First thing we need to understand is that appendicitis is an surgical emergency. When treated appropriately complications are very few.
What are the symptoms of appendicitis?
It has dull aching pain around the umbilicus and slowly localises to right lower side. It is associated with vomiting and anorexia (patient does not feel hungry). If ignored then might lead to temperature, high heart rate (tachycardia).
How is appendicitis diagnosed?
It's based on history and clinical examination. Blood tests will reveal infection (Increased WBC, CRP). Ultrasound of abdomen might help to confirm the diagnosis but negative ultrasound scan does not rule out possibility of appendicitis. Ultrasound is more important in females as problems in ovaries, fallopian tube and uterus might present in the similar way and ultrasound helps to rule out those possibilities.
What is the treatment of appendicitis?
In short treatment of appendicitis is immediate surgery. It is not I am busy for next few days and will have surgery later and this might lead to serious complications.
Now a days surgery is done laparoscopically (Key hole) and involves three small cuts which will be barely visible with time. Most patients go home 24 hours later being able to do regular activities. There will be no food restrictions. Only restriction being not to lift weights for 1 month.
Can appendicitis be treated with medicines? if so what are the complications?
There are times when patients want antibiotics and not surgery. While this is proven treatment it is logistically difficult to apply in Indian settings unless patients and affordable and ready to take risks.
Medical proof so far tells us to treat appendicitis with antibiotics we need to do CT scan and prove that there is no collection of pus inside abdomen. Once this is done admit patient for Intravenous antibiotics (IV) for 48 hours. Regularly review patient to make sure infection is not spreading. If infection does not settle down or patient suffers complication then do complicated surgery with more risks involved.
What we have to be very careful is young females with appendicitis as untreated or poorly treated appendicitis might lead to infertility in the future by affecting the movements of fallopian tubes.
In all patients treated with antibiotics there is small risk of long term abdominal pain and very rarely appendicitis might recur needing surgery.