Appendectomy

Overview

An appendectomy is surgery to remove the appendix, a small, finger-shaped pouch attached to the large intestine on the lower right side of your belly. It's most often done when the appendix becomes infected and swollen, a condition called appendicitis. The infected appendix is removed to stop it from bursting and to relieve pain.

Yes. An appendectomy is a very common operation. It is one of the first surgeries that many surgeons learn to do.

It can happen at any age, but appendicitis is most common between ages 10 and 30. It affects slightly more males than females.

Symptoms

Common symptoms

• Pain that starts near the belly button and moves to the lower right side
• Loss of appetite
• Nausea or vomiting
• Swelling in the belly
• Low fever
• Constipation or diarrhea

Symptoms in children

• Tummy pain that gets worse
• Vomiting
• Very low energy
• Not wanting to eat
• Crying or fussiness that's hard to soothe

Symptoms in older adults

• Pain may be less sharp or in a different place
• Mild nausea or belly upset
• Confusion
• Only a slight fever or no fever
• General feeling of being unwell

Causes

Main causes

• Infections of the appendix (appendicitis) caused by germs
• A blockage in the opening of the appendix, often from a small piece of hardened stool
• Swelling of the lymphatic tissue in the appendix wall

Risk factors

• Being under 30
• Being male
• Family history of appendicitis
• A recent digestive or respiratory infection

When to see a doctor

See a doctor urgently if:

• If you have belly pain that is getting worse, moves to the lower right side, or comes with fever and vomiting, see a doctor straight away — it could be appendicitis.

Book a routine appointment if:

• If you're thinking about having a planned appendectomy (for example, to prevent future problems), talk to your GP or specialist.
• See your doctor if you have mild symptoms that keep coming back.

Diagnosis

A doctor will ask about your symptoms, press on different parts of your belly, and check your temperature. They may order tests to rule out other causes.

Tests that may be done

• Blood test to look for signs of infection
• Urine test to check for kidney or bladder problems
• Ultrasound to see the appendix and nearby organs
• CT scan for a detailed picture of the belly

What to expect at your appointment

You may be told not to eat or drink before some tests. If the doctor thinks it's appendicitis, they will likely recommend surgery quickly. If surgery isn't needed, they'll explain what to watch for and when to come back.

Treatment

Appendectomy is the standard treatment for appendicitis. The infected appendix is removed either using a few small cuts (laparoscopic surgery) or one larger cut (open surgery). Both are done under general anaesthetic, so you won't feel pain during the operation.

Self-care at home

• Follow the 'nil by mouth' rule before surgery — no food or drink for the time your doctor tells you
• After surgery, take over-the-counter or prescribed pain relief as your care team recommends
• Keep the wound clean and dry, and change dressings as explained
• Don't lift heavy things or play contact sports until your surgeon says it's safe
• Go for short walks to keep your blood moving

Medical treatments

If a scan shows an abscess (a pocket of pus), the doctor may drain it first. You might also receive antibiotics to treat infection. In some mild cases, antibiotics alone can calm the infection, but surgery is still the most reliable way to remove the problem appendix. Your care team will decide the best approach for you.

When is surgery considered?

Surgery usually happens as soon as possible after a diagnosis of appendicitis. If your appendix is severely inflamed or about to burst, it's an emergency. If there's an abscess, surgery may be delayed until the infection is controlled.

Living with this condition

Right after surgery, you'll wake up with a sore belly. You'll likely stay in hospital 1 to 2 days. You may feel tired and need help at home for the first week. Most people can return to school or desk work in 1 to 2 weeks, and to heavy activity in 4 to 6 weeks.

Lifestyle tips

• Rest when you feel tired, but get up and move around a little every day
• Avoid driving while taking strong pain medicine
• Don't soak in a bath or swim until your wound is healed
• Eat smaller, light meals to start

Diet and exercise

Start with clear fluids like water and broth, then slowly add plain toast, crackers, and easily digested foods. Once you're eating normally, a balanced diet with plenty of fibre helps prevent constipation. Walk a little each day, and wait for intense exercise until your surgeon clears you.

Mental health and emotional wellbeing

It's normal to feel a little blue or anxious after surgery. The medicines and recovery can affect your mood. Talk to friends, family, or your GP if you're struggling. If you feel in crisis, call a crisis line or your local emergency number.

Prevention

There's no sure way to prevent appendicitis. Eating a diet high in fibre may lower the risk slightly by helping food move through the digestive tract normally. But most cases happen without warning.

Complications

If left untreated

• The appendix can burst, spilling infected matter into the belly
• A burst appendix can lead to peritonitis — a dangerous infection of the belly lining
• An abscess may form and need draining with a needle or a second smaller operation

Long-term outlook

With prompt treatment, almost every person who has an appendectomy recovers completely. Complications are uncommon, and the surgery rarely causes long-term problems. After a few weeks of rest, you can usually get back to your normal life.

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