Appendicitis (Appendicitis) is an inflammation of the appendix (Appendix vermiformis) and usually manifests itself in severe pain in the right lower abdomen, accompanied by symptoms such as nausea and vomiting.

Approximately 7% of the population will develop appendicitis in the course of their life, with a peak between the ages of 10 and 20. As the only causal one (causal) Therapy applies to the removal of the appendage as part of a so-called Appendectomy.

How can one imagine the appendix?

The appendix is ​​a worm-like protuberance of the appendix, usually 8-10 cm long, and in exceptional cases significantly longer (Caecum)which is the first part of the colon.
Contrary to previous assumptions, it is not a functionless holdover from evolution, but has important tasks in the defense against germs and pathogens, which is why it also often 'Intestinal tonsil' is called. The wall of the appendix consists largely of lymph follicles, in which cells of the immune system come together.

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Read more on this topic: Task of the appendix

The wall structure greatly restricts the elasticity, so that the pressure in the organ can rise quickly and inflammation processes are promoted. Furthermore, the inside diameter is (Lumens) of the appendix with approx. 1-2 mm much narrower than the rest of the intestinal components. A blockage of the narrow lumen is therefore not unlikely.

Overview of the causes of appendicitis

The causes of appendicitis are largely in the blueprint of the organ. Various factors can now trigger the inflammation, although the exact cause of the disease often remains unclear.
For example, manure stones can close the opening. Bacteria are now increasingly multiplying there and penetrating deep into the mucous membrane. Certain bacteria, e.g. Escheria coli or Campylobacter cause direct damage to the wall structure, causing painful sensations.

Read more on the topic: Symptoms of appendicitis

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The following causes can be present:

  • Feces
  • constipation
  • mechanical kinks
  • scar
  • indigestible food components (Cherry stones, melon seeds and grape seeds)
  • foreign body
  • Infections
  • stress
  • alcohol
  • Worms / parasites
  • Crohn's disease (inflammatory bowel disease)
  • Appendix tumors (rare, here a tumor blocks the opening)
  • Appendix diverticulosis (rare, see Diverticulitis)

The exact cause of the disease can often only be determined after a histological (histological) Examination of the removed appendix to be determined by a pathologist.

It is not uncommon for general as well as local infections of the intestine to lead to appendicitis. It is often diseases that are spread by viruses, such as Measles, Epstein-Barr virus, flu or scarlet fever. Sometimes children have appendicitis and tonsillitis (Tonsillitis) in a temporal context of 2-3 weeks. The defense cells in the wall of the appendix react to the infection and cause swelling.

Another cause is to be found in the blood supply to the organ. If there is an occlusion, a reduced blood flow can develop so that the appendix is ​​no longer adequately supplied with oxygen (so-called ischemia). Consequential damage occurs in the wall of the organ.

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also read: Duration of appendix irritation

Constipation as a cause of appendicitis

Constipation is one of the possible causes, or at least one of the contributing factors, that can lead to appendicitis.
When constipated, the stool is particularly hard and the passage through the colon slows down. As a result, stool can build up in the appendix and, for example, a fecal stone can close the appendix. As a result, there is an excessive increase in intestinal bacteria, which penetrate the wall of the appendix and trigger the inflammatory reaction there. Anyone suffering from constipation should therefore take measures early to treat it. In the first place are:

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  • the intake of sufficient fluids
  • lots of movement
  • a high fiber diet

Stool softeners can be taken if there is insufficient improvement. Laxatives should only be used in exceptional cases.

Also read: Home remedies for constipation

Mechanical causes

The appendix appendix is ​​a blind-ended appendix of the intestine with only a small opening. Inflammation of this organ often has a mechanical cause.
The appendix can either be bent or closed, for example, with a cherry stone or a fecal stone. As a result, intestinal bacteria can multiply excessively and invade the wall of the appendage of the appendix. There they cause an inflammatory reaction that leads to the typical symptoms of appendicitis. It is believed that mechanical causes are often responsible for appendicitis. However, the cause often remains unexplained.

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Can stress also be a cause?

Excessive stress has negative effects on the whole body and can be responsible for a variety of diseases.
Stress can reduce the function of the body's own defense system and thus, among other things, favor the development of inflammatory reactions. Therefore, stress can also be partly responsible for the development of appendicitis. However, this is not the only cause.

The inflammation of the appendix often has a mechanical cause, for example if the appendix kinks or is closed by a fecal stone. In most cases, however, the cause of appendicitis remains unclear.

Can alcohol also play a role?

Excessive alcohol consumption has a negative effect on most organ systems and can, among other things, lead to damage to the gastrointestinal tract.
An increased susceptibility to inflammation can also be favored by alcohol. However, appendicitis is usually not directly related to excessive alcohol consumption. People who consume little or no alcohol also often develop appendicitis.
Nevertheless, alcohol should only be consumed in moderation and not too often in order to avoid life-threatening organ damage.

Are there psychosomatic causes?

As "psychosomatic"Conditionally one describes complaints that have a psychological cause, but are perceived as physical complaints.
An actual damage or illness or impairment of the body cannot be proven. In principle, psychosomatic complaints can occur in any organ system and in any region of the body. Symptoms typical of appendicitis such as severe pain in the right lower abdomen can also have psychosomatic causes. However, the appendix is ​​not actually inflamed.

In the event of such complaints, one will often decide to have the appendix removed surgically anyway, since only such an operation can ultimately determine whether the appendix is ​​really inflamed or not. If the symptoms persist, another cause of the symptoms is more likely. A psychosomatic illness is therefore not a cause of appendicitis, but can itself be responsible for the symptoms if a physical cause can be ruled out.

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More on this: Psychosomatics

Worms or parasites cause appendicitis

Contaminated water or food can absorb parasites or worms into the gastrointestinal tract, which can cause various ailments. If such a parasite settles in the area of ​​the appendix, it can trigger an inflammatory reaction there and thus be responsible for appendicitis.
In Germany, due to the high quality of drinking water, such infections are less common, but cannot be ruled out. Parasite-induced appendicitis can also occur, especially after traveling to less developed regions. As with all forms of appendicitis, surgical therapy is the method of choice. If a parasite is detected, drug therapy may also be required.

Also read:

  • Parasites in the intestines
  • Worms in the intestines

What can be the causes of chronic appendicitis?

As a rule, appendicitis is an acute clinical picture that occurs and is treated within a few hours to days. However, there are also processes in which complaints such as pain in the right lower abdomen repeatedly occur, which are sometimes more pronounced and sometimes less pronounced. The cause can be chronic inflammation of the appendix.

However, such a course occurs at most in one in a hundred people who suffer from appendicitis. Many doctors are also of the opinion that chronic appendicitis does not exist as a clinical picture and that the symptoms in such cases must be attributed to another cause. On the other hand, it is assumed that an occlusion of the appendix, which occurs only temporarily but more frequently, can lead to chronic appendicitis.

You may also be interested in this topic: Duration of appendicitis

Illustrations appendix

Figure appendix with appendix
  1. Appendix - Caecum
    (Light blue border)
  2. Opening the Bauhin flap -
    Ostium ileal
  3. Mouth of the appendix -
    Ostium appendicis vermiformis
  4. Free tape strip -
    Taenia libera
  5. Appendix -
    (Light green border)
    Appendix vermiformis
  6. End part of the ileum -
    Ileum, pars terminalis
  7. Ileum-appendix valve
    (Bauhin flap) -
    Ileal papilla
  8. Transverse folds of the colon -
    Plicae semilunares coli
  9. Colon, ascending part -
    Ascending colon

You can find an overview of all Dr-Gumpert images at: medical illustrations

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