Appendicitis causes tummy pain that often starts around the belly button and moves to the lower right side, and in most cases it is treated by removing the appendix. A laparoscopic appendectomy removes the appendix through small openings in the abdomen. Appendicitis is an emergency: if you have sudden, severe abdominal pain, in Amman or anywhere else, go to the emergency department straight away.
Note: Sudden, severe abdominal pain needs the emergency department, not a clinic appointment. Go to the emergency department straight away, especially if the pain is getting worse or comes with vomiting, fever, or a swollen, hard tummy.
When is appendix removal considered?
Signs that may point to appendicitis include:
- Pain that starts around the belly button and moves to the lower right side of the abdomen
- Pain that gets worse when you move, cough or walk
- Loss of appetite, feeling sick or vomiting
- A mild fever
- Constipation or diarrhoea in some cases
- Symptoms can be different in children, older adults and pregnant women, so never ignore severe tummy pain
What does the operation treat?
The appendix is a small tube attached to the large bowel in the lower right side of the abdomen.
- Inflammation often happens when the inside of the appendix becomes blocked and bacteria multiply
- If it is not treated, the appendix can burst and spread infection in the abdomen, which is a serious complication
- There is no known way to prevent appendicitis
- You can live normally after the appendix is removed
Diagnosis
Appendicitis is usually diagnosed in the emergency department. The doctor asks about your symptoms and examines your abdomen, then may request tests to help confirm the diagnosis and rule out other causes of pain.
- Blood tests for signs of inflammation
- A urine test to rule out a urine infection
- An ultrasound or CT scan
- A pregnancy test for women when needed
Treatment options
Options are listed from the simplest to the most invasive:
Your surgeon will choose the right option based on your examination, test and scan results and general health. Do not try to treat severe tummy pain at home.
- Observation in hospital: when the diagnosis is unclear, you may be watched and re-examined.
- Antibiotics: for some selected cases of uncomplicated appendicitis, this may be used under medical supervision, though the inflammation may come back later.
- Laparoscopic appendectomy: the appendix is removed through small openings under general anaesthetic. This is a common treatment for appendicitis.
- Open surgery: done through a cut in the lower right abdomen, and may suit some cases or be needed when there are complications.
What to expect on the day and after
The operation is done under general anaesthetic, usually soon after diagnosis. Some patients go home quite soon, while others need to stay longer, especially if the appendix has burst.
- You may have pain around the small cuts and some bloating, which ease gradually
- Gentle walking early on is encouraged
- You return to eating gradually, following the team's advice
- Avoid hard exercise and heavy lifting for the period your surgeon advises
- Recovery time varies, and your surgeon will explain what to expect in your case
- Contact a doctor or the emergency department if you get a fever, worsening pain, ongoing vomiting, or redness and discharge from a wound
When to see a doctor
Appendicitis needs the emergency department, not an appointment. Go to the emergency department straight away if you have:
- Severe or sudden abdominal pain
- Pain in the lower right abdomen that gets worse over time or with movement
- Abdominal pain with vomiting or fever
- A tummy that is hard or very tender to touch
- After surgery: book a follow-up as your surgeon advises, or see a doctor about any unusual change in your wound