In most incidents, the initial symptoms of appendicitis such as stomach ache, fever and loss of appetite are usually confused with other ailments.

By Dr Suruchi Goyal

Shreya, an eight-year-old girl, began complaining about stomach ache one morning. As Shreya did not like online classes, Shreya’s mother thought her daughter was making excuses and ignored the complaint. When Shreya began crying due to intense pain, her mother thought it could be a case of indigestion and she resorted to home remedies to treat it. As the Covid cases were increasing during that time, her mother was hesitant to take the child to the hospital.  But the pain increased even more the next day and Shreya began vomiting and even developed a slight fever. Concerned about her daughter’s condition, she immediately fixed an online appointment with us.

During the online consultation, Shreya’s mother informed us about the stomach ache and vomiting. As kids mostly complain about these symptoms, we asked the mother to press Shreya’s abdomen at some points and observe the way she responds to it. After a careful inspection, when she pressed the lower abdomen of the child, Shreya began to experience severe pain and the doctor had a strong feeling that the pain was due to appendicitis. Upon our advice, the child was immediately brought to the hospital where we performed surgery on time and removed her appendix. It certainly was a brave act by Shreya’s mother to be attentive and it was because of her mindfulness that we were able to detect the problem on time and treat it successfully.

In most incidents, the initial symptoms of appendicitis such as stomach ache, fever and loss of appetite are usually confused with other ailments. Also, in most of the cases, parents may not take such complaints from their kids seriously, as this keeps happening frequently. Therefore, diagnosing appendicitis in children may become difficult.

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Appendicitis starts as a pain around the child’s belly-button and spreads to other parts of the abdomen especially the right lower area. This occurs when the inside of the appendix is blocked by something, leading to an infection. The blockage can happen due to stool, parasites or a twist in the appendix as well. The appendix then gets sore and inflamed. and bacteria in the appendix begin to increase quickly. As the soreness and swelling gets worse, the blood supply to the appendix is cut off.

Symptoms of appendicitis in children

Each child may experience different symptoms. Below are few common symptoms of appendicitis:

• Loss of appetite

• Fever

• Vomitting

• Nausea

• Elevated white blood cell count

• Difficulty in passing gas or stool

• Abdominal swelling

• Constipation or diarrhoea

Appendicitis can occur at any age although most commonly seen in children in the age group of eight to 16 years. In younger children, the symptoms may be a little nonspecific and it is important to maintain a high index of suspicion to make an early diagnosis.

If a kid experiences noticeable tummy pain when moving, coughing, sneezing, or touching the abdomen, it is important for the parents to immediately consult the doctor. For babies younger than two years of age, appendicitis can lead to vomiting, a bloated abdomen, and fever, though diarrhoea is not very uncommon.

Is appendicitis serious?

Appendicitis is a serious medical condition that needs to be assessed, investigated and managed appropriately to avoid complications such as a perforated appendix or collection of pus.

When should you consider stomach ache seriously among kids?

In case your kid experiences any of the following signs along with stomach ache, make sure to schedule an appointment with the doctor to understand the cause of pain your child is going through.

• Recurrent stomach pain with no clear cause

• Blood in stool

• Constipation that is becoming frequent

• Diarrhoea

• Pain when urinating

• Fever and cough

• Unexplained weight loss

• Pain that is waking your kid up from sleep or begins to affect their daily lives

Symptoms like these certainly need an urgent assessment. In case you think your kid has appendicitis, book an online consultation, see the doctor or go to the emergency room right away.

(The writer is Consultant, Paediatrics and Pediatric Endocrinology, Columbia Asia Hospital Whitefield-A unit of Manipal Hospitals)

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