b'AppendicitisChapter hapterThe appendix is a short tube attached to the lower end of the large intestine (caecum). It has been stated that as we have evolved and begun to eat less cellulose and more meat, this special organ is no longer needed for digestion of fibrous food. The appendix could therefore be described as a relic of evolution. Nature appears to have adapted it to act as a watchdog for infection at the lower end of the gut. Like the tonsils and adenoids, it contains numerous lymph glands for this purpose but if it becomes inflamed, appendicitis results and the organ may have to be removed.Inflammation occurs when the tube becomes blocked or ulcerated. The western diet has become so refined that it now lacks sufficient fibre, or roughage. This deficiency causes the food to slow down in the intestines. This sluggishness can lead to blockages, which may be a cause of appendicitis.Appendicitis is more common in children but can also occur frequently later in life.Conversely, the appendix does not seem essential to health. It can be removed at an early age and is often almost completely shrivelled up by the time you reach 40.How to RecogniseAbdominal pain and tenderness, often severe and radiating to the right groin.Nausea and sometimes vomiting.Loss of appetite and bad breath can develop.High temperature, diarrhoea or constipation.If the appendix ruptures (bursts), peritonitis can develop. Peritonitis is inflammation of the abdominal cavity lining due to a perforation of the intestine or leakage of its contents into the abdominal cavity. If you suspect appendicitis, arrange medical assistance or Ambulance 000.Management for appendicitis is the same as for abdominal pain(refer to page 232) .Vomiting and DiarrhoeaMost likely causes are food poisoning, upset stomach due to contaminated water, poor hygiene, overeating or allergy. Vomiting and diarrhoea does not always occur together but when both conditions develop, there is a high risk of dehydration. This can be a very serious threat particularly to children.How to ManageGive plenty of fluids, preferably high in sugar such as juices.Orange juice is a good source of potassium, which is a vital mineral that is depleted throughdiarrhoea.When the appetite returns, give only starch, bland or sugary food for the first 24 hours.Reassure and rest the patient.Arrange medical assistance if the condition persists or does not improve.Common Illness and Ailments 233'