pain that starts around the navel and moves to the lower right, becoming constant and severe, with feeling unwell — urgent medical assessment is needed. In hospital, diagnosis is based on the history and examination, blood and urine tests, and sometimes scans (such as ultrasound or CT), though the diagnosis can be difficult and is sometimes made during surgery. The main treatment is usually an operation to remove the appendix (appendicectomy), most often done as keyhole (laparoscopic) surgery, which allows quicker recovery; this is a common operation and is generally very effective, and removing the appendix causes no long-term problems. Antibiotics are given, and in some selected cases antibiotics may be used as part of treatment, but surgery is the usual approach. If the appendix has already burst, treatment is more involved (including managing the resulting infection). Because delay increases the risk of the appendix bursting, the key messages are to recognise the typical pattern and seek urgent help promptly, and not to delay, take painkillers that might mask the pain, or "wait and see" with worsening tummy pain. It is worth noting that tummy pain is very common and usually not appendicitis — but the specific pattern of pain moving to and settling in the lower right, becoming constant and severe with feeling unwell, should prompt urgent assessment. The reassuring message is that appendicitis, while an emergency, is common and, when treated promptly, is usually resolved successfully with a routine operation and full recovery.