Can appendicitis go away on its own? Inflammation of the appendix - can appendicitis hurt for a week? Causes and symptoms of pathology

Appendicitis

I am 29 years old, four years ago for a long time I had prolonged pain in the side. I went to the doctor and he explained to me that it was chronic appendicitis (the cases of which were in childhood). After that, with similar symptoms, I applied ice to my side and everything went away. But now, for about five months now, pain in the side began to appear periodically after two or three weeks and last up to two weeks or more. Please tell me if it could be appendicitis and I shouldn't be worried, or is it something else and should I see a doctor?

Sometimes, against the background of inflammatory processes in the intestines that were previously, such residual pains can form (when the problem has disappeared, and nervous system still falsely "remembers" her). In order to be sure of this, go through a dispensary (preventive) examination with a consultation with a gynecologist, urologist, neuropathologist, gastroenterologist. If everything is in order, it will give you confidence and not to worry, but to adapt to your situation - maybe you will find that the pain occurs more often if you eat sweet or spicy (other food), maybe you need to go on a diet at this time - fermented milk or ..., do not drink coffee, ..., or maybe decoctions will help you at this time medicinal herbs(gastrointestinal fees), etc.

what does chronic appendicitis mean? why can't it be removed? what to do when attack?

Chronic appendicitis is a chronic recurrent inflammation of the appendix - the appendix of the rectum. With frequent attacks, surgery is indicated. In the case of each attack, it is necessary to contact a surgeon or call an ambulance, as there is a risk of developing peritonitis - inflammation of the peritoneum due to rupture of the process. Heating pads and compresses on the stomach are contraindicated. Self-administration of painkillers, including baralgin, is dangerous, since these drugs mask the manifestations of the disease and may interfere with the timely diagnosis of peritonitis.

what is the most reliable way to diagnose chronic appendicitis and whether it should be cut out

Chronic appendicitis is a controversial concept. Modern point of view: it is understood as a very rare disorder of the immune system of the intestine (including the appendix), which can lead to periodic pain. This condition differs from ordinary appendicitis, which is fraught with severe inflammation, rupture of the appendix and peritonitis; with chronic appendicitis, the likelihood of complications is low. In addition, there are many other diseases that occur with a similar clinic: Crohn's disease, diverticulitis, chronic colitis, pancreatitis, typhlitis, etc., dysbacteriosis. Sometimes the changes are so subtle that the correct diagnosis can only be made by cutting off the process and looking at it under a microscope. Therefore, the diagnosis is made by excluding the above conditions. It is not worth chasing this diagnosis, it is quite rare, and the reason for your complaints may be simpler. Chronic appendicitis itself does not require surgery (i.e. preservation of the appendix is not life-threatening). But if he (really he) calls constant pain and disrupts the quality of life, if you constantly think about it and worry about it, then you can resort to surgery - not for treatment, but to eliminate pain and anxiety.

nutrition after appendectomy

If the operation went without complications (peritonitis), then after discharge from the hospital, special dietary restrictions are not required.

We hear the word "appendicitis" quite often. In childhood, parents and teachers tell us about it, doctors check us for its presence or absence. And from time to time one of the acquaintances goes to the hospital - "to cut the appendicitis." And then it may turn out that the doctors made a mistake with. It seems that appendicitis is not dangerous ...

Moreover, more and more often you can hear that the operation is "superfluous": they say, surgeons just need to cut ... But which of this is true, and which is fiction?

Disease of all ages

Appendicitis is called inflammation of a special hollow organ, departing from the caecum - appendix, or appendix. The cavity of the appendix communicates with the lumen of the intestine, the intestinal contents can fall into the process - and at the same time it must exit freely, otherwise stagnation of the contents in the cavity and the development of inflammation are possible. This may even happen due to anatomical features appendix: the fact is that both the size of this process and its location in abdominal cavity, and the presence of bends can be purely individual - which, we note, in the case of inflammation, significantly complicates the diagnosis. However, most often, due to the relatively small size of the appendix cavity, only very a small amount of intestinal mass.

