Worried that your kid might have appendicitis? We have devised a guide to help you detect the signs of appendicitis in kids. Read along to find out more.
According to the Society of American Gastrointestinal and Endoscopic Surgeons, 70,000 children experience appendicitis in the United States each year. The condition affects more boys than girls.
While appendicitis is the leading cause of stomach surgery in children, it can be a serious condition. If the appendix ruptures, bacteria will be released into the abdominal cavity. This can cause severe infection. According to the Cleveland Clinic, 20 to 30 percent of children experience a ruptured appendix.
There are a few signs of appendicitis in kids that you need to look out for. These signs have been discussed in the article in detail. If you think your child may be suffering from the condition, contact your health care provider immediately.
Table of Contents
What is appendicitis?
The appendix is a thin tube that is joined to the large intestine. It sits in the lower right part of your belly (abdomen). When you are a young child, your appendix is a working part of your immune system, which helps your body to fight disease. When you are older, your appendix stops doing this and other parts of your body keep helping to fight infection.
The appendix can get infected. If not treated it can burst (rupture). This can happen as soon as 48 to 72 hours after you have symptoms. Because of this, appendicitis is a medical emergency. If you have symptoms, see a doctor right away to avoid more infection, which can be life-threatening.
Types of appendicitis
Acute appendicitis
Acute appendicitis is a severe and sudden case of appendicitis. It’s most common in children and young adults between the ages 10 and 30 years old and occurs more frequently in males than females. Pain tends to develop and intensify quickly over the course of 24 hours.
It requires immediate medical treatment. If left untreated, it can cause your appendix to rupture. This can be a serious and even fatal complication.
Acute appendicitis is more common than chronic appendicitis, occurring in about 7 to 9 percent of all Americans in their lifetime.
Chronic appendicitis
Chronic appendicitis is less common than acute appendicitis. It occurs in only about 1.5 percent of all people who have already had a case of chronic appendicitis.
In chronic cases of appendicitis, the symptoms may be relatively mild and are thought to usually occur following a case of acute appendicitis. Symptoms may disappear before reappearing again over a period of weeks, months, or even years.
This type of appendicitis can be challenging to diagnose. Sometimes it’s not diagnosed until it develops into acute appendicitis.
Chronic appendicitis can be dangerous. Get the information you need to recognize and treat this condition.
What Causes appendicitis?
Appendicitis happens when the inside of your appendix is blocked. Appendicitis may be caused by various infections such as virus, bacteria, or parasites, in your digestive tract. Or it may happen when the tube that joins your large intestine and appendix is blocked or trapped by stool. Sometimes tumors can cause appendicitis.
The appendix then becomes sore and swollen. The blood supply to the appendix stops as the swelling and soreness get worse. Without enough blood flow, the appendix starts to die. The appendix can burst or develop holes or tears in its walls, which allow stool, mucus, and infection to leak through and get inside the belly. The result can be peritonitis, a serious infection.
Who is at risk of appendicitis?
Appendicitis affects 1 in 1,000 people living in the U.S. Most cases of appendicitis happen to people between the ages of 10 and 30 years. Having a family history of appendicitis may raise your risk, especially if you are a man. For a child, having cystic fibrosis also seems to raise the risk of getting appendicitis.
Why is appendicitis in children a concern?
An irritated appendix can rapidly turn into an infected and ruptured appendix, sometimes within hours. A ruptured appendix can be life-threatening. When the appendix ruptures, bacteria infect the organs inside the abdominal cavity, causing peritonitis. The bacterial infection can spread very quickly and be difficult to treat if diagnosis is delayed.
Symptoms of appendicitis
Appendicitis causes a variety of symptoms, including:
- abdominal pain
- low fever
- nausea
- vomiting
- loss of appetite
- constipation
- diarrhea
- difficulty passing gas
Not all people will have the same symptoms, but it’s crucial that you see a doctor as quickly as possible.
According to Johns Hopkins Medicine, the appendix can rupture as quickly as 48 to 72 hours after the onset of symptoms. Go to the hospital immediately if you’re experiencing any of the following symptoms.
Abdominal pain
Appendicitis usually involves a gradual onset of dull, cramping, or aching pain throughout the abdomen. As the appendix becomes more swollen and inflamed, it will irritate the lining of the abdominal wall, known as the peritoneum.
This causes localized, sharp pain in the right lower part of the abdomen. The pain tends to be more constant and severe than the dull, aching pain that occurs when symptoms start.
However, some people may have an appendix that lies behind the colon. Appendicitis that occurs in these people can cause lower back pain or pelvic pain.
Mild fever
Appendicitis usually causes a fever between 99°F (37.2°C) and 100.5°F (38°C). You may also have the chills.
If your appendix bursts, the resulting infection could cause your fever to rise. A fever greater than 101°F (38.3°) and an increase in heart rate may mean that the appendix has ruptured.
Digestive upset
Appendicitis can cause nausea and vomiting. You may lose your appetite and feel like you can’t eat. You may also become constipated or develop severe diarrhea.
If you’re having trouble passing gas, this may be a sign of a partial or total obstruction of your bowel. This may be related to underlying appendicitis.
Signs of appendicitis in kids
Recognizing appendicitis in your little one is tough because your child can’t always speak in full words or describe their symptoms.
Appendicitis usually starts out as pain around your child’s belly button. Symptoms your child could experience include:
- elevated heart rate
- frequent urination and pain with urination
- low grade fever
- poor appetite
- stomach pain, especially in the lower right abdomen
- vomiting
According to Cincinnati Children’s Hospital, most children with appendicitis are between ages 8 and 16. However, children under age 5 can get the condition. They can often have more serious effects because they aren’t as able to talk about their symptoms. A child may have noticeable pain when moving, coughing, sneezing, or touching the abdomen.
