Appendicitis in Children

Watching your child deal with excruciating pain and not knowing the reason is a known way for parents to have panic attacks. When your child has a stomachache or a headache, it’s almost an instinct to call the doctor. Sometimes however, an illness or condition leaves parents helpless. The first step towards fighting a condition that you can’t manage for your child is to understand it. Conditions like appendicitis are extremely painful for children and can lead to more severe repercussions if left untreated. In fact, if left untreated for too long, appendicitis can become life threatening.

What is Appendicitis?

Appendicitis is a condition that is caused because the appendix which is located in the lower abdomen has become inflamed or filled with pus. An enlarged appendix that leads to lower abdominal swelling is one of the most painful conditions a young child can face during their development. Appendicitis can afflict anyone between the ages of ten to thirty. According to most pediatric specialists appendix pain in children is more common than appendix pain in adults.

This condition is not at all contagious and if caught early can be treated without problems. Sometimes doctors will recommend surgery to remove the appendix in children; there is no need to worry. This procedure is extremely low risk.

In cases where the appendix is infected, it has been known to explode causing the spread of harmful bacteria that may spread the already existing bacterial infection or cause an abscess.

Once appendicitis has a positive diagnosis however, consult a doctor on treatment options immediately. This condition can deteriorate quickly and may lead to possible fatal outcomes.

Is Appendicitis Common in Children?

Appendicitis is a common condition that affects a lot of children on a regular basis; it is also something that can affect adults. Understanding who is most at risk can help you identify if a loved one may be affected and the breakdown of age groups most at risk are:

• Appendicitis is mostly common in children between the ages of 9-15. This is known as pediatric appendicitis.
• It has been known to manifest in adults up to the age of thirty but is not as common. The second most common age group for appendicitis is 16-30.
• This condition is highly unlikely to affect toddlers, infants and adults above 30 get appendicitis. Although extremely rare, children from the age of 2 to 8 and adults beyond the age of 30 can theoretically be affected by this.

What Causes Appendicitis In Children?

This condition occurs due to the appendix getting inflamed, swollen or infected. This can happen because the organ itself is exposed to and interacts with stool, parasites and mucus. This causes a drastic dilution or blockage of blood supply to the organ itself leading the organ to lose nourishment and eventually die. Every organ requires blood supply as a source of nourishment, the appendix is the same. The lack of blood penetrating this wall of infections and impurities causes an increase in pressure from the organ itself, leading for it to start tearing and creating holes this is called an appendix rupture. This rupture results in the leaking of the appendix into the abdominal cavity, leading to possible abscesses.

Predominantly, there are two reasons why children develop appendicitis. They are:

• Obstructions: Obstruction could be complete or partial. It could be caused by a number of reasons such as an injury, foreign organisms, worms, tumors or cancer.
• Infections: When the body is fighting an infection, the appendix tends to swell up. However, some infections cause the intestinal lymph nodes to swell up, which can cause a blockage to the appendix.

Signs and Symptoms of Appendicitis in a Child

There are many signs and symptoms that indicate appendicitis in your child. Knowing these signs will help you be prepared in case of any issue with your child’s appendix.

1. Pain in the lower abdominal region: The appendix is located on the lower right side of the abdomen. If your child is suffering from appendicitis, he will complain of pain in the area. However, not all abdomen pain is indicative of appendicitis.
2. Loss of appetite: A consistent loss of appetite with no enthusiasm towards his favorite foods could indicate that your child has appendicitis.
3. Low to mild fever: Appendicitis is sometimes accompanied by a mild fever between 99 and 102 degrees.
4. Nausea and vomiting: Any prolonged bouts of nausea and vomiting should be brought to the notice of your pediatrician.
5. Pain while urinating: Any pain in the lower abdomen area could cause difficulty in urination.
6. Diarrhea: This symptom occurs a few days after the appendicitis begins. If your child suffers from sustained diarrhea, then you must get medical attention for your child.
7. Constipation: This is also a common symptom for appendicitis.
8. Swelling of the abdomen: A tenderness of the stomach along with inflammation could be indicative of appendicitis.
9. Painful cramps: Appendicitis is usually accompanies with sharp and excruciating pain in the abdomen.

Risk Factors

There are certain risk factors that are unavoidable. These are because they are not in your control. Neither you nor your doctor can deny these factors. These include:

• Age: It remains unknown why children and young adults are most likely to develop appendicitis. The age group between 10-30 is most vulnerable.
• Infections: An infection in the gastro-intestinal area could be the precursor to appendicitis.
• Trauma: An injured appendix could cause appendicitis with higher chances of it getting ruptured. The injury could be caused by contact sports or an accident.

One of the risk factors for appendicitis that you can control is having a low fiber diet. This diet particularly causes constipation. Some of the hardened stool can get itself lodged in the appendix and can cause swelling. You can avoid this situation by having a diet that is rich in fiber.

Complications of Appendicitis

• Peritonitis: If a condition of appendicitis is ignored and is not removed in time by a surgeon, the appendix could burst and spill all of its infected fluids to leak into the abdominal cavity. This could then infect the lining of the abdomen. This condition is known as peritonitis. If the condition is not treated with antibiotics, it could be life threatening.
• Abscess: If the infected fluids mix with the intestine, it causes an abscess filled with puss. The abscess is either treated with antibiotics or is drained out through a tube.
• Septicemia: The ruptured appendix contents release harmful bacteria into the blood stream. These bacteria could cause an infection of the blood called septicemia. This can be dangerous and must be treated as an emergency.

