By Drs. Sally Robinson and Keith Bly

The appendix is a small, finger-shaped structure attached to the large intestine on the lower right side of the abdomen. The appendix does not serve any purpose in the body.

The appendix can become infected when it is blocked by something, such as a piece of food that was being digested, or if a person has had an intestinal infection. This infection is known as appendicitis.

There is no way to prevent appendicitis, and the only way to treat it is to remove the organ surgically. If an infected appendix is not removed, a life-threatening situation occurs, because it may burst and spread its infection throughout the abdomen in as little as 48 hours.

Symptoms of appendicitis include:

· Sharp, intense pain around the belly button that spreads to the lower right side of the abdomen
· Fever
· Loss of appetite
· Nausea and vomiting
· Diarrhea (in small amounts, with mucus)
· Frequent urination or a strong urge to urinate
· Constipation
· Swollen or bloated abdomen (especially in infants)

Many of these symptoms are common signs of other childhood illnesses. Because appendicitis can be confused with stomach cramps or indigestion, it is important to contact your child's doctor if these symptoms are present.

The pain associated with appendicitis usually begins around the belly button area and may move downward to the right. In appendicitis, pain begins before nausea and vomiting, which is a sign that the child does not have an intestinal infection. The pain may be so intense that it can keep a child up at night. A child with appendicitis may not want to move around because it feels better when he or she lies down and curls up.

For children under 2 years of age, the most common signs of appendicitis are vomiting and a bloated or swollen abdomen. A child this young may also have abdominal pain, but they are too young to tell adults.

Appendicitis is an emergency and cannot be treated at home. The infection is usually diagnosed with a blood test, through which a doctor assesses the number of white blood cells present in the body. A high number of white blood cells means that there could be an infection. The doctor may also order other tests, such as an X-ray, ultrasound or CT scan. These allow the doctor to see an image of the appendix.

If the doctor decides that a child has appendicitis, the appendix will need to be removed surgically. Surgical removal of the appendix is called an appendectomy. A patient undergoing an appendectomy will receive anesthesia to fall into a deep sleep so that the procedure is painless. The surgeon makes a small cut in the abdomen and removes the appendix. The surgery leaves a small scar.

After an appendectomy, the patient will stay in the hospital for a few days. A child normally needs about one to three weeks to recover completely after the surgery before returning to school.
Dr. Sally Robinson is a pediatrician in the division of children's special services at the University of Texas Medical Branch at Galveston. She teaches medical students about caring for children with chronic medical conditions. Dr. Keith Bly is a hospitalist and assistant professor of pediatrics at UTMB.

The Your Health column is written by health and medical experts at the University of Texas Medical Branch at Galveston. The column focuses on topical health issues that we believe are of interest to your readers. It is e-mailed every Tuesday. If you have any questions about the column, or would like to suggest topics, please contact John Koloen, media relations specialist, at (409) 772-8790 or email