Sometimes a parent or doctor may think appendicitis is another condition. Some conditions that cause similar symptoms include:
- urinary tract infection
- kidney stones
- severe constipation
- pneumonia
How is appendicitis diagnosed?
Your healthcare provider will ask about your past health and do a physical exam. He or she may also have you take the following tests:
- Blood tests: To check for signs of infection, such as having a high white blood cell count.
- Urine tests: To see if you have a urinary tract infection.
You may also have some imaging tests, including:
- Abdominal ultrasound: Lets the doctor see internal organs as they work and checks how blood is flowing through different blood vessels.
- CT scan: Shows detailed images of any part of the body, such as the bones, muscles, fat, and organs.
- MRI: Sometimes used to diagnose appendicitis, especially in a pregnant woman, instead of CT scan.
When to call the doctor
If you suspect your child might have appendicitis, it’s crucial to seek medical attention right away.
If appendicitis is not diagnosed within 48 hours, there is a significant risk that your child’s appendix could burst or rupture. Immediate medical care is essential if your child shows symptoms such as stomach pain that worsens, vomiting, loss of appetite, or fever.
The doctor will inquire about your child’s symptoms and may recommend imaging tests, such as an ultrasound or CT scan, along with blood and urine tests to help diagnose appendicitis and rule out other conditions.
Diagnosing appendicitis can be challenging, as no single test can definitively confirm it. The doctor will use the symptoms and test results to make the best possible diagnosis. Surgery remains the only definitive method to confirm whether the appendix is affected.
What are the treatments available for appendicitis?
Appendicitis is a medical emergency. It is likely the appendix will burst and cause a serious, deadly infection. For this reason, in almost all situations, your healthcare provider will advise that you have surgery to remove your appendix.
The appendix may be removed in an open procedure or using laparoscopy:
- Open (traditional) surgery method. You are given anesthesia. A cut (incision) is made in the lower right-hand side of your belly. The surgeon finds the appendix and takes it out. If the appendix has burst, a small tube (shunt) may be placed to drain out pus and other fluids in the belly. The shunt will be taken out in a few days, when your surgeon feels the infection has gone away.
- Laparoscopic method. You are given anesthesia. This surgery uses several small cuts (incisions) and a camera (laparoscope) to look inside your belly. The surgical tools are placed through a few small incisions. The laparoscope is placed through another incision. A laparoscopy can often be done even if the appendix has burst.
If your appendix has not burst then your recovery from an appendectomy will only take a few days. If your appendix has burst, your recovery time will be longer and you will need antibiotic medicine.
You can live a normal life without your appendix. Changes in diet or exercise are usually not needed.
Is immediate surgery always necessary in appendicitis?
Health care providers may recommend non-operative treatment of a ruptured appendix if there is a contained abscess and the child is stable. In some cases in which the appendix has ruptured and formed a localized abscess, a health care provider may recommend that the appendix not be removed right away.
Instead, your child may receive treatment with intravenous antibiotics given through an intravenous catheter (called a peripherally inserted central catheter or PICC line) for about 10 to 14 days. This may be done along with CT- or ultrasound-guided drainage of the abscess. This allows the infection and inflammatory process to resolve. Your child will then undergo an elective (planned) interval appendectomy six to eight weeks later.
A child whose appendix ruptured will have to stay in the hospital longer than the child whose appendix was removed before it ruptured. Some children will need to take antibiotics by mouth for a period of time specified by the health care provider after they go home.
What happens after your child goes back home?
Your physician will generally recommend that your child not do any heavy lifting, play contact sports, or “rough-house” for several weeks after the operation.
If a drain is still in place when your child goes home, she should not take a tub bath or go swimming until the drain is removed. Your child may need to take antibiotics at home to help fight the infection in the abdomen. You will be given a prescription for pain medication for your child to take at home to help her feel comfortable. Some pain medications can make your child constipated, so ask your physician or pharmacist about any side effects the medication might have.
Moving around after surgery rather than lying in bed can help prevent constipation. Drinking fruit juices and eating fruits, whole grain cereals, and breads and vegetables after being advanced to solid foods can help with constipation as well. Most children who have their appendix removed will have no long-term problems.
When to call the doctor after the appendicitis surgery?
Please call us if your child has any of the following after appendicitis surgery:
- Fever greater than 101.5 degrees F
- Vomiting or inability to tolerate any food or liquids
- Increasing or continuous abdominal pain
- Abdominal distention (swollen or enlarged)
- Drainage from incision(s)
- Redness or swelling of the incision(s)
- If you have any further questions or concerns
Key points about appendicitis
Appendicitis is when your appendix becomes sore, swollen, and diseased.
- It is a medical emergency. You must seek care right away.
- It happens when the inside of your appendix gets filled with something that causes it to swell, such as mucus, stool, or parasites.
- Most cases of appendicitis happen between the ages of 10 and 30 years.
- It causes pain in the belly, but each person may have different symptoms.
- Your health care provider will advise that you have surgery to remove your appendix.
- You can live a normal life without your appendix.
What to do when visiting a health care provider?
Here are some tips to help you get the most from a visit to your healthcare provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
Conclusion
There is no way to prevent appendicitis. But when kids get the right medical care quickly, doctors usually find and treat it without problems. Hence, look out for the above mentioned signs to ensure that your kid does not face any complications.
