What does appendix pain feel like? - David R. Flum
In April 1961, the Sixth Soviet Antarctic
Expedition took a harrowing turn.
Doctor Leonid Rogozov,
the team’s only physician,
began feeling weak and feverish,
with an excruciating pain
in his right side.
After a few days, it became clear
that he had appendicitis,
an infection that can cause
the appendix to burst.
And Rogozov knew that if his appendix
did rupture,
it would likely kill him.
Outside a blizzard raged,
making it dangerous for him
to leave the station,
or to have anyone else travel in.
So Rogozov faced a gut-wrenching choice:
wait for help that may never come,
or cut open his own abdomen
and remove the appendix himself.
While Rogozov’s predicament may
have been extreme,
appendicitis is not uncommon.
It affects roughly 1 in 12 people.
So, what causes appendicitis?
And why is this organ
so prone to bursting?
The appendix is a small, worm-shaped pouch
attached to the large intestine
that houses a diversity of gut microbes.
Scientists long speculated that it was
a useless artifact of evolution.
Recent evidence shows that this organ
independently evolved
in many different mammals.
This suggests that it
probably has some function,
though it's likely subtle.
One possibility is that the appendix
serves as a reservoir
for healthy gut bacteria,
or it may play a role
in mounting immune responses.
What we do know is this puzzling organ
can cause serious complications.
Most cases of appendicitis start
with some sort of obstruction.
For example, a small, dried piece
of stool,
called an appendicolith,
can lodge itself in the organ’s entrance.
Other times, pathogens like viruses or
parasites activate the immune system,
causing inflammation.
This immune response may
even be triggered
by one of hundreds of species of bacteria
that normally reside in your gut.
As a result, nearby lymph nodes swell,
effectively closing off
the appendix’s opening.
Because the appendix is a closed loop,
when it's sealed, pressure builds quickly.
This creates the perfect environment
for bacteria to colonize and overgrow.
As the inflamed appendix bloats,
discomfort sets in.
And this pain is different
from your everyday stomach ache.
It typically starts near the belly button
and then migrates to the lower right
abdomen and intensifies.
If left untreated,
the appendix can continue to stretch,
hindering blood flow
and weakening the organ walls.
Eventually, this can cause
the appendix to rupture,
allowing the infection to spread
within the abdomen,
where it can pose fatal consequences.
Thankfully, not all cases of appendicitis
will lead to a rupture,
but it's impossible to know
exactly when or if
the appendix will burst
from symptoms alone.
So, it’s recommended that all people
with severe abdominal pain
seek immediate medical attention.
Since doctors first identified
appendicitis in the late 1800s,
an appendectomy, or the surgical removal
of the appendix,
has been the standard treatment.
It’s normally performed quickly,
within 24 hours of diagnosis.
Doctors remove the inflamed organ,
which can double in size,
either through one large incision,
or through several smaller incisions
using a camera and small instruments.
Recovery is typically quick,
and most patients are discharged
within a day or two.
Though, if the appendix has burst,
surgery can be more extensive
as any bacteria and pus need to be
thoroughly cleaned
from the abdominal cavity.
In the long term,
living without an appendix
is unlikely to lead to any health issues.
Today, thanks to medical advances,
many patients avoid surgery altogether.
Doctors have learned that appendicitis
can often be treated
with a simple course of antibiotics,
started in the emergency room
and continued at home.
No matter the chosen course of treatment,
it’s likely to be less distressing
than Rogozov’s,
who, after giving himself
local anesthesia,
removed his own appendix,
stitched himself up,
and resumed his regular duties
just two weeks later.
Nevertheless, thanks to his story,
doctors on remote stations in Antarctica
now know to bring plenty of antibiotics
to treat appendicitis,
just in case.
