Appendicitis
Appendicitis is the most common of all serious intestinal disorders. It
refers to an inflammation of
the vermiform appendix. It presents itself in acute and chronic forms and
affects both the sexes
equally. This disease now accounts for about half the acute abdominal
emergencies occurring
between the ages of 10 to 30 . It is more frequent in developed countries than
underdeveloped
countries.
The appendix is a small tube located at the end of the caecum, the first part
of the large
intestine. It is called vermiform appendix as it resembles a worm. It is
usually eight to ten cm.
long. Its structure is made of the same tough fibrous outer covering as
protects the entire
alimentary canal. There is a layer of muscular tissue under the outer covering
and further a layer
of lymphoid tissue. The function of the appendix, which is performed by this
lymphoid tissue, is
to neutralise the irritating waste material generated in the body or the
organic poisons introduced
through the skin or membranes.
Symptoms
Appendicitis usually begins with a sudden pain in the centre of the abdomen,
which gradually
shifts to the lower right side.
The pain may be preceded by general discomfort in the abdomen,
indigestion, diarrhoea or constipation. The patient usually has a mild fever
varying from 100 o to
102 o F. Nausea is common, and the patient may vomit once or twice. The muscles
of the right
side of the abdomen become tense and rigid. The patient draws some comfort by
drawing up the
right leg. The pain increases on the right side on pressing the left side of
the abdomen.
Coughing and sneezing makes the pain worse.
If the inflammation continues to increase, the appendix may rupture and
discharge its pus into
the abdominal cavity. This may result in a serious state known as peritonitis.
The temperature
rises and the patient becomes pale and cold. This condition may call for urgent
operation.
In the chronic state of appendicitis, the patient may suffer from recurrent
pain in the right lower
abdomen with constipation, loss of appetite and mild nausea.
Causes
Appendicitis is caused by a toxic bowel condition. An excessive amount of
poisonous waste
material is accumulated in the calcium. As a result, the appendix is irritated
and over-worked and
becomes inflammed. It is an attempt on the part of nature to localise and "burn
up" the toxins.
This condition is brought about by wrong feeding habits and enervation of the
system.
Inflammation of the bowel lining, due to the habitual use of apparent drugs, is
a potent
predisposing factor in the development of appendicitis. Further inflammation
and infection comes
from certain germs which are usually present in the intestinal tract.
Treatment
The patient should be put to bed immediately at the first symptoms of severe
pain, vomiting and
fever. Rest is of utmost importance in the treatment of this disease. The
patient should resort to
fasting which is the only real cure for appendicitis. Absolutely no food should
be given. Nothing
except water should enter the system. Low enemias, containing about one pint
(1/2 litre) of
warm water should be administered everyday for the first three days to cleanse
the lower bowel.
Hot compresses may be placed over the painful area several times daily.
Abdominal packs,
made of a strip of wet sheet covered by a dry flannel cloth bound tightly
around the abdomen,
should be applied continuously until all acute symptoms subside.
When the acute symptoms subside by about the third day, the patient should be
given a full
enema containing about 1 1/2 litre of warm water and this should be repeated
daily until the
inflammation and pain have subsided. The patient can be given fruit juices from
the third day
onwards. This simple treatment sensibly applied will overcome an appendicitis
attack.
After spending three days on fruit juices, the patient may adopt an all-fruit
diet for a further four
or five days. During this period, he should have three meals a day each meal of
fresh juicy fruits.
Thereafter, he should adopt a well-balanced diet based on three food groups
namely, (i) seed,
nuts and grains, (ii) vegetables and (iii) fruits.
In case of chronic appendicitis, a short fast should be followed by a full milk
diet for two or three
weeks. In this regimen, a glass of milk should be taken every two hours from 8
a.m. to 8 p.m. on
the first day, a glass every hour and a half the next day and a glass every
hour the third day.
Then the quantity of milk should be gradually increased so as to take a glass
every half an hour,
if such a quantity can be tolerated comfortably. After the full milk diet, the
patient should
gradually embark upon a well- balanced diet, with emphasis on fresh fruits and
green leafy
vegetables.
Certain vegetable juices, especially carrot juice, in combination with the
juices of beets and
cucumbers, have been found valuable in the treatment of appendicitis. Regular
use of tea made
from fenugreek seeds has also proved helpful in preventing the appendix from
becoming a
dumping ground for excess mucous and intestinal waste.
The patient of appendicitis should adopt all measures to eradicate
constipation., if it is habitual.
Much relief can be obtained by the application of hot fomentation and abdominal
packs every
morning and night.
An abdominal massage is also beneficial. Once the waste matter in the
calcium has moved into the colon and thence eliminated, the irritation and
inflammation in the
appendix will subside and surgical removal of the appendix will not be
necessary. The surgical
operation should be resorted to only in rare cases, when the appendix has
become abscessed.
