Does acute appendicitis hurt?

Written by Ren Zheng Xin
Gastroenterology
Updated on March 24, 2025
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Acute appendicitis is associated with abdominal pain, the severity of which is directly related to the extent of the inflammation. If the inflammation is mild, the abdominal pain can be tolerable. However, if there is significant pus in the appendix or perforation, it can cause severe abdominal pain, similar to being cut by a knife. Acute appendicitis generally requires surgical treatment. Currently, a common procedure is laparoscopic appendectomy, which causes less bleeding during surgery and allows for a quicker recovery with minimal damage to the body. For patients who cannot tolerate general anesthesia, spinal anesthesia can be used, and the appendix can be removed through an incision at McBurney's point.

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Gastroenterology
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Precursors of acute appendicitis

Acute appendicitis is acute inflammation of the appendix lumen, and currently, there are no particularly typical precursors, but the causes of acute appendicitis should be noted, which are related to obstruction and infection of the appendix cavity. If the appendix lumen is compressed for a long time, the accumulation of secretions can cause blood supply disorders in the distal appendix wall, directly causing damage to the appendix mucosa, and inducing infection that leads to appendicitis. Additionally, gastrointestinal dysfunctions such as diarrhea and constipation can also cause spasms of the appendix muscles and vessels, leading to blood supply disorders and mucosal damage, thereby causing acute appendicitis.

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General Surgery
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Acute appendicitis pressure point

Acute appendicitis is primarily diagnosed by pressing on McBurney's point in the lower right abdomen, as the appendix is located in the right iliac fossa in the vast majority of patients, and its surface projection is mainly at the outer third of the line connecting the umbilicus and the anterior superior iliac spine. However, a very small number of people may experience situs inversus, where the appendix could possibly be located in the lower left abdomen. Tenderness at a fixed point in the lower right abdomen is often a specific diagnostic criterion for acute appendicitis in clinical practice. If most patients exhibit symptoms of peritoneal irritation, it indicates worsening appendicitis symptoms, possibly even gangrene perforation. Most patients who experience a course lasting more than 3-5 days can develop a mass in the lower right abdomen, indicating the formation of a periappendiceal abscess. In cases where the symptoms are manageable, conservative treatment strategies can be adopted. Traditional Chinese Medicine methods can be used to promote the absorption of inflammation, with an appendectomy scheduled three months later.

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Gastroenterology
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Early symptoms of acute appendicitis

The symptoms of the early stage of acute appendicitis primarily include vague abdominal pain, initially across the abdomen, then transitioning around the belly button, and after several hours, shifting to the lower right abdomen where the pain becomes localized. The early symptoms of acute appendicitis are not typically distinctive, with the onset being quite sudden, accompanied by severe abdominal pain, vomiting, and fever. Based on these typical clinical manifestations, diagnosing acute appendicitis is not difficult. Clinically, the main treatment is the surgical removal of the appendix, with laparoscopic appendectomy being the more common practice nowadays. This method involves less bleeding during the operation and a quicker post-operative recovery.

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Gastroenterology
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How to medicate for acute appendicitis

Acute appendicitis is commonly treated surgically in clinical settings. Medication for acute appendicitis should be used with caution according to indications; if the appendix is not purulent, it is appropriate to use anti-inflammatory drugs to control the infection and choose sensitive antibiotics, such as quinolones. If the appendix becomes purulent or perforates, timely surgical treatment should be administered to prevent further exacerbation of appendicitis. Before and after the surgery, it is important to monitor whether the patient's symptoms and signs have significantly worsened. (Medications should be taken under the guidance of a physician and based on actual conditions)

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Acute Appendicitis Etiology

The cause of acute appendicitis is primarily bacterial infection of the appendiceal lumen due to various reasons. The appendix itself is a narrow tube connected to the cecum. If a fecalith falls into the lumen, it can cause obstruction of the appendiceal lumen, leading to an increase in intra-luminal pressure and circulatory disturbances in the appendiceal wall. At this time, the mucosa is susceptible to damage, and bacterial invasion of the wall can cause infections of varying degrees. Additionally, gastrointestinal dysfunction, such as diarrhea or constipation, can also cause spasms of the appendiceal vessels, leading to blood supply disturbances and resulting in acute inflammation.