Diagnosing Appendicitis in Kids

Diagnosing appendicitis in children can be hard as it exhibits various symptoms that are not exclusive to this condition. A full medical history plus an initial physical exam will help your doctor with the diagnosis. If he does suspect appendicitis, he will ask for more tests.

• Blood tests: This test is most common as it is an easy test to tell if there is any infection in the body.
• Urine test: A urine test is carried out to rule out kidney and bladder infections
• Abdominal Ultrasound: This diagnostic procedure is used to see how your body’s internal organs and blood vessels function.
• CT or CAT scan: This diagnostic tool combines X-ray technology with computer technology to get imaging that is clear and crisp.

Treatment for Children’s Appendicitis

The treatment for your child’s appendicitis is based on a lot of factors. These include:

• The extent of the problem
• Age, overall health, and medical history
• Allergies to medications
• Tolerance towards certain procedures

Since the nature of appendicitis is in itself considered an emergency and one that could lead to serious complications, the best option to treat appendicitis is through surgery where the appendix will be removed. Do not worry; since the appendix is a vestigial organ, it has no particular function.

How is Surgery for Appendicitis Done?

The appendix will be removed surgically. This is usually done in one of two methods.

• Open method: This surgery is conducted under general anesthesia. An incision is made on the lower right side of the abdomen, near the appendix. The surgeon will then find and remove the appendix. If the appendix has ruptured, she will insert a tube into the abdominal cavity to drain out all the fluids.
• Laparoscopic method: This surgery is considerably newer and involves making several tiny incisions. Through these incisions, a camera and light source are inserted for the surgeon to see what is happening. He will then remove the appendix. This method results in minimal scarring and quicker recovery time. However, it is not recommended if the appendix has ruptured.

What Happens After Appendicitis Surgery?

Post-surgery, your child will not be allowed to eat or drink any fluids as her intestines recover. Her nutrition will be taken care of with intravenous (IV) fluids through which medication will also be administered. If her appendix had ruptured, then she will have to stay longer in the hospital longer than if it hadn’t. In either case, your child will have to continue taking antibiotics even after she is discharged for a certain period of time.

After discharge, your child must not play any contact sports or lift heavy objects. Some of the pain medications prescribed can cause constipation. Talk to your doctor about this and try to find a solution for the same. Light movements after the surgery instead of staying still will help reduce the occurrence of constipation. Once your child can eat solid foods again, she must have a fiber rich diet and drink plenty of water and soups.

What to Do if the Child’s Appendicitis Has Ruptured?

Ruptured appendix in a child can seem very frightening. It is caused when the wall of the appendix weakens enough to rupture due to the fluid buildup inside it. When it ruptures, there will be a temporary abatement in the pain. A ruptured appendix could cause many other issues. Abscess formation is quite common. Scar tissue will soon start to develop around the abscess to ward it from further infections.

Preventing Appendicitis in Children

There is no sure way of preventing appendicitis in children or adults. However, medical experts are of the opinion that persons who have a high fiber diet seem to suffer less from appendicitis. This is because such a diet reduces the chances of hard stools causing any issue with the intestines.

Home Remedies for Appendicitis

There are many home remedies that will help ease the pain and discomfort of your child.

Mint is known for relieving pain. Mix a couple of drops of mint essential oil in water and ask your child to drink up.

• If your child has a fever due to the appendicitis, then you can boil a few basil leaves in water. After it cools down, strain it and give your child the clear liquid to drink.
• Garlic will help reduce the inflammation. Boil a few pods of garlic in water. Add honey for sweetness.
• Moong beans are said to help with appendicitis. Give your child a spoon full three times a day.
• Buttermilk reduces the growth of bacteria in the gut. However, it is effective only when a liter is consumed.
• A tea made from steeping fenugreek seeds in hot water can help with the mucous and waste in the intestine.
• Give your child a combination of carrot, beet and cucumber daily.
• Lemon juice and honey will help with any digestive issues.
• Ask your pediatrician if your child can consume ginseng tea. If yes, then give it to your child twice a day.
• Provide green vegetables and fresh fruits will help make sure that your child doesn’t develop constipation.
• Give your child a paste of turmeric and ginger as they are anti-inflammatory and anti-bacterial.
• Ginger has analgesic, anti-inflammatory, and antiemetic properties. Hence give it to your child in a candied form.
• Whole wheat will help your child’s digestive system.

When to Contact Your Child’s Doctor?

Childhood appendicitis is extremely treatable but can be serious. You should rush your child to the doctor if none of the symptoms seem to be abating. If your child is in severe pain, then seek immediate medical assistance. A ruptured appendix causes more complications and is harder to recover from. Reaching your doctor early enough is a key to a quick recovery.

Conclusion: Appendicitis can be an exhausting and excruciating experience for everyone involved, follow your doctor’s instructions, and treat the condition fully and at an early stage to help your child live a long healthy life. Do not medicate your child without your doctor’s knowledge or prescription. For the treatment to be completely effective ensure you fully disclose all information about your child’s medical history to your doctors.