Appendicitis in Children
The appendix is a finger-shaped tube in the body that is attached to the large intestine. Appendicitis is inflammation of the appendix. If appendicitis is not treated, it can cause the appendix to tear (rupture).
A ruptured appendix can lead to a life-threatening infection. It can also cause a painful collection of pus (abscess) to form in the appendix.
What are the causes?
This condition may be caused by a blockage in the appendix that leads to infection. The blockage may be due to:
- A ball of stool (fecal impaction).
- Enlarged lymph glands in the intestine. Lymph glands are part of the body’s disease-fighting (immune) system.
- Injury (trauma) to the abdomen.
In some cases, the cause may not be known.
What increases the risk?
This condition is more likely to develop in people who are 10–30 years old.
What are the signs or symptoms?
Symptoms of this condition include:
- Pain that starts around the belly button and moves toward the lower right abdomen. The pain may get more severe as time passes. It gets worse with coughing or sudden movements.
- Tenderness in the lower right abdomen.
- Nausea.
- Vomiting.
- Loss of appetite.
- Fever.
- Constipation.
- Diarrhea.
- Generally not feeling well (malaise).
How is this diagnosed?
This condition may be diagnosed with:
- A physical exam.
- Blood tests.
- Urine test.
To confirm the diagnosis, your child may have an ultrasound, MRI, or CT scan.
How is this treated?
This condition can sometimes be treated with medicines, but is usually treated with surgery to remove the appendix (appendectomy). There are two methods for doing an appendectomy:
- Open
appendectomy. For this method, the appendix is removed through a large
incision that is made in the lower right abdomen. This procedure may be
recommended if:
- Your child has major scarring from a previous surgery.
- Your child has a bleeding disorder.
- Your adolescent child is pregnant and is near term.
- Your child has a condition, such as an advanced infection or a ruptured appendix, that makes the laparoscopic procedure impossible.
- Laparoscopic appendectomy. For this method, the appendix is removed through small incisions. This procedure usually causes less pain and fewer problems than an open appendectomy. It also has a shorter recovery time.
If your child’s appendix has ruptured and an abscess has formed, a tube (drain) may be placed into the abscess to remove fluid, and antibiotic medicines may be given through an IV. The appendix may or may not need to be removed.
Follow these instructions at home:
If your child’s appendix is not going to be removed and you will be taking him or her home:
- Give over-the-counter and prescription medicines only as told by your child’s health care provider. Do not give your child aspirin because of the association with Reye syndrome.
- Give antibiotic medicine to your child, if prescribed, as told by his or her health care provider. Do notstop giving the antibiotic even if your child starts to feel better.
- Follow instructions from your child’s health care provider about eating and drinking restrictions.
- Have your child return to normal activities as told by his or her health care provider. Ask your child’s health care provider what activities are safe for your child.
- Watch your child’s condition for any changes.
- Keep all follow-up visits as told by your child’s health care provider. This is important.
Contact a health care provider if:
- Pain wakes up your child at night.
- Your child’s abdomen pain changes or gets worse.
- Your child had a fever before starting antibiotic medicines, and the fever returns.
Get help right away if:
- Your child who is younger than 3 months has a temperature of 100°F (38°C) or higher.
- Your child cannot stop vomiting.
- Your
child who is younger than 1 year shows signs of dehydration, such as:
- A sunken soft spot on his or her head.
- No wet diapers in 6 hours.
- Increased fussiness.
- No urine in 8 hours.
- Cracked lips.
- Dry mouth.
- Not making tears while crying.
- Sunken eyes.
- Sleepiness.
- Your
child who is 1 year or older shows signs of dehydration, such as:
- No urine in 8–12 hours.
- Cracked lips.
- Dry mouth.
- Not making tears while crying.
- Sunken eyes.
- Sleepiness.
- Weakness.
Summary
- Appendicitis is inflammation of the appendix, a finger-shaped tube in the body that is attached to the large intestine.
- Symptoms include pain and tenderness that start around your child’s belly button and move toward the lower right abdomen, nausea, vomiting, loss of appetite, fever, constipation, diarrhea, and generally not feeling well.
- To confirm the diagnosis, an ultrasound, MRI, or CT scan may be ordered for your child.
- This condition can sometimes be treated with medicines, but is usually treated with surgery to remove the appendix (appendectomy).
- If your child’s appendix is not going to be removed and you will be taking him or her home, follow instructions as told by your child’s health care provider about medicines, activities, and eating and drinking restrictions.
Appetite Slump, Pediatric
An appetite slump is a period of time in which a child’s desire for food decreases. During an appetite slump a child may:
- Eat very little at one meal and a lot at another.
- Eat less than he or she used to.
- Eat less than you think he or she should.
- Be very picky about what he or she eats.
It is normal for children to experience an appetite slump. Most of the time, it is not a problem.
What causes an appetite slump?
An appetite slump may be caused by:
- A change in growth. This is the most common cause. Growing slows down between the ages of 1 and 5 years. For this reason, children in this age group need fewer calories and their appetite decreases.
- A strong dislike of a food or a type of food. For example, a child might suddenly begin to dislike any food that has lumps or refuse to try any new food. This often happens in children who are 1–2 years old.
- Forcing a child to eat. Children who are forced to eat may avoid meals.
- Control issues. Children may refuse to eat as a way of getting attention or as a way of feeling more in control.
Tips for managing appetite slumps
Refusal To Eat
- Do notforce your child to eat a new food that he or she does not like.
- Do
notpush your child to eat if he or she is not hungry.
- Do notinsist that the child finish all of the food on the plate.
- Do notpromise dessert in exchange for finishing what is on the plate.
- Do notmake the child stay at the table to finish eating after the meal is over.
Mealtime
- Eat meals at the same time each day.
- Give your child time