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Nov 26, 2009

Healthy Living cuts deep into Appendicitis

Story PictureAppendicitis is a well known medical condition. It is considered an medical emergency and requires immediate removal, but like most other conditions discussed on Healthy Living, the earlier the diagnosis and treatment, the lesser the complications. Healthy living this week looks at the symptoms, diagnosis and treatment of appendicitis.

Marleni Cuellar, Reporting
The appendix is a small a small, finger-shaped sac that is attached to your large intestine. It is found in both humans and animals. In herbivores the appendix is much larger and contains bacteria that are used to break up cellulose for digestion. In humans, it serves no real function but can be the source of problems.

Dr. Victor Lizarraga, General Vascular Surgeon
“The problem with the appendix is even though it’s just hanging there and contents don’t travel through it, it’s in communication with the large bowel which is full with bacteria. And it also has a lining that produces mucus on a constant basis so it has to empty itself. Whenever you have an infection of any sort or other gut infection these follicles become active and the cells start multiplying—we call it hyperplasia—and the space is limited it will cause a bulge in the skin that lines the tube so it blocks the tube and if that process continues, it sets up a series of events. The first thing that happens is that it doesn’t empty, so it bulges, compresses the venous return. Veins are low pressure vessels that drain blood from the appendix, so it compresses that and eventually blood cannot come in so if you don’t get blood you die. The appendix literally dies.”

Left untreated the appendix may perforate or break and spill infectious material into the abdominal cavity. Recognizing the symptoms early enough will prevent this life threatening situation.

Dr. Victor Lizarraga
“The classical presentation again, to a well trained doctor, is you get peri-umbilical pain which is a chronic kinda like cramping pain. Its pain due to the fact that the appendix is obstructed so it is contracting trying to empty itself and any bowel that is obstructed would do the same. And you feel it as pain but it’s not localized pain, it’s a kind of diffused pain and it’s associated with anorexia which means you don’t feel hungry, you feel weird, and you may vomit.”

While the first indicator is a dull pain in the stomach area, as the situation worsens the pain becomes more localized to the lower right abdomen. In addition to the loss of appetite and nausea, other symptoms may include abdominal swelling and fever.

Dr. Victor Lizarraga
“It can progress very rapidly from patients that we see, they feel completely well and they wake up in the night with this terrible pain and by the time you come to the hospital midday or so you have a well inflamed appendix we don’t wait. Once we decide that it’s appendicitis it’s time to take it out because the longer you wait you increase the risk of it perforating and it can perforate any time after.”

This is the reason why once diagnosed, it is immediately treated by an appendectomy or surgical removal of the appendix. The difficulty of the procedure is dependent on the time of diagnosis.

Dr. Victor Lizarraga
“Appendectomy for early appendicitis is quite straightforward. It is done through a very tiny incision and the recovery period is within twenty-four hours you are back home. So all you have is a tiny incision that needs to heal within a week to ten days you’re fine. If its perforated or if it is more advanced not quite perforated but getting there, the incidence of wound infection is much greater so you may end up with a wound infection or you may stay in the hospital up to two to three days because that inflammation has affected your bowels. If it’s perforated you may stay in the hospital for up to a week. Fortunately, your body has or tries to contain the infection and untreated appendicitis or sometimes what happens you go to the doctor and he tells you, you have a gut infection and he gives you antibiotics and what it does it cools down the appendix for a while, giving your body the chance to wall it off. But the minute the antibiotics stop it starts back up again.”

Appendicitis is mainly attributed to gut infections or when the appendix is blocked by stool, foreign body or cancer. According to Dr. Lizarraga, more men suffer with appendicitis than women and in Belize, approximately three hundred cases of appendicitis are detected per year.

Dr. Victor Lizarraga
“So the message is early diagnosis, early treatment and so you don’t have what we call increase morbidity.”

Viewers please note: This Internet newscast is a verbatim transcript of our evening television newscast. Where speakers use Kriol, we attempt to faithfully reproduce the quotes using a standard spelling system.

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