Usually, in an adult, the appendix reaches a length of 7-9 cm (although there have been cases of underdeveloped processes only 0.5 cm long, and especially long ones - up to 23 cm) and a diameter of not more than 1 cm. At the same time, the location of the appendix relative to others organs can be different: it can descend into the pelvic cavity, adjacent to the anterior abdominal wall or peritoneum, located among the intestinal loops and even grow into the wall of the caecum. How important is this process for a person? On the one hand, this organ is rudimentary, gradually losing its importance in the course of evolution, on the other hand, it participates in the work of the immune system, primarily due to the lymphoid tissue. It has the greatest value for immunity in children and adolescents under 16 years of age; but also in more late age it is needed - for example, as a reservoir for normal intestinal microflora, from which bacteria (primarily coli) are settled throughout the large intestine. However, not only beneficial microorganisms, but also pathogenic: when studying remote processes, they also found pathogenic microflora, and eggs of worms, and the helminths themselves.

Now doctors are inclined to believe that without good reasons this organ is still better not to be removed. However, if there is at least a suspicion of appendicitis and the doctor insists on surgical intervention, you must agree: the risk of complications is too high, possible benefit from the remaining appendix, there is many times less risk to health and life during exacerbation and complication of appendicitis.

Appendicitis is also chronic

There are no age restrictions for appendicitis either; it can also develop in infants, and the elderly. Appendicitis is one of the most common surgical diseases: it leads to the need for surgery in about every 20th person. At the same time, up to a third of cases may remain undetected - inflammation proceeds without severe symptoms and goes away by itself, without medical intervention. Almost all other cases are related to acute appendicitis.

If the appendix was not removed during the development of acute appendicitis (for example, due to the development of a special formation - appendicular infiltrate, which is considered a complication of appendicitis and is a dense lump of the appendix and tissues of neighboring organs) and seizures diseases are repeated, such appendicitis is considered chronic. It is often extremely difficult to distinguish an attack of appendicitis from other diseases: a similar picture is observed during exacerbation peptic ulcer stomach and duodenum, strangulated hernia, enterocolitis, renal colic, fit acute cholecystitis, some infectious diseases gastrointestinal tract(especially in children).

Diagnosis is not always easy

Therefore, suspicion of appendicitis should arise at any sudden

emerging severe pain in the stomach (especially accompanied by an increase in temperature), which does not pass within 6 hours. Most often, pain occurs at night or in the morning, all over the abdomen or near the navel, less often in the hypochondrium, "under the spoon." At first, the pain is not clearly expressed, but then its character from pulling and bursting becomes clearly expressed, intensifying (especially when walking or lying on the left side); at the same time (up to 4 hours from the onset of the attack), the temperature may rise (up to 39-40 ° C, sometimes even higher), nausea, vomiting, intestinal upset, and dry mouth may occur.

However, all these symptoms (as well as specific diagnostic signs - for example, sharp pain pressing on the right iliac region) can be expressed indistinctly, they depend on the degree of development of inflammation, the location of the appendix and other features. In some cases, even an ambulance doctor who came to the patient cannot unambiguously make a diagnosis - an examination by a surgeon in a hospital is necessary, to clarify the diagnosis - blood and urine tests, ultrasound, for women, a consultation with a gynecologist may be required . In order not to "lubricate" the picture of the disease, if an attack of appendicitis is suspected, one should not take strong painkillers, especially pestosteroid anti-inflammatory drugs - Ketorol, ndomethacin, Analgin, Baralgin M, etc. It is allowed to take antispasmodic drugs (for example, No-shpy - no more than 2 tablets at a time), but if they turned out to be ineffective and the pain does not go away, you should definitely contact a surgeon! Before the examination, you can not eat, put heating pads and warm compresses on the stomach (this increases inflammation), be treated with various "folk remedies": remember that an untimely diagnosis or an error in it due to a "blurred" picture can cost the patient life!

When you need to "cut" immediately

Approximately 12 hours after the onset of the attack, inflammation covers the entire wall of the appendix, then after a day, a maximum of two, the wall may collapse, and the contents of the intestine will begin to pour into the abdominal cavity. The most "innocent" complication in this case will be abscesses - abscesses around the process, between the intestines, under the diaphragm, etc., but peritonitis occurs much more often - inflammation of the peritoneum (the membrane covering all organs abdominal cavity), often leading to sepsis - blood poisoning, fraught with death. by the very serious complication is pylephlebitis - inflammation of the main vein of the liver (portal) when emboli enter it from the veins of the appendix - particles leading to blockage of the vein, and in the case of a rupture of the walls of the process - also containing intestinal microflora. With this disease, the functions of the liver are disturbed, and, unfortunately, it is practically impossible to cure it ...

