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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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