What Causes Appendicitis and How to Prevent It

Appendicitis is the inflammation and infection of the appendix, a small, pouch-like organ in the lower right abdomen. It occurs when something blocks the appendix, leading to increased pressure, reduced blood flow, and the growth of bacteria inside. This blockage results in inflammation, which may require immediate medical intervention. Appendicitis can either be acute or chronic. Acute appendicitis comes on suddenly, while chronic appendicitis involves long-term, recurring symptoms.

Acute appendicitis is a medical emergency that requires prompt treatment, as a ruptured appendix can spread infection throughout the abdomen. About 1 in 15 people in the U.S. will experience appendicitis in their lifetime.

Causes of Appendicitis

Appendicitis develops when the opening of the appendix becomes blocked. This blockage restricts blood flow to the organ, leading to inflammation and trapping bacteria inside. Several causes can lead to a blockage of the appendix, including constipation, swollen lymph nodes, and infections.

Hard Stool and Constipation

A hardened mass of stool, also called a fecalith, can block the opening of the appendix. When constipation causes stool to move slowly through the digestive tract, it can harden and become trapped, forming a fecalith. This leads to a blockage, causing inflammation and infection in the appendix.

Swollen Lymph Nodes

Infections in the body can cause lymph nodes in the abdomen to swell as they fight the infection. These swollen lymph nodes can press on the appendix, blocking its opening and causing inflammation.

Bacterial, Viral, or Parasitic Infection

Infections in the digestive tract or other abdominal organs can spread to the appendix, causing it to become inflamed. In some cases, parasitic infections can block the appendix and increase the risk of rupture.

Growths or Tumors

Benign growths, such as polyps, and malignant tumors in the appendix, large intestine, or ileocecum can cause irritation or blockage, leading to appendicitis.

Inflammatory Bowel Disease

Conditions like Crohn’s disease and ulcerative colitis cause chronic inflammation in the gastrointestinal tract, which can affect the appendix. This inflammation may lead to blockages, increasing the risk of appendicitis.

Trauma or Injury

Trauma to the abdomen can lead to appendicitis in rare cases. Accidents, sports injuries, or other physical traumas can cause stool to become impacted in the appendix or cause inflammation, blocking the appendix opening.

Foreign Bodies

Occasionally, foreign bodies such as fruit seeds or non-food items can block the appendix, leading to appendicitis. While most foreign objects pass through the digestive system without issue, they can occasionally enter the appendix and cause inflammation.

Chronic Appendicitis Causes

The causes of chronic appendicitis are less understood. The leading theory suggests that it results from partial obstruction of the appendix. This allows some stool and bacteria to pass through, causing intermittent inflammation. Some individuals with a history of mild acute appendicitis treated with antibiotics may develop chronic appendicitis.

Is Appendicitis Hereditary?

Appendicitis is not directly inherited, but studies suggest that genetics may play a role. People with a family history of appendicitis are at higher risk. Research has identified gene variants linked to an increased risk of appendicitis, including:

• NEDD4L: This gene produces a protein that helps cells communicate and break down proteins. Variants of NEDD4L may make the appendix more prone to inflammation.

• IL-6: This gene is involved in inflammation. Variants of IL-6 may increase the risk of appendicitis and worsen symptoms.

• IL-17: This gene plays a role in the immune response, and variations are associated with a higher risk of appendicitis.

• HLX: This gene is involved in the development and maintenance of the appendix. Variants may increase the risk of appendicitis.

• CTSB: This gene is linked to cell death and protein breakdown. Variants of CTSB increase the risk of appendicitis and may cause more severe symptoms.

Having a first-degree relative with appendicitis increases your risk by about three times.

Who Gets Appendicitis?

While anyone can develop appendicitis, some people are more likely to experience it. Factors associated with an increased risk include:

• Age: Appendicitis is most common in individuals aged 10 to 30.

• Sex: Men are slightly more likely to develop appendicitis than women.

• Ethnicity: Appendicitis rates are higher in Hispanics compared to other ethnic groups.

• Colorectal Cancer History: People with a history of colorectal cancer may have a higher chance of developing appendicitis.

• Childhood Antibiotics: Children who received antibiotics in the first six months of life are at higher risk later in life.

Risk Factors for Appendicitis

Some factors increase the likelihood of developing appendicitis, although not everyone with these risk factors will develop the condition.

Geography

Some studies suggest that where you live and your socioeconomic status can affect your risk of appendicitis. Areas with lower median incomes tend to have higher rates of appendicitis. Additionally, people living in warmer climates may have a higher risk of developing appendicitis.

Diet

A diet low in fiber and high in processed foods is associated with an increased risk of appendicitis. Eating a high-fiber diet with plenty of fruits and vegetables may lower your risk.

Smoking

Smoking has been linked to an increased risk of appendicitis, particularly when the appendix ruptures. Smoking constricts blood vessels, which may affect the blood supply to the appendix.

Inflammatory Bowel Disease

People with inflammatory bowel disease (IBD), such as Crohn’s disease or ulcerative colitis, are more likely to develop appendicitis. IBD causes chronic inflammation in the gastrointestinal tract, which can affect the appendix.

A Quick Review

Appendicitis occurs when the appendix becomes inflamed due to a blockage. It is commonly caused by fecal matter, infections, or tumors. While anyone can develop appendicitis, it is most common in individuals between the ages of 10 and 30. Certain risk factors, such as age, diet, and family history, can increase the chances of developing appendicitis. Early recognition and treatment are essential to prevent complications like a ruptured appendix. If you experience symptoms, seek medical attention immediately.