Causes of irritation of the appendix
The appendix appendix consists of many lymph follicles. If the connection between the appendix and the descending appendix is blocked, a secretion congestion in the appendix occurs. This allows bacteria from the large intestine to multiply and lead to irritation or inflammation.
This congestion of secretion is usually caused by hardened, thickened stool. A kinking of the appendix due to an unfavourable position in the abdominal cavity can also lead to a congestion of secretion and thus to irritation, but this occurs rather rarely. Fruit stones, worms or foreign bodies can also be the cause of an occlusion.
Intestinal infections can also spread to the appendix and lead to irritation. Due to the various possible causes, the cause of an irritation or inflammation of the appendix should always be clarified. Especially in children, the appendix plays an important role in the immune defence.
The lymph nodes in the area of the appendix react to bacteria in the intestine. In the course of an irritation of the appendix, a defence reaction is triggered by pathogens, which leads to a swelling of the mucous membrane. The mucous membranes become more sensitive and secretion is secreted.
These reactions cause pain. When the swelling of the mucous membrane subsides again, the pain disappears again. However, it is often difficult for the doctor treating the patient at the moment of the pain to distinguish between an irritation of the appendix and a more dangerous appendicitis.
For this reason, patients are often admitted to hospital for safety reasons, as an acutely inflamed appendix must be removed immediately, otherwise the appendix may rupture and the inflammation can spread to the abdomen and peritoneum, where it can lead to a life-threatening inflammation. Stress alone is very unlikely to be the cause of appendicitis, but it plays an important role in connection with other phenomena. Persistent stress suppresses the immune system and can disturb the intestinal flora. Therefore, a co-involvement or intensification of the irritation is quite possible.
Diagnostics
Often the pain resembles an irritation of the appendix, the symptoms of ovarian inflammation, cystitis or kidney stones. Therefore, abdominal pain must always be assessed by differential diagnosis in order to be able to make a clear diagnosis. There are many methods of examination that can be used to diagnose irritation of the appendix or inflammation.
During the examination, the doctor palpates certain pressure points that are typical for irritation/ inflammation of the appendix. One of these is, for example, the landmark, which lies on an imaginary line between the two anterior bony protrusions on the ilium. The lancet point is located where the middle and right third meet.
If pain can be resolved at this point by applying pressure, this examination is positive. Another point that can be examined for pain is the so-called McBurney point. It is located on a confessional line between the navel and the right frontal upper iliac crest, between the outer and middle third of the connecting line.
Furthermore, the doctor can check whether the patient suffers from rebound pain. In this case, pressure is applied to the painful area in the lower abdomen and then suddenly released. A positive pain of release is present when the pressure on the area relieves the pain and releasing it again leads to strong pain.
On the opposite side, too, the pain of release can be triggered for diagnosis. This is known as contralateral release pain – also known as blumberg’s sign. Another test is to ask the patient to jump on the right leg.
If the pain increases during movement, it is probably an appendicitis, a typical concussion pain. Whether an irritation or an inflammation is present is decided by ultrasound examination of the abdomen and taking a blood sample. An increased white blood cell count, an elevated CRP value (C-reactive protein) and an increased sedimentation rate indicate an inflammation.
In some cases, computer tomography can also help to make a diagnosis. In women, additional gynaecological examinations are carried out for clarification, for example to rule out an inflammation of the fallopian tubes. There are numerous tests to diagnose irritation of the appendix or appendix.
However, these tests are only specific with regard to determining the location of the “appendix”. This means that it is very easy to test that it is probably the appendix. However, it is very difficult to distinguish between irritation and inflammation.
A doctor should be consulted to specify this. There are, for example, the two pressure points in the right lower abdomen mentioned above which are often very painful (the so-called “McBurney point” and “Lanz point”). In another test, pain occurs when releasing an indented point in the left lower abdomen, because the pressure wave reaches the right and is painful there. Often patients also experience pain when pulling the right leg against a resistance. From time to time, a temperature difference can also be detected during an axillary and rectal temperature measurement.
