What Causes Appendicitis?
Aug 02, 2022
Source: Cainiu Health
Dr. Zhao Haiming
Introduction
In most patients, appendicitis primarily results from obstruction of the appendiceal orifice by substances such as food residue or fecaliths—sometimes even leading to impaction—which impedes blood flow and lymphatic drainage in the appendix. This causes venous congestion, edema, and swelling of the appendiceal wall, resulting in a sterile inflammatory response. Subsequently, intestinal bacteria may ascend retrograde, leading to secondary bacterial infection and conversion of the inflammation into an infectious process.
The appendix occupies an awkward position within the human body—awkward because it is a part of everyone’s anatomy yet serves no known physiological function. Shaped similarly to an earthworm, the appendix varies in length among individuals: some are as short as 2 cm, while others may exceed 20 cm. So, what causes appendicitis?
What Causes Appendicitis?
In most patients, appendicitis arises primarily from obstruction of the appendiceal lumen by fecaliths (hardened fecal debris) or other materials such as undigested food residue. This blockage may even lead to impaction, impairing blood flow and lymphatic drainage in the appendix. Consequently, venous return becomes compromised, resulting in swelling of the appendiceal wall, tissue congestion, and edema—initially manifesting as a sterile inflammatory response. Subsequently, intestinal bacteria may ascend retrograde into the obstructed appendix, converting the sterile inflammation into an infectious one. If left uncontrolled, the inflammation may progress further, leading to necrosis of appendiceal tissue—resulting in gangrenous appendicitis—and potentially even perforation of the appendix.
The inflammation may spread to surrounding tissues, causing either localized or diffuse peritonitis; in severe cases, septic shock may develop. Prior to onset, some patients may have a history of factors that compromise immune defenses—such as upper respiratory infections (e.g., colds), excessive alcohol consumption, use of immunosuppressive medications, or poor food hygiene (e.g., ingestion of contaminated food).
If symptoms arise, patients should seek immediate medical attention at a hospital. We hope this explanation has been helpful.
