Appendicitis in Children: Treatment, Cost and Side Effects

An inflammation that occurs in an appendix that extends from the large intestine. When an appendix becomes blocked due to a foreign body, cancer or stool appendicitis may occur. The appendix tends to swell as a response to infection in the body. The common symptoms of appendicitis include dull pain around the navel or upper side of the abdomen. When it becomes sharp it moves towards the right lower abdomen. People often undergo loss of appetite. Vomiting and nausea followed by abdominal pain. Usually, fever with a temperature of 99-102 degree Fahrenheit and abdominal swelling occurs. Often there will be an inability to pass gas. When the symptoms develop appendix starts getting inflamed causing pain because of collected pus. Other symptoms include painful urination, severe cramps and constipation or diarrhea with gas. It mostly affects children of age between 6-18. Not all will have an appendix in the same place. They can be also located behind the colon, liver or pelvis. If a doctor observes these symptoms, they will diagnose for appendicitis. The doctor may ask to take some tests as a part of the diagnosis. To detect infection if any, you may be asked to undergo a blood test. Usually, an MRI, ultrasound or CT scan will be taken to see how much inflammation has occurred in an appendix. It is often difficult to detect appendicitis among children. To prevent the child’s body from exposure to radiation, an ultrasound is carried out first and only if it is inconclusive, CT scan is recommended. Kidney or bladder infection will be checked using urinary tests. It has been found that if proteins are detected in urine, it can be treated as an indicator of appendicitis. Depending upon the severity and symptoms the doctor may suggest treatment which covers medications like antibiotics and surgery to remove the appendix.

The treatment for the appendicitis vary according to the conditions and can be any one of the following:

1. Antibiotics are recommended only if the symptoms are mild; in most of the cases, surgery is recommended. Most common type of surgery is laparoscopy or keyhole surgery. These surgeries are done within 24 hours of appendix diagnosis.
2. There is a 1-hour operation performed under a local anesthesia called APPENDECTOMY in which requires a 3-inch small incision on your right side and 3 incisions on the left side and middle side of the belly. You can leave the hospital on the same day.
3. Laparoscopy is an invasive keyhole surgery which follows the steps
4. First a thin tube, the laparoscope is inserted into the abdomen. It has a video camera tiny in nature and light. This is inserted into the abdomen using a hollow instrument commonly known as a cannula.
5. The inner side of the abdomen can then be viewed using a monitor. This usually gives magnified images.
6. The instrument can remove the appendix using abdominal incisions. The surgeon's hand movement makes a response in the instrument which helps in the appendix removal.
7. Open surgery: When it requires abdominal cavity to be cleaned, larger incisions will be made. This is required when the infection in appendix has spread and appendix becomes ruptured, Abscess is caused due to the appendix when tumors are detected in the digestive system, if a woman is found to be in her third trimester period of pregnancy and if the patient has undergone abdominal surgeries before.

   Antibiotics will be recommended after the operation. If symptoms have lasted for more than 4 days, a course of antibiotics will be given so that infection reduces and appendix gets shrink. It has been found that surgery is more effective than antibiotics. If an abscess is found, it will be first drain and surgery will be performed at a later date.

If the symptoms are detected in an early stage, antibiotics will be sufficient. But if severe inflammation is found in scan and infection in blood tests, surgery will be recommended within 24 hours of appendix detection. This is to avoid risks and complications. If the inflammation worsens, it may lead to peritonitis. In the worst case, the infections start entering the bloodstream causing Septicemia.

Not all patients are eligible for surgery and antibiotic medication. The antibiotics are an option if the appendicitis is found to be uncomplicated. If a patient is having problems with immune systems, or undergone chemotherapy or organ transplant, or had any heart implants or bowel disease in the near past, these treatment options may not suitable. Surgeons have to analyze and come up with a different treatment method.

The most common side effects of surgery that are likely to occur are allergic reactions to the medications, people tend to develop a difficulty in breathing in some cases, the incisions made can trigger infections, people might feel obstruction of bowel, if the procedure causes ruptures , inflammation can happen, there are chances of pus collection in the abdomen.

After 12 hours you can move around as normal. Consult a doctor after surgery if you tend to have an uncontrolled vomiting, increased pain in the abdomen, if you feel dizziness or faintness, if you see blood during vomiting or urination, pus in the wound, fever and pain and redness in your incision. Avoid tedious activity in the first few weeks, if you have undergone laparoscopy, you can limit the activity up to five days. If you have undergone open surgery, you can limit the activity up to 2 weeks. Follow the instructions given by the surgeon.

• Do remember to support your abdomen while coughing. You can place a pillow or apply pressure while coughing, laughing or moving. It can help in to reduce your pain.
• Always reach out for a doctor if pain medications are not helping you. Pain can give you more stress and decelerate your healing process.
• Slowly increase your physical activity, keep calm for 2 weeks and start with short movements.
• You tend to sleep more during your healing process. Sleep whenever you feel like sleeping and take enough rest.
• Normal activities can be resumed after one week, like going to school or work. Strenuous activities like gym or sports can be resumed after four weeks.

Recovery time depends upon the type of surgery. Laparoscopic surgery can get you back to your normal routine in one to three weeks while an open surgery will take up to four weeks. The inside sutures dissolve in about 6 weeks and you can gain full strength only in 6 months.

The average price in India ranges from Rs 20,000 to Rs 2, 00,000. Majority of the cities in India offer treatment for the appendix. The average cost can be estimated at Rs 65,000.

A patient who has undergone laparoscopy treatment seems to have satisfying results. If you take a good care of yourself during the healing time. You can get rid of appendicitis. There are rare chances that it may reappear again. Since you have only one appendix and once it is removed, it cannot grow back.

Take the proper diet and enough water. Stay hydrated all the day. Don't skip food or do fasting. Antibiotics can act as an alternative to the treatment. Include garlic, fenugreek seeds, lemon, and basil in your diet. You can choose Ayurveda as one of the alternatives to the surgery.