Therefore, in cases where the doctor suspects appendicitis, you need to "cut" it right away. Even if the diagnosis is not confirmed later, it is better to be left without an organ, which an adult does not really need, than to delay in doubts due to unclear signs and wait until death dangerous complications. In itself, the operation of appendectomy (removal of the appendix) in most cases - if it did not come to complications - is quite simple and requires not so significant restrictions on the regimen and diet (except for the first 2 days), with healing and well-being already After 7-8 days, the stitches can be removed and the patient can be discharged home. A gentle regimen will be needed - again, depending on the condition - for 1.5-3 months, and after 3-6 months, after the formation of a dense scar, all restrictions on loads can be removed - up to resumption of weightlifting.

The questions of our readers about this "master of reincarnation" are answered by the deputy chief physician for surgery of the Moscow City Clinical Hospital No. 31, candidate medical sciences, surgeon of the highest category Avtandil Manvelidze.

No organ - no problem?

- I heard that somewhere in the middle of the last century in America it was customary to get rid of the appendix of every newborn baby. Why did the doctors refuse this idea, because, as they say, there is no organ - there are no problems? Olga, Saratov

- Indeed, in the last century in America, prophylactic appendectomy was widely practiced. But then this had to be abandoned, because as a result of many years of observation of these people, it turned out that the removal of appendicitis in infancy led to the development of serious immune disorders from the intestines.

How to "extra" organ to the appendix for a long time applied in Russia. In fact, there are no extra parts in the body. The appendix does not take part in the process of digestion, but since it consists of lymphoid tissue, in which cells function that perform immune functions, he plays important role in protecting the gastrointestinal tract from infections. For this reason, this process is sometimes called the "intestinal tonsil".

Painkillers are banned

- What should a person do if he is "caught" by an attack acute appendicitis?Ekaterina, Moscow

- You need to do only one thing - dial the number of "Ambulance" by phone, without waiting for the development of peritonitis. But what you can’t do in any case is take painkillers, because taking them will “lubricate” clinical picture diseases and the doctor will be more difficult to diagnose. IN last resort, if the pain is unbearable, you can drink no-shpu, but still it is better to be patient until the doctor arrives and refrain from using any medication. Another common mistake is to apply a warm heating pad to the sore spot or take a bath. This is the most short cut to intensify inflammation and bring the development of purulent peritonitis closer. Do enemas, drink choleretic drugs also not worth it. All that is required is to provide the patient with complete rest.

No self-activity!

- How can a person himself understand with pain in the right side - is it appendicitis or something else? Tatiana, Nizhny Novgorod

- No way. It's none of his business, but the doctor's duty. Even an experienced specialist there are often doubts that he is dealing with this particular disease, because appendicitis very skillfully disguises itself as almost any ailment in the abdominal region. But since this disease is fraught with very dangerous consequences for the health and even life of a person, then in case of pain in the abdomen (and anywhere, not necessarily on the right), you must definitely call an ambulance, and not try to recognize the disease yourself.

The less time has passed since the development of inflammation, the easier the operation will be and the shorter rehabilitation period. Unfortunately, the most a big problem- this is when people sit at home for a day, two, three, suffer pain, and then they go to the hospital already with peritonitis, when pus has spread throughout the abdominal cavity. And then they have to endure an extensive, difficult, lengthy operation, after which they will be forced to spend on hospital bed instead of a week whole month, if not more.

Examination according to the rules

- What investigations should be carried out to make a diagnosis of "appendicitis"? Valery, Izhevsk

- First of all, the doctor interviews the patient, collects an anamnesis. He asks leading questions, finding out when and under what circumstances the pain appeared, where it gives off, etc. This is followed by examination, palpation. Then analyzes (blood, urine) are taken - high level white blood cells will confirm the presence of inflammation. It is also necessary to do an ultrasound of the abdominal cavity. And in some cases it is necessary to resort to diagnostic laparoscopy. Through a puncture in the abdominal wall, a device with fiber optics is inserted, and with its help, the surgeon can already see on the monitor a picture of what is happening inside the patient.

