Appendicitis symptoms: what they are and how it’s treated

Is it appendicitis or just a stomach ache? Can a child have appendicitis without fever or vomiting? Our GP Dr Philippa Kaye reveals all - plus, hear one mum's story

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Appendicitis happens when the appendix – part of the intestines – becomes inflamed. If left untreated it can burst and infectious materials can get into the abdominal cavity lining, which can be fatal unless treated quickly with strong antibiotics.

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Children often get tummy aches for lots of reasons – anything from constipation to a tummy bug – and so it can be really tricky to know when it’s something more serious like appendicitis pain.

Signs it might be appendicitis are:

  • that the pain often starts around the belly button and then moves to the right hand side of the abdomen
  • that there may be a temperature and often nausea
  • decreased appetite or vomiting occurring as the pain gets worse
  • in young children there may also be some swelling in the abdomen.

Moving around may make the pain worse so they often want to lie still.

Often too, we reckon a mother’s intuition will probably let you know if something’s going on more than the usual trapped win or hunger pain scenario.

One of our mums, Tanya B, shares how she knew something was up when her 6-year-old woke from her sleep in pain. She says:

“My daughter complained of pains in her tummy at around 8pm, but did fall asleep quite quickly.

“She woke up from being fast asleep at around 10pm in such agony I knew something was wrong – she’s never woken up from stomach pains (or any pains) before so the fact she couldn’t sleep made me think it was appendicitis.

“There was no fever or vomiting, but she was pulling on her right side in particular, which I’d read was a symptom of appendicitis, and crying in such agony I just knew it was serious.

“We got her to A and E and, sure enough, she was eventually diagnosed with appendicitis.”

How will the doctors diagnose appendicitis?

“The doctors will feel your child’s tummy and may check the urine to rule out a urine infection, request blood and do an ultrasound test, but appendicitis can often be diagnosed just by examining the abdomen,” says Philippa.

In Tanya B’s case, they tested her daughter’s urine on arrival at hospital and felt her abdomen, and while they were pretty sure it was appendicitis, they gave her painkillers to help her sleep overnight and carried out an ultrasound the next morning which confirmed it was appendicitis.

How will appendicitis be treated?

Treatment is with surgery to remove the appendix, often performed using a laparoscope – key-hole surgery or via a traditional incision. Your child will generally stay in hospital for 2-3 days.

One parent is usually allowed to go in with the child before they’re given the anaesthetic prior to the surgery. It can be daunting but the procedure is routine and generally goes ahead with no issues.

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One thing to be aware of is that seeing your child after surgery can be distressing.

“I thought my daughter would be calm and  a bit hazy after the operation,” says Tanya B. “But she was crying in pain, was very disorientated and was begging for water – of which she was only allowed a few small drops at a time but not too much in case she was sick.

“She did get painkillers which kicked in quickly but I think it’s good to know beforehand that your child will probably be seriously out of sorts when they come round: it’s scary but it does pass and they’ll be a different person in a couple of hours.”

How should you look after the stitches once you’ve had your appendix taken out? 

You will be advised by the hospital but generally dissolvable sutures are used, which don’t have to be removed. 

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If dissolvable ones are used there may be some steristrips (sort of like paper stitches) on the outside which should be kept clean and dry for 7 days before being peeled off. 

If this isn’t the case you will be advised where and when to go to have the stitches taken out, generally about 7 days.

Keep the wound itself dry and covered for about 3 days. Your child can shower but then pat dry and put on a clean dressing.

How long will your child have to be off school?

Tanya B told us she was advised by doctors before she left the hospital that her daughter should stay off school for a week.

“For the first 4or 5 days we stayed in and took it easy, but after that we went out as usual – not to the park for the first week, but we definitely did our regular walks, cinema trips and shop visits.”

“Children are really good at showing you what they are able to do,” Philippa adds: “When it hurts they won’t be running around or jumping up and down on the trampoline.

“Give your child painkillers as needed, but avoid exercise like swimming or PE for 10 days.”

Pics: Getty/Tara Breathnach

Dr Philippa Kaye is a London GP who has written several books on pregnancy and childcare including The First Five Years. See www.drphilippakaye.com and follow her on twitter @drphilippakaye

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