When Tinuke Moshood was diagnosed with Appendicitis, she could not help but express her shock. She gave reasons like “I eat stone-free rice,” “I chew the seeds of any fruit I eat,” ranting on and on to whosoever cared to listen.
Sure, most people share Tinuke’s feelings about what causes and prevents Appendicitis, but it would interest them to know that there is a lot more to the disease than simply eating stones.
Appendicitis typically begins with a vague pain in the middle of the abdomen, often near the navel or “belly button” (umbilicus). Then the pain slowly moves to the right lower abdomen (toward the right hip) over the next 24 hours.
In the classic description, abdominal pain is accompanied with nausea, vomiting, lack of appetite and fever. All of these symptoms, however, occur in fewer than half of the people who develop Appendicitis. More commonly, people with the disease have any combination of these symptoms.
“Symptoms of Appendicitis may take 4-48 hours to develop. During this time, someone developing Appendicitis may have varying degrees of loss of appetite, vomiting, and abdominal pain. Some may have constipation, diarrhea or there may be no change in bowel habits,” explains Shola Kushimo, a medical practitioner with LUTH.
Early symptoms are often hard to separate from other conditions including gastroenteritis (an inflammation of the stomach and intestines). For this reason, many people admitted to the hospital for possible Appendicitis sometimes leave the hospital with a diagnosis of gastroenteritis.
Children and the elderly often have fewer symptoms, which makes their diagnosis less obvious and the incidence of complications more frequent.
However, a new study spearheaded by the Johns Hopkins Children’s Centre in the US may ease the pediatrician’s problem-solving and parents’ anxiety regarding Appendicitis among children.
Reporting on their review of the frequency of the most common symptoms of actual Appendicitis in children, the researchers concluded that beyond fever, the most telltale signs are ‘rebound’ tenderness or pain that occurs after pressure is removed abruptly from the lower right part of the abdomen -abdominal pain that starts around the belly button and migrates down and to the right; and an elevated white blood cell count (10,000 or more per microlitre), which is a marker of infection in the body.
Notably, losses of appetite, nausea and vomiting, hallmark appendicitis symptoms in adults, were not predictive of appendicitis in children.
“These signs don’t give you an absolute diagnosis, but they should prompt the doctor to refer the child to a surgeon for evaluation,” said study lead author David Bundy, M.D., M.P.H., a pediatrician at the Johns Hopkins Children’s Centre.
There have also been reported severe cases where the appendix can burst and spread bacteria and infection throughout the abdomen, leading to serious health problems. Such was Esther Umoh’s case, who recalls that “I had nursed the pain for a very long time, but did not know it was Appendicitis. It got to the peak on this day that I lay down flat on the floor and could not move again. I was rushed to Ethiope Hospital in Tincan, Apapa Lagos, where I was told that it was ruptured Appendicitis. It was after the surgery when I regained consciousness that the doctor told me it did not only rupture but had actually burst, and that if I had delayed, it would have cost me my life.”
Surely, Esther’s experience drives home the point that Appendicitis is as life-threatening as it is costly to treat, especially because it usually involves surgery. So experts advise that whenever symptoms that point at the disease are in evidence, the public should shun self-medication in favour of professional opinion. Their suggestions certainly count if Appendicitis must be diagnosed and expelled in record time.
