We all want our kids to be hale and hearty always. And so as parents, we try to take good care of their health. However, there are times when things are not under our control. For instance, appendicitis, an inflammation of the appendix, can occur suddenly and is a common cause of emergency abdominal surgery in children. Identifying the early signs of appendicitis can make a significant difference in the outcome.
Dr Amita Jain, an eminent laparoscopic surgeon and specialist for appendix in Delhi shares some valuable insights on the topic.
What is Appendicitis?
Appendicitis is an infection or inflammation of the appendix, a small, tube-shaped organ attached to the large intestine, located in the lower right side of the abdomen.
In severe cases, the appendix can burst which is when appendectomy or surgical removal of the appendix is required.
What are the Causes of Appendicitis in Kids?
The causes include:
Blockage: The inside of the appendix gets blocked by:
- Nose or mouth fluid (mucus)
- Stool or parasites
- swollen lymph nodes in the intestines
As the appendix swells and its blood supply diminishes, it may eventually rupture, causing stool and mucus to leak into the abdomen, which can lead to a severe infection called peritonitis.
What are the Risk Factors?
Some of the risk factors associated are:
- Children with cystic fibrosis may be at a higher risk.
- A family history of appendicitis can increase a child’s risk.
- It mostly affects kids and teens aged 5–20 years.
- Appendicitis is rare in infants.
- It is not contagious, so it cannot be spread from person to person.
What about the Early Signs?
Some of the early signs are:
- Initial Pain: Often starts as a mild pain near the belly button, which may seem like a stomachache.
- Pain Migration: Pain usually worsens and shifts to the lower right side of the abdomen, near the hip bone (McBurney’s point).
- Pain Characteristics:
- Localized: Pain is concentrated in one area rather than spread throughout the belly.
- Intensity: Sharp, sudden pain that can be severe enough to wake the child from sleep.
- Duration: Persistent pain lasting several hours to days, not relieved by bowel movements or OTC medications.
- Aggravation: Pain worsens with movement, deep breaths, coughing, sneezing, or jostling.
- Pain Variations:
- Advanced Pregnancy: Pain might be felt in the upper right quadrant.
- Retroperitoneal Appendix: Pain may be located in the lower right back/flank.
- Rare Cases: Pain could be on the left side if the appendix is unusually positioned or elongated.
Gastrointestinal Symptoms:
- Loss of Appetite: Reduced desire to eat as the body tries to avoid stress on the GI tract.
- Nausea and Vomiting: Feelings of queasiness and vomiting that don’t alleviate symptoms.
- Difficulty Passing Gas: Bloated feeling with an inability to pass gas.
- Constipation or Diarrhea: Either hard stools and constipation or loose stools and diarrhea, with the potential for complete digestive shutdown.
It may be difficult to understand whether your child has appendicitis or gastroenteritis as many of the symptoms overlap. However, the most significant difference is that gastroenteritis usually hits suddenly and resolves quickly, while appendicitis tends to cause more persistent and worsening symptoms.
- Fever
A child may have a mild fever ranging from 99 to 100.3 degrees Fahrenheit with early appendicitis as their body responds to inflammation and infection. If the fever exceeds 100.4 degrees Fahrenheit, it could indicate that the appendix has ruptured.
Explain to your Child
There is a sense of fear attached to the word surgery, but understanding what’s happening can help ease your child’s anxiety. Explain that they have a problem that needs fixing at the hospital, but avoid scary words like “cut” or “open up.” Reassure them that the surgery will make them better and that they’ll be asleep and not feel any pain during the procedure, with the doctor waking them up afterward.
Thus, it is always advisable to consult a doctor the moment you notice any signs of appendicitis in your child, such as persistent abdominal pain, nausea, or fever. Early diagnosis and treatment are crucial to prevent complications and ensure a swift recovery.
Dr Amita Jain is a surgeon with highest degree of professional competence, precision and surgical craftsmanship. Performed all complicated general surgery procedures with in depth knowledge of invasive and few minimal invasive and onco surgical techniques. Underwent special training in trauma, executed various trauma-related complex life-saving neurosurgical procedures, reconstructed injured mangled limbs and performed vascular and reconstructive procedures with critical care.
Dr Amita Jain holds 28 plus years of rich experience in Trauma and General Laparoscopic Surgeries (including Gallbladder stone removal, appendix removal, hernia repair surgery, piles and fissure surgeries). She was the Professor Surgery of at the Army College of Medical Sciences and Base Hospital Delhi Cantt. In 1994 she was commissioned as Surgeon under the United Nations Mission in Congo. From 2020 to 2022, she worked with Bansals Hospital. Currently, Dr Amita Jain is the Senior Consultant, (Speciality: General and Laparoscopic Surgeon) at Artemis Lite Hospital, New Delhi