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Pain In The Gut
Pain In The Gut
Pain In The Gut

Sudden severe pain in the lower right side of your abdomen could signal appendicitis – a serious infection that requires immediate medical attention.

A finger-shaped pouch that extends from the lower right side of your colon like a vestigial tail, the appendix is something of a mystery.

In herbivores, the appendix – much larger than ours – is used to store and digest dietary fibre. In humans, however, the appendix – located in the right lower abdomen – serves no purpose as we are not able to digest fibre. In theory, our tiny appendix could be a remnant of an ancient digestive tract when our ancestors were able to digest leaves and bark. Though it serves no known purpose, the appendix can cause severe trouble if it gets infected, a condition called appendicitis. While the risk is very low, appendicitis requires immediate medical attention when it does occur.

Causes and signs of appendicitis

Appendicitis refers to a condition where the appendix becomes swollen and filled with pus. This may happen if bits of faeces drop into the appendix and block it. The bacteria in the trapped stool may cause infection and swelling. Very infrequently, a small tumour within the appendix can also cause appendicitis. The swollen and inflamed appendix results in pain in the lower right side of the tummy, nausea, vomiting, and fever.

Emergency medical care is essential in the case of appendicitis as the infected organ needs to be removed before it bursts. In this severe scenario, pus is released into the body and the infection may spread and progress to a critical condition called sepsis. Organ failure and even death can result.

Diagnosis and treatment

In the past, appendicitis was diagnosed based on physical examination – pressing the abdomen to check for pain, fever and a blood test. Today, a more accurate diagnosis can be made using a computed tomography (CT) scan. Surgery for appendicitis has also benefitted from technological advancements. Laparoscopic or keyhole surgery means the appendix can be removed via three small incisions instead of a single long one. The earlier the treatment, the more likely it can be removed through minimally invasive keyhole surgery. When the appendix has ruptured and caused infection around the area, poor visualisation of the organs may necessitate traditional open surgery.

In keyhole surgery, a 1cm cut is made around the navel into which a tube-like camera is inserted. Two smaller 5mm cuts are then made in the abdomen to insert the cutting instruments. These “arms” tie of the connection between the appendix and the colon, cut away the infected appendix, and remove the tissues through the cut at the navel.

Some signs of appendicitis

  • Initial pain near the navel that moves to the lower right abdomen and increases in intensity
  • Loss of appetite, nausea and/or vomiting
  • Abdominal swelling
  • Fever
  • Less typical symptoms such as diarrhoea, constipation, back pain, painful urination and severe cramps
These are just some of the signs of appendicitis. If you experience these symptoms, seek medical attention immediately. Avoid eating, drinking, or using any pain remedies, antacids, laxatives, or heating pads, which can aggravate the inflamed appendix.

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Ho Kok Sun Colorectal

Colorectal Surgeon

3 Mount Elizabeth,
Mount Elizabeth Medical Centre
#04-08, Singapore 228510

Tel (+65) 6737 2778
Fax : (+65) 6737 2389

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