Appendicitis Known as Great Imitator Due to Varying, Vague Symptoms

Health Minute     Fall 2017

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Pain in the lower right quadrant of a person’s abdomen is the classic sign for appendicitis, but one local surgeon said individuals need to be careful not to bank their understanding of the disease on that one symptom.

“Appendicitis has been given the name ‘The Great Imitator’ among those of us in medicine for a good reason,” said L. Stewart Lowry, MD, a surgeon with Miami County Surgeons. “It’s a disease that can look and feel like many other things. You can have pain in the low midline instead of the right lower quadrant or you could just have pain in your back. Some people think they’re having a GI virus because of nausea and vomiting and find out later on that it is appendicitis.”

Appendicitis is a common illness that affects people of all ages although it is most commonly found in younger adults. Symptoms of the illness include right lower quadrant pain, fever, chills, and usually an elevated white blood cell count. 

“Appendicitis is an acute illness that affects a person once, but if not promptly and properly treated can progress to extreme illness and to a point where the appendix perforates,” said Dr. Lowry, who practices with Premier Physician Network. 

How Appendicitis Happens

Appendicitis is most commonly treated by surgically removing the organ since the body can function without it. The appendix is thought to have an immunologic function in the body since it has lymph nodes and is covered with lymphatic tissue. It also is thought to play a part in processing the food a person eats. Over time the appendix and its shape morphs from a conical organ at birth, to a long thin sac once a person hits adulthood.

It’s this shape that is thought to contribute to the occurrence of appendicitis. The adult’s thin, sac-like organ contains cells that secrete mucus that drains into the large intestines. The appendix becomes sick when something blocks its ability to drain into the large intestines. The obstruction begins a cycle where the organ swells and that swelling creates pressure, which ultimately leads to the death of the cells that line the appendix, Dr. Lowry said.

The most successful treatment of appendicitis in the United States is the surgical removal of the organ, known as an appendectomy. There are more than 300,000 appendectomies performed across the country each year. The surgery can often be performed laparoscopically if caught early and no perforation of the organ has occurred. 

Recent studies have caused a debate as to whether appendicitis can be successfully treated just with antibiotics. However, Dr. Lowry said the research to support that originates out of Europe where appendicitis is still treated through open surgery, which can have a more extensive recovery time. It also comes with the risk that a person will suffer from symptoms down the road.

“Unfortunately, about 20 percent of those patients will have a recurrent bout of appendicitis within a year,” Dr. Lowry said. “That’s a fairly high number of people. Appendectomy is still considered a very safe and successful surgery here in the United States where the complication rate is between one and three percent, which is very low.”

Dr. Lowry said the most important thing is to understand the variety of warning signs that appendicitis can display. Timely treatment of the disease is critical to positive outcomes. Anyone who is experiencing the following symptoms should seek medical attention right way: abdominal pain that is new or unusual that starts at the belly button and migrates to the lower right quadrant, and fever with chills.

“These are the signs that should direct a person to emergency care within 24 hours of experiencing them,” Dr. Lowry said.

For more information on appendicitis or to find a Premier Physician Network physician near you, visit premierhealthspecialists/surgery.  

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