Seeds - nothing

- I was told from childhood: do not eat seeds, do not swallow watermelon pits and that would be appendicitis. And how they looked into the water - indeed, at the age of 20 I was operated on for this reason. Now my son is growing, and I also forbid him to clog his body with seeds. Am I doing the right thing? Nicholas, Eagle

- The reasons for the development of inflammation of the appendix - the vermiform appendix of the caecum - are not known to science for certain. There are a lot of assumptions and theories on this subject, but none of them has been proven yet. As for the seeds, I think their danger is exaggerated. A tomato or cucumber also has seeds, albeit small ones, and no one says that it is dangerous to eat these vegetables. Unfortunately, there is no way to prevent appendicitis. Well, unless it is necessary to try to eliminate all inflammatory processes in the body in time, whether it be caries or tonsillitis, because chronic infection, wherever it is, can provoke inflammation in other organs. However, this applies not only to the appendix, but to the whole organism as a whole.

Difficult simple operation

- Surgery for appendicitis is considered to be something elementary. Is this really so and can there be complications after this intervention? Alexander, Moscow

- Indeed, most often the first operation, which is entrusted to a novice surgeon, is an appendectomy. After all, this is the most common surgical intervention because appendicitis is one of the most common "sores". However, surgeons say this: "There is nothing easier than an operation to remove the appendix, and there is nothing more difficult than this operation." After all, the deceit of this small process is inexhaustible. The appendix can be located in such "back streets" of the abdominal cavity that seven sweats will come off the surgeon before he gets to it. Therefore, the operation can last both half an hour and 2-3 hours. In mild cases, yesterday's student is also able to remove the appendix, and in complex cases, the hand of an experienced master is required. The decision to whom to entrust the operation is made during the intervention itself.

As for complications, they happen after any operation. Even after this one. They can range from healing problems to abdominal abscesses and even death. Mortality from appendicitis - 0.1 - 0.2%. These figures could be even lower if people applied for medical care on time and would not self-medicate.

No cuts

Is it possible to do an operation to remove the appendix without incisions? Ilya, Perm

– Yes, today laparoscopy is used very often in this disease. Then, after the intervention, only three almost imperceptible marks from the punctures through which the instruments were inserted remain on the patient's body. Benefits of using laparoscopy: less pain after surgery and more fast recovery and good cosmetic effect.

But, unfortunately, laparoscopy is not always applicable, but only if it is technically possible. This can only be resolved during the operation. If the surgeon understands that laparoscopy in this case does not fit, he resorts to the traditional method.

By the way

Appendicitis occurs in both children and the elderly, but more often this trouble occurs at the most flowering age - from 20 to 40 years. The number of patients among people of both sexes is approximately the same. In this case, the hereditary factor may be important, but not decisive.

There are two answers to the question of whether appendicitis can hurt for a week: maybe if the appendix cannot be operated on and after a second attack the disease can become chronic. The second answer is also positive: yes, but during this time the patient can lose not only health, but also life.

Many experts believe that the appendix is an excess in the body that requires removal, regardless of the situation.

What is appendicitis

The very name of the disease means an inflammatory process in acute form. Often inflammation of the appendix manifests itself on the dangerous stage- purulent appendicitis. The appendix is an organ in the form of a process, which, in the course of evolutionary changes, has lost its relevance. Inflammatory processes occur for various reasons.

Due to impaired blood circulation of the organ.
Ascaris accumulation.
Abdominal trauma.
Deposition and concentration of feces.

Inflammatory process It has different characteristics: mild form diseases and manifestations of necrotic processes of the gangrenous type. In the second case, the stomach can hurt for three to four days, during which time the tissues of the abdominal cavity and intestines begin to die around the process. It is not uncommon for catarrhal appendicitis (a mild form of the disease), during short span time (several hours), turns into gangrene, which does not allow using several days to prepare for the operation.

In this case, the time allotted for the operation is calculated in hours.

The stomach can hurt for several days and then tissue death can lead to inflammation of the abdominal cavity, or peritonitis, which is dangerous for blood poisoning. At this stage of the disease it is possible death. The life and death of a patient depends on how many hours or minutes of precious time surgeons have. Another complication that can occur within a week of inflammation of appendicitis is pylephlebitis. With pylephlebitis, irreversible processes associated with liver functions occur.

