Appendicitis
Appendicitis is the most common of all serious intestinal disorders. It
refers to an inflammation of the vermiform appendix. It presents itself in
acute and chronic forms and affects both the sexes equally. This disease now
accounts for about half the acute abdominal emergencies occurring between the
ages of 10 to 30 . It is more frequent in developed countries than
underdeveloped countries. The appendix is a small tube located at the end of
the caecum, the first part of the large intestine. It is called vermiform
appendix as it resembles a worm. It is usually eight to ten cm. long. Its
structure is made of the same tough fibrous outer covering as protects the
entire alimentary canal. There is a layer of muscular tissue under the outer
covering and further a layer of lymphoid tissue. The function of the appendix,
which is performed by this lymphoid tissue, is to neutralise the irritating
waste material generated in the body or the organic poisons introduced through
the skin or membranes.
Symptoms
Appendicitis usually begins with a sudden pain in the centre of the
abdomen, which gradually shifts to the lower right side. The pain may be
preceded by general discomfort in the abdomen, indigestion, diarrhoea or
constipation. The patient usually has a mild fever varying from 100
o to 102 o F. Nausea is common,
and the patient may vomit once or twice. The muscles of the right side of the
abdomen become tense and rigid. The patient draws some comfort by drawing up
the right leg. The pain increases on the right side on pressing the left side
of the abdomen. Coughing and sneezing makes the pain worse. If the
inflammation continues to increase, the appendix may rupture and discharge its
pus into the abdominal cavity. This may result in a serious state known as
peritonitis. The temperature rises and the patient becomes pale and cold. This
condition may call for urgent operation. In the chronic state of appendicitis,
the patient may suffer from recurrent pain in the right lower abdomen with
constipation, loss of appetite and mild nausea.
Causes
Appendicitis is caused by a toxic bowel condition. An excessive amount of
poisonous waste material is accumulated in the calcium. As a result, the
appendix is irritated and over-worked and becomes inflammed. It is an attempt
on the part of nature to localise and "burn up" the toxins. This condition is
brought about by wrong feeding habits and enervation of the system.
Inflammation of the bowel lining, due to the habitual use of apparent drugs,
is a potent predisposing factor in the development of appendicitis. Further
inflammation and infection comes from certain germs which are usually present
in the intestinal tract.
Treatment
The patient should be put to bed immediately at the first symptoms of
severe pain, vomiting and fever. Rest is of utmost importance in the treatment
of this disease. The patient should resort to fasting which is the only real
cure for appendicitis. Absolutely no food should be given. Nothing except
water should enter the system. Low enemias, containing about one pint (1/2
litre) of warm water should be administered everyday for the first three days
to cleanse the lower bowel. Hot compresses may be placed over the painful area
several times daily. Abdominal packs, made of a strip of wet sheet covered by
a dry flannel cloth bound tightly around the abdomen, should be applied
continuously until all acute symptoms subside. When the acute symptoms subside
by about the third day, the patient should be given a full enema containing
about 1 1/2 litre of warm water and this should be repeated daily until the
inflammation and pain have subsided.
The patient can be given fruit juices from the third day onwards. This
simple treatment sensibly applied will overcome an appendicitis attack. After
spending three days on fruit juices, the patient may adopt an all-fruit diet
for a further four or five days. During this period, he should have three
meals a day each meal of fresh juicy fruits. Thereafter, he should adopt a
well-balanced diet based on three food groups namely, (i) seed, nuts and
grains, (ii) vegetables and (iii) fruits. In case of chronic appendicitis, a
short fast should be followed by a full milk diet for two or three weeks. In
this regimen, a glass of milk should be taken every two hours from 8 a.m. to 8
p.m. on the first day, a glass every hour and a half the next day and a glass
every hour the third day. Then the quantity of milk should be gradually
increased so as to take a glass every half an hour, if such a quantity can be
tolerated comfortably.
After the full milk diet, the patient should gradually embark upon a well-
balanced diet, with emphasis on fresh fruits and green leafy vegetables.
Certain vegetable juices, especially carrot juice, in combination with the
juices of beets and cucumbers, have been found valuable in the treatment of
appendicitis. Regular use of tea made from fenugreek seeds has also proved
helpful in preventing the appendix from becoming a dumping ground for excess
mucous and intestinal waste. The patient of appendicitis should adopt all
measures to eradicate constipation., if it is habitual. Much relief can be
obtained by the application of hot fomentation and abdominal packs every
morning and night. An abdominal massage is also beneficial. Once the waste
matter in the calcium has moved into the colon and thence eliminated, the
irritation and inflammation in the appendix will subside and surgical removal
of the appendix will not be necessary. The surgical operation should be
resorted to only in rare cases, when the appendix has become abscessed.
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