Health Matters | From your community pharmacist
We have all experienced stomach pain at some point. It may be something we ate, trapped wind, constipation or a bout of indigestion. Most of the time, the discomfort settles and life goes on.
But what if the pain keeps getting worse, begins around the belly button and gradually moves towards the lower-right side of the abdomen? That is when we need to pay attention. One possible cause is appendicitis, a condition that can become dangerous if treatment is delayed.
In my experience as a community pharmacist, one of the most important parts of giving health advice is knowing when a problem should not be managed with an over-the-counter medicine. Appendicitis is a good example: recognising the warning signs and seeking medical help promptly can prevent serious complications.
What is appendicitis?
The appendix is a small, finger-shaped pouch attached to the large intestine, usually in the lower-right part of the abdomen. Appendicitis occurs when the appendix becomes inflamed, often following a blockage. The precise cause is not always clear.
If the inflammation is not treated, the appendix can rupture. This may allow infection to spread within the abdomen, causing peritonitis, an abscess or potentially life-threatening sepsis.
Appendicitis can occur at any age, although it is more common in children, teenagers and young adults. Older people can develop it too, sometimes with less obvious symptoms.
The pain often tells a story
One of the classic warning signs is pain that starts around the belly button. Over several hours, it may move towards the lower-right side of the abdomen and become increasingly persistent.
The pain may worsen when walking, coughing or moving. Some people also experience nausea, vomiting, loss of appetite, fever, constipation or diarrhoea.
However, not everyone develops the textbook symptoms. In young children, older adults and pregnant women, the pain may occur in a different location or develop more gradually.
This is why I would never advise someone to dismiss worsening abdominal pain simply because they do not have a fever or are not vomiting. There is no reliable home test that can rule out appendicitis.
Is it indigestion, constipation or appendicitis?
This can be difficult to judge because several conditions cause abdominal discomfort.
Indigestion commonly causes upper abdominal discomfort, bloating or a burning sensation after eating. Constipation may cause cramps and difficulty passing stools. Gastroenteritis often produces diarrhoea, vomiting and sometimes fever.
Appendicitis becomes more concerning when the pain steadily worsens, moves towards the lower-right abdomen or becomes more painful with movement. Nevertheless, symptoms can overlap, and other problems — including urinary infections, kidney stones and gynaecological conditions — can cause similar pain.
My advice is straightforward: do not spend hours trying different indigestion remedies when the pain is getting worse. A pharmacist can help you recognise when medical assessment is needed, but suspected appendicitis requires urgent hospital evaluation.
When should you seek help?
If you or a family member develops abdominal pain that is progressively worsening, does not go away or moves to the lower-right side, seek urgent medical assessment.
Go to an emergency department immediately if the pain is severe, rapidly worsening or spreads across the abdomen. A ruptured appendix can sometimes cause a brief reduction in pain before more widespread, severe pain develops. Do not mistake this temporary change for recovery.
Confusion, difficulty breathing, fainting or looking seriously unwell are additional emergency warning signs.
For readers in Malaysia, attend the nearest hospital emergency department if appendicitis is suspected. Do not delay assessment while trying traditional remedies or waiting for the pain to become unbearable.
How is appendicitis diagnosed?
A doctor will ask when the pain started, where it is located and how it has changed. They will examine the abdomen and may arrange blood tests, a urine test and imaging such as an ultrasound or CT scan.
There is no single test that identifies every case immediately. Sometimes the symptoms are unclear, so doctors may monitor the patient in hospital and repeat the examination.
This is one reason why a proper assessment matters: abdominal pain can have several causes, and treating the wrong condition at home may delay the care that is actually needed.
What is the treatment?
The usual treatment is an operation to remove the appendix, known as an appendicectomy or appendectomy. It is often performed using keyhole surgery, although open surgery may be necessary in some cases.
Antibiotics are also used when indicated. In selected patients with uncomplicated appendicitis, a hospital team may consider antibiotics without immediate surgery. This is not suitable for everyone, and the risk of treatment failure or recurrence needs to be discussed with the surgical team.
If the appendix has ruptured or an abscess has formed, treatment may be more complicated and can involve antibiotics, drainage or surgery.
Most people recover well with appropriate treatment, although recovery takes longer when complications occur.
References: NHS – Appendicitis treatment; Malaysia Ministry of Health – National Antimicrobial Guideline, gastrointestinal infections and appendicitis
What should you avoid doing?
If appendicitis is a possibility, do not try to treat the pain with laxatives or enemas, and do not repeatedly press on your abdomen to test whether it hurts.
Most importantly, do not delay seeking help while experimenting with painkillers, antacids or other remedies. Follow the emergency team’s advice about eating, drinking and taking medicines, as an operation may be required.
If you take regular medicines, bring a list or the packets with you to hospital. This is particularly useful if you take medicines that affect blood clotting.
A final word from your pharmacist
Not every stomach ache is appendicitis, and there is no need to panic over every episode of abdominal discomfort. What matters is recognising when the pattern is unusual.
Pain that becomes progressively worse, particularly when it moves towards the lower-right abdomen, should not be ignored. Appendicitis is treatable, but delaying assessment can allow complications to develop.
As pharmacists, we can help people understand symptoms and choose appropriate remedies for minor ailments. We also have a responsibility to recognise when a symptom falls outside the limits of self-care.
If you suspect appendicitis, do not wait for certainty at home. Seek urgent medical assessment.
Until next time, take care of your health — and remember that sometimes the most important advice is knowing when not to wait.
Health Matters (zaynp100@yahoo.com) is a content creator under the Newswav Creator programme, where you get to express yourself, be a citizen journalist, and at the same time monetize your content & reach millions of users on Newswav. Log in to creator.newswav.com and become a Newswav Creator now!
The User Content (as defined on Newswav Terms of Use) above including the views expressed and media (pictures, videos, citations etc) were submitted & posted by the author. Newswav is solely an aggregation platform that hosts the User Content. If you have any questions about the content, copyright or other issues of the work, please contact creator@newswav.com.
