Experiencing pain in the lower right abdomen should not be ignored and should be examined by a doctor immediately. These symptoms may be caused by appendicitis. Appendicitis, also known as appendicitis, is one of the most common diseases of the digestive tract. Appendicitis occurs due to inflammation of the appendix or appendix part of the large intestine. The appendix is between 5-35 cm long, with an average length of 9 cm and is located in the lower right abdomen. The function of the appendix is still being debated, but it is known that the appendix has cells that support the body's immune system.
Appendicitis is mostly experienced by people aged 10-30 years although it can be experienced by anyone, including children. Indonesia is the country that ranks first with the highest incidence of appendicitis in Southeast Asia, namely 24.9 cases per 10,000 population, followed by the Philippines and Vietnam.
The cause of appendicitis is an infection in the cavity of the appendix. As a result, bacteria develop rapidly resulting in inflammation, followed by swelling and pus. Several factors are thought to cause inflammation of the appendix, including:
- Blockage at the door of the appendix cavity due to a buildup of hard stools
- Thickening of the appendix wall tissue due to infection in the digestive tract, or it could be from other parts of the body.
- Blockage due to the growth of parasites such as pinworm infection or ascariasis in the digestive tract.
- Certain medical conditions, such as tumors in the abdominal cavity or inflammatory bowel disease.
- Injury or trauma to the abdominal area.
Symptoms of appendicitis can be divided into typical and atypical symptoms.
The typical symptoms of appendicitis are:
- Pain in the lower right abdomen or around the navel which then moves to the lower abdomen.
- Loss of appetite
- Nausea and vomiting as soon as abdominal pain appears
- Bloated
- Fever and chills
- Difficult to pass gas
Meanwhile, symptoms that are not typical but still need to watch out for are:
- Dull pain or sharp pain anywhere in the lower abdomen, back, or back.
- Pain or difficulty when urinating
- Terrible stomach cramps
- Constipation or diarrhea and excess gas production.
In addition to recognizing appendicitis from symptoms and physical examination, supporting examinations also play a role in establishing the diagnosis of appendicitis. A number of supporting tests that can be carried out are laboratory tests to check blood to check the white blood cell count as a marker of infection, a urine test to rule out possible symptoms caused by other diseases such as urinary tract infections or kidney stones, and a pregnancy test to make sure the pain is not caused by pregnancy ectopic. Radiological examinations are also carried out such as abdominal ultrasound to see an overview of the organs in the abdomen and check blood flow in the abdomen, a CT scan or MRI can also be done to see the organs more clearly, sometimes a chest X-ray will also be examined to make sure the pain is not caused by pneumonia to the right.
After the diagnosis of appendicitis has been established, the patient must immediately receive treatment in the form of drugs, such as antibiotics, and treatment in the form of surgery if needed. The main treatment for appendicitis is surgical removal of the appendix. There are two ways to do this, namely through laparoscopy or keyhole surgery and open surgery or laparotomy.
Keyhole surgery (laparoscopy) is to make several small incisions and through these incisions the doctor will insert surgical instruments to remove the appendix. Meanwhile, laparotomy is to make a 5-10 cm long incision to remove the appendix. Inflammation of the appendix must be treated immediately, if it is not treated immediately, it is feared that the inflamed and swollen appendix will rupture, so that the colonizing bacteria will spread and infect the abdominal cavity and cause inflammation of the lining of the stomach which is known as peritonitis.
Several precautions can be taken to avoid inflammation of the appendix, such as drinking lots of water and increasing fiber foods, maintaining a healthy lifestyle, and carrying out regular check-ups so that you can detect disease earlier.
If you experience signs and symptoms as described above, immediately consult your doctor to get the right treatment.
Article written by dr. Irawan Sukarno, Sp. B (General Surgery Specialist at EMC Cikarang Hospital).