Appendicitis and preventive care

There are still 15,000 to 20,000 deaths a year in this country from appendicitis and its complications. Naturally, it is of the utmost importance to reduce the possibility that an inflamed appendix will rupture. There- fore, if symptoms are equivocal after 8 to 12 hours of observation, the physician will be inclined to operate rather than risk rupture. 

The patient's role in preventing rupture is important. Delay in diagnosis or improper treatment greatly increases the risk. The guidelines are simple:

1. Do not treat any abdominal pain lasting for 3 to 4 hours with cathartics, enemas or local heat. Laxatives and enemas increase contractions in the large intestine and cause pressure to develop in the appendix, increasing the chance of rupture. With each dose of laxative, the risk of rupture and death increases greatly. Local heat may obscure symptoms and may also hasten rupture.

2. Consult a physician as soon as possible.

3. Do not eat or drink anything. Recurrent attacks of acute appendicitis are uncommon but can occur. Chronic appendicitis-that is, appendicitis causing pain for weeks or months-does not occur; this type of pain is indicative of other medical or surgical problems.  

 It most frequently affects the joints of the fingers, wrists, knees, ankles, and toes, alone or in combination, although all joints may be involved. One hallmark of the disease is that usually both sides of the body are affected; that is, both hands and both ankles, for example, are involved at the same time.