Duration and nature of the course of the disease

There are cases when chronic appendicitis can disturb the patient for several months, and patients living with this diagnosis may feel constant pain in the abdomen for a long time. The inflammatory process can manifest itself for several days, and then pass without disturbing long time, or constantly create discomfort and remind you of yourself.

Sometimes an appendix surgically it is impossible to remove due to the formation of appendicular infiltrate (the case when there are connections with other organs in the density of the lump). If a repeated attack of appendicitis occurs under such circumstances, the disease becomes chronic and at this stage it can remind of itself for a long time, sometimes for several months. During this period, the patient may experience both constant aching pain, and impulsive attacks that disturb from time to time.

On the stage chronic appendicitis other manifestations of the disease are possible. An attack can quickly pass - literally in one day, and this is explained by the peculiarity of the foci of inflammation. In response to the question whether appendicitis can hurt for a long time, experts say that only at the stage chronic form this disease can disturb the long period.

Is it possible to do without surgery

Studies have shown that the removal of the appendix sometimes makes itself felt in completely unexpected manifestations. Removal of this organ in children early age often leads to mental retardation, and in people who underwent surgery in adulthood increases the risk of bowel cancer. You should not immediately panic if there is pain in the abdomen in the area of \u200b\u200bthe appendix and all the symptoms of this disease are present: fever and vomiting.

In some cases, the attack is resolved quickly enough and on its own. Cases when a breakthrough occurs directly into the large intestine, without getting into the abdominal region, are not uncommon. The place of the breakthrough hurts for a day or several (two or three), diarrhea is observed, the body completely restores normal work all organs from a week to two. This situation occurs in older people, and it is not uncommon for them to not even suspect what exactly happened. If the pain in the stomach area continues for more than one day, the situation needs to be brought under control in order to avoid peritonitis. If the diagnosis is confirmed by a specialist, a reasonable decision would be surgical intervention. By the end of the week general state returns to normal, and the patient can resume his previous lifestyle.

Rules for diagnosing

A feature of appendicitis is the suddenness of the onset of symptoms and the transience of the inflammatory process.

The first signal is pain in the region of the right hypochondrium, closer to the navel, or the epigastric part.
Along with increased pain, new symptoms appear: nausea, dizziness, nausea, vomiting, lack of appetite.
After some time, chills, fever, accompanied high temperature. The pain develops and moves closer to the right side, while nausea and weakness increase.

The listed symptoms are classic in inflammation of the appendix and require quick clarification by specialists.

Difficult to diagnose early period development of appendicitis: the first 3 hours the patient cannot accurately determine the location of the pain, it is of a wandering nature. The inability to fix the body in a certain position amplifies the confusion, the pain is constantly moving, its attacks can both intensify and weaken.

After 3 hours from the onset of the attack, the doctor can accurately diagnose the disease: the pain becomes constant and in one place, the patient is due to severe attacks practically unable to move independently.

Unusual manifestations in the form of an incorrect location of the appendix, when its location is in the back of the caecum, is not such a rarity (6-20%) of people. This case in medicine is called retrocecal type appendicitis, pain can manifest as right side lumbar region, and closer to the stomach.

Diagnosis by ultrasound does not guarantee a diagnosis, only X-ray gives complete picture the presence of an inflammatory process.

Self-diagnosis of an attack

Diagnosis of the disease can be performed independently, this requires the following steps:

Take the fetal position, while lying on your right side.
While straightening the legs, smoothly roll over to the left side. With a sharp increase in pain during a turn on left side diagnosed with inflammation of the appendix. attenuation pain means that the problem is something else.
Severe pain in appendicitis makes it impossible to strain the abdominal muscles, if the patient tries to cough, this will cause acute attack and an increase in pain.
If the palm of your hand slightly presses down on the place where pain is felt, and then abruptly let go, increasing pain during recovery indicates the presence of inflammation of the appendix.

In any case, if signs of the disease appear, it is best to call ambulance, or invite specialists to establish a diagnosis. Some of the symptoms are not unique to an appendicitis attack, so comprehensive examination necessary for exact definition causes of pain and other symptoms.