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Diagnosis & Treatment

Appendicitis

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How is Appendicitis Diagnosed?

Diagnosis

Chronic appendicitis can be harder to diagnose, as symptoms can be mild or may come and go, whereas acute appendicitis causes more severe, sudden pain.

Both acute and chronic appendicitis can be diagnosed using a range of different tests and imaging, including:

  • A physical exam will be conducted to assess for abdominal pain. In biologically female people, a pelvic exam may be done to rule out pain caused by the ovaries or uterus.
  • A medical history review will help your doctor determine any risk factors you may have, as well as rule out other medical conditions that could be causing your symptoms.
  • Lab tests such as blood tests and urine tests may be used to help diagnose appendicitis:
    • Blood tests can assess white blood cell count. If an appendicitis blood test shows a high white blood cell count, this can be a sign of an inflammation/infection, which may point to appendicitis.
    • Urine tests can rule out urinary tract infections, which can cause pain that may be mistaken for appendicitis
  • Imaging tests can help make a definitive diagnosis of appendicitis:
    • CT scans (computed tomography scans) use multiple X-rays to take pictures of the inside of the abdomen. This is considered the most accurate test for diagnosing appendicitis. CT scans involve the use of ionizing radiation, a form of energy that allows for cross-sectional images of the inside of the body.
    • Ultrasounds use sound waves to create images of the inside of the abdomen. To avoid radiation exposure, ultrasounds are the preferred imaging method for children. They are less helpful in adults.
    • MRIs (magnetic resonance imaging scans) can also be used. Although they are not typically considered a first-line imaging option, they still offer high accuracy and do not expose patients to radiation.

How is Appendicitis Treated?

Treatment

Acute appendicitis is a medical emergency requiring immediate medical care. Most cases will require surgical removal of the appendix, called an appendectomy. Milder cases of acute appendicitis or chronic appendicitis may be able to be treated with medication.

Surgery

Most cases of appendicitis require surgery — an appendectomy — to remove the appendix. Waiting too long to remove the appendix can cause the appendix to rupture, which can lead to life-threatening complications. An appendectomy cures appendicitis and is a very common surgery.

There are two methods available for appendectomies:

Open appendectomy

Open appendectomies involve making a single large cut, or incision, to the lower right of the navel (belly button), or a vertical incision along the midline of your abdomen, allowing the surgeon to remove the appendix.

Laparoscopic appendectomy

Laparoscopic appendectomies involve creating a small incision in the abdomen, through which a small device called a port is inserted. The port creates an opening that the surgeon uses to fill the abdomen with gas, creating enough space to operate. A small camera is then inserted through the port, allowing the entire surgery to be shown on a screen in the operating room. More ports are then inserted to allow for the insertion of narrow instruments that are used to remove the appendix.

This method creates smaller incisions, allowing for faster appendicitis surgery recovery time and a lower chance of infection.

Medication

In some milder acute or chronic appendicitis cases, antibiotics may be enough to heal inflammation and fight off infection.

In lower-risk cases, people are typically given intravenous appendicitis antibiotic treatment right away to see whether medication alone will be sufficient, rather than immediately moving to surgery. Many low-risk people recover on these antibiotics and do not require surgery, though these patients are at higher risk for getting appendicitis in the future.

People may also receive pain medications to help with the pain caused by appendicitis. Depending on the severity, opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen may be administered upon admittance to the emergency room.

Due to the seriousness of the condition, home appendicitis treatments are not recommended. If you are experiencing symptoms of appendicitis, seek emergency medical care immediately or call 911.

FAQs

Some frequently asked questions about appendicitis include:

FAQs

Acute appendicitis usually causes sudden pain on the lower right of the abdomen. It may also begin near the navel and then move to the lower right of the abdomen. Pain may vary depending on the exact location of your appendix. The pain may seem to be in the upper abdomen during pregnancy, as the appendix is higher. Pain typically worsens if you cough, sneeze, walk, or make other jarring movements. Chronic appendicitis usually causes pain in the same areas but may be more of a dull ache.

No single food can cause appendicitis. Additionally, contaminated food and water can lead to infections, such as E. coli, that cause appendicitis.

There is no direct link between stress and appendicitis.

If you’re noticing pain in the lower right of the abdomen or near the navel, you may be experiencing appendicitis. Nausea, vomiting, lack of appetite, swelling of the abdomen, difficulty passing gas, fever, and constipation are also common symptoms of appendicitis.

In acute appendicitis, the pain is usually sharp and sudden and becomes worse when you make jarring movements. In chronic appendicitis, you may have milder symptoms, symptoms that come or go, more of a dull ache than a sharp pain.

Appendicitis that is not treated quickly enough can lead to a ruptured appendix. This can cause serious complications, including peritonitis, an infection of the abdomen lining, or sepsis, an extreme bodily response to infection that can lead to organ failure and even death.

It’s important to seek medical care for appendicitis treatment promptly if you think you may be experiencing symptoms of appendicitis.

Get Care

Trust NewYork-Presbyterian for Appendicitis Treatment

Understanding the symptoms of this condition is crucial for early appendicitis treatment and care. The experts at NewYork-Presbyterian can assess your symptoms and create a treatment plan that’s right for you. Get in touch today to make an appointment.

If you think you may be experiencing symptoms, seek care at an emergency department or call 911 immediately.