Separating Tummy Aches from Appendicitis

By Eliana Osborn | December 21st, 2011 at 10:00 am

If your kids are anything like mine, they are very open to the power of suggestion. “Does your head hurt?” I ask and immediately get a yes. “Your toe? Your back?” Let’s just say that the toddler set isn’t known for being reliable.

So how can you know if your kid is having a stomachache or a legitimate appendix problem? First, know what the problem is. An appendix infection happens when the small, finger-sized organ attached to the large intestine gets blocked and swells. If the infected organ isn’t removed, it might rupture, leading to risks including further infection, female infertility, and even death.

No parent wants to take for granted a situation that could be lethal, but short of rushing to the ER for every case of flatulence, assessing the problem on your own can be tricky. How’s a parent supposed to know if their kid has the stomach flu or an appendix about to rupture? Dr. John Maa, Assistant Professor in the Department of Surgery at University of California San Francisco, weighs in.

“The classic symptoms of appendicitis begin with vague pain around the belly button,” reports Dr. Maa. Then comes nausea, then pain moving to the lower right section of the abdomen, then fever. All of this happens over time as the appendix gets more inflamed.

Easy enough to follow, right? The problem is, only about 20% of patients follow this pattern, which doesn’t even take into account kids who are hard to pinpoint about pain. In fact, it is often so hard to tell what is going on with young children that they often aren’t seen by a doctor until the appendix has already ruptured or perforated.

What should you look for if you are worried? These are some basic signs:

• Swollen abdomen

• Tender abdomen muscles, especially in that lower right section but it may start elsewhere

• Pain if the lower right section is touched

• A child sitting perfectly still, trying not to move to keep the pain from getting worse

“Be concerned for a child who doesn’t appear their normal self and complains of abdominal pain persisting over the course of several hours,” says Dr. Maa.

Other signs to look for:

• Loss of appetite

• Nausea and vomiting

• Fever

• Diarrhea

• Frequent urination

So what should you do if you think your child might have an inflamed appendix? Call your doctor, arrange to take your child in, and stay away from pain medication as well as food or drink until your doctor says it’s okay. An appendix can often rupture within 24-72 hours of the initial inflammation, so dealing with it quickly is essential.

Should your doctor recommend an appendectomy, remember: This is one of those surgeries that has really improved with technology. Today’s appendectomies are performed laproscopically, meaning the only incisions made are tiny ones, and your child’s recovery time should be about 2-3 days in the hospital. While no one ever wants to see their child suffer discomfort, this is one of those situations in which the treatment is minimally invasive and the outcome is, more often than not, very good.

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