How does one know your Appendix needs to be looked at?

[Phlosphr]

I certainly don't need to eat rocks and pebbles to help digest my food anymore, but I know I still have an appendix. It may not serve a function but why would it hurt all of a sudden?

Anyone have their appendix out. If so why? And what were the symptoms? How was it diagnosed? Any info would be great.

[In Conceivable]

I had my appendix out as a child. My symptoms were pain in my side and vomiting and a high fever. A trip to the doctor showed I had a high white blood cell count. I think they also did a pelvic exam to rule out any "female problems".

I was very sick though. It wasn't something you could just ignore. It was very painful and I couldn't stop vomiting. I don't know if everyone is that way.

[3waygeek]

I had my appendix removed back in the 6th grade (1975 or thereabouts), following a diagnosis of acute appendicitis (inflammation of the appendix). I'd spent the entire day with mild abdominal pain and loss of appetite. As I recall, I didn't have any noticeable fever, and I didn't start vomiting until I was at the hospital.

It was the loss of appetite that tipped off my Dad -- we had steak for diinner that night, and I didn't eat. That set off warning bells in his head, as I have never been known to refuse a good slab of sirloin. So after dinner, we went to the ER, where I was diagnosed -- as it turned out, my appendix was quite severly inflamed and in risk of rupturing, which would spread nasty stuff throughout the abdominal cavity, leading to peritonitis and possible death.

As I recall, the ER diagnosis was pretty rapid -- all they did was take vitals and some blood, and felt my abdomen. Pain or tenderness at McBurney's point (http://www.whonamedit.com/synd.cfm/534.html) is one of the main tools docs use to diagnose acute appendicitis. IIRC, an elevated white blood cell count is often used to confirm the diagnosis.

[Phlosphr]

Hmm. I'm not vomiting at all. But I have a sharp pain in the area where my appendix is. My wife says, "AHH it's just gas"
But it is waaay to acute to be gas I think. It usually happens when I lay down or when sitting.

[MsRobyn]

The classic symptoms for appendicitis are basically what In Conceivable listed. The pain will localize in the lower right quadrant of the abdomen. (Below and to your right of the navel.)

In the "in case you were wondering, but you're probably not" category, the point of tenderness in the abdomen in appendicitis is called McBurney's point.

Robin

[Captain Amazing]

Generally your Appendix only needs to be looked at if you have extensive end-noting, or mention, but do not generally explain, a technical point in the main work.

d&r

[In Conceivable]

Gas pain can be pretty sharp.

My appendix pain was not a sharp occasional pain. It was a constant pain. It would get sharper at times, but it always hurt.

It was less then 24 hours from when I first noticed the pain till when I had my appendix removed. I started getting sick one evening and by noon the next day I was appendixless. I probably would have gotten to the doctor earlier, but I didn't want to wake my parents up early in the morning just because I was feeling sick. (I was a good kid)

[In Conceivable]

Oh yeah...One more thing.

It is your body. You know if something isn't right. If you have a sharp pain that concerns you then stop by the Doctors today. Even if your appendix are fine there might be something else wrong. And if nothing else maybe they can give you something for that gas! :)

[Parrothead]

I had mine out when I was in the 7th grade... IIRC, the way that they determine if pain at McBurney's point was gas or appendicitis was "rebound tenderness" (I never particularly lost appetite or vomited)

Press two fingers slowly, but quite firmly at the point you are having pain. This should be sore, but not just "killer, I think I want to die" pain. Hold it for about 10 seconds. Release quickly.

If the first thought that goes through your mind is that you have been stabbed by a big rusty knife, and it hurts so bad you see colors... (OK, an exaggeration, but not by much) you need to see a doctor, pronto. You may very well have an appendix problem.

I am definitely not a doctor, though, so if it hurts, go anyway.

Hope you get all fixed up soon.

[AWB]

My appendicitis felt like stomach flu for about a week. On Friday I couldn't even walk all the way to my apartment building's elevators.

My pain was actually high and centered, and not all that sharp. It was thought that it might be some sort of gall bladder problem.

Finally, on Saturday night, a nurse insisted that I be looked at again, since my vitals were going down. Lo and behold, my appy was rupturing.

My appendix was higher in my body that most. My scar is 6" long and directly to the right of my navel.

[Bosda Di'Chi of Tricor]

do some sit-ups.

If it is gas, the bubles will be worked out.

If it isn't...you'll know.


Right away.

The above is a joke.

If you are really sick, getchyer @ss to a ER---ASAP.

[easy e]

Originally posted by Phlosphr
I certainly don't need to eat rocks and pebbles to help digest my food anymore, but I know I still have an appendix. It may not serve a function but why would it hurt all of a sudden?

minor nitpick, but--

The appendix is not analogous to the gizzard (that's the organ in birds where swallowed stones are used to help grind up food). It's analogous to the cecum, which is a long, blind-ended tube in many animals, including rabbits and koala bears, that helps digest plant material. Bacteria capable of breaking down cellulose live in there.

[Spiff]

Minor nitpick of your nitpick:

A koala is not a bear, but a marsupial.

[smaft]

Country doctor wisdom (meaning I don't have a cite) for appendicitis:

Your breath smells like rotting apples.

[Belrix]

I had my appendix out when I was in college.

At first, because of the mild pain & naseua, I though I had food poisoning. Later, the pain localized to my lower right side & I was running a mild fever.

A blood test show massive (5x normal) white cells counts. A probing jab to the sore spot nearly made me leap off the table through the ceiling tiles.

The idiot Dr. at the college health center though my white cell count was "too high" for appendicitis & put a lot of focus on why I hadn't thrown up (I hadn't eaten due the nausea). He sent me home for six hours. When I returned, he referred me to the local hospital adjunct for a consult with a surgeon. That Dr. sent me right across the street, do not pass go, do not collect $200, and I got surgery to remove a bouncing baby appendix. The made a big hole since they said they found a big lump. I guess they got it just in time.

I was sick a week or two before the appendix got infected. The nurse nodded and said that wasn't uncommon. Perhaps something infected then infects the appendix as a secondary?

[Dr_Paprika]

I have seen and diagnosed several dozen hot appendices in my emergency department. My track record is well over 95%. A high white count is NOT a reliable indicator of appendicitis -- it is often normal (although may rise with time).

More common symptoms include pain before vomiting; migrating pain (which may start around the belly button but localizes around McBurney's point, 2/3 of the distance between the belly button and anterior spine of the hip); loss of appetite; pain "going over the bumps" when driving to hospital; fever; tenderness when you puff out your stomach; tenderness when you shake the bed. Other signs you sometimes see are "rebound tenderness" (when you push over McBurney's point, it hurts just as much when you let go as when you push down), a "psoas" sign (it hurts to bend the legs), an inflated white count, or an ultrasound or CT scan which shows a big-ass appendix (we don't have access to CTs easily at my small hospital, but don't need it to make the diagnosis either). A rectal exam should be done too. A pelvic exam should also be done in women to exclude right ovarian pathology (ruptured cyst, ovarian torsion, etc.)

[easy e]

Originally posted by Spiff

A koala is not a bear, but a marsupial.

I know they're not bears, but aren't they sometimes called "koala bears"? That's how I remember hearing about them as a kidlet.

Anyways, they have a huge cecum because of all of the eucalyptus they eat.

[MLS]

I've known 3 people who had appendicitis: my mother, my daughter, and a friend. My daughter had some but not all of the symptoms Dr. P mentioned above. We took her to the pediatrician, who sent us to the hospital, where the surgeon's exam results were inconclusive. For one thing, the pain wasn't in exactly the normal place. The doctors both told me that there is no "gold test" for appendicitis, and that they were not 100% sure she had it. For one thing, they said, abdominal pain can be perceived in a place far removed from where the problem really is. It's also possible for the inflamed appendix to be in a slightly different position from normal. However, they added, the risks involved with what might turn out to be unnecessary surgery were not nearly as great as those associated with failing to operate when it was necessary. They operated; the appendix was indeed infected, and she was fine a couple of days later.

My friend told me that she had various vague abdominal pains for a long time, and various doctors found nothing wrong. This went on for months. Finally somebody took a blood sample and found a very high white blood cell count. Appendectomy was done, symptoms never recurred.

For what it's worth, I second the suggestion to check with your doctor. Also, it's usually advised NOT to take laxatives if there's any chance of appendicitis; that apparently can make things infinitely worse.

[Dragonblink]

I had my appendix removed when I was in the first grade. I woke up with a stomachache, mostly on one side, that wouldn't go away. I thought it might be gas but I couldn't get any to come out. My dad took me to the doctor, doc poked and prodded a bit and arranged for my appendix to be removed that night.

Alas, it turned out I had a swollen lymph node and not appendicitis at all, but they took the appendix out anyways and I have like a five inch scar. I have heard that the techniques for determining whether it's appendicitis or something else have improved since then (it's been about seventeen years).

Here's the thing with appendicitis. If you go in and it's not your appendix that's the problem, you're just out some money for the doctor visit. If it is your appendix and you don't go in, the results could be doubleplusungood.

[Zoe]

I was nauseated, weak and feverish -- but I had no pain. My temperature was going up a degree every half hour to an hour.

[hutchley]

I'm living proof of what happens if you DON'T get it checked out....appendicitis (i.e. swollen appendix) can turn into peritonitis (ruptured appendix), a far more unpleasant, painful, and potentially lethal condition. Lucky it happened when I was too young to remember how much it hurt ....

So - if in doubt, check it out !!!

[Motog]

Originally posted by easy e
I know they're not bears, but aren't they sometimes called "koala bears"? That's how I remember hearing about them as a kidlet.

Koalas are most definitely known also known as koala bears here in Australia.

[Motog]

Originally posted by easy e
I know they're not bears, but aren't they sometimes called "koala bears"? That's how I remember hearing about them as a kidlet.

Koalas are most definitely known also known as koala bears here in Australia.

To the OP: Get yourself to a doctor.

FWIW my appendix made itself known (for the first and last time in my life) via screaming agony that caused me to pass out. I awoke 12 hours later with a new 6inch scar on my side.

[Motog]

Sorry about the double post. I thought I had hit the stop button in time.

[dauerbach]

Dr_Paprika,

95% accuracy is too high. We were always taught that if you were right more than 75% of the time you were missing some of the positive cases.

[Kalhoun]

My 50-year-old cousin had her appendix out about a year ago. She was doubled over in pain and had a fever. From what I hear, it's pretty excruciating. If you're worried, you should see a doctor.

[BwanaBob]

Another peritonitis survivor checking in....

Have it checked. My parents got bum advice from well meaning neighbors and it nearly cost them "me".

The doctors were pretty sure I was a goner as the peritonitis had gotten so bad that my blood was poisoned too ( I think they call it septicemia, but I'm not sure).

I was in the hospital for three weeks. I was only 7 at the time and I'm sure this bout of illness cost me a growth spurt. :)

[Dr_Paprika]

The accuracy of the diagnosis, though, depends on the time frame in which the diagnosis is made. If someone comes in, and it looks like they might have appendicitis but only have a few of the symptoms, I would likely admit them to hospital (in which case the diagnosis usually becomes more obvious with time), get a surgical consult, organize an ultrasound (which is pretty good at making the diagnosis) and follow the white blood cell count (I find changes in this count useful, but not an elevated value in itself).

The textbooks also say that 30% of the time, the surgeons operate but the appendix is not inflamed. From my experience, this number seems quite high. And as an emergency doctor in a small town, I'd see most of the missed cases too if they come in with peritoneal signs. And I'm not seeing them. I don't think 95% is too high providing you suspect it in any person who comes in with any abdominal pain, which was our training. I also think Tintinalli's method of "odds ratios" is far more useful than some of the older tests to make the diagnosis.

[Jadis]

Phlosphr hasn't been back to this thread since 6/25/03...anyone know if he actually had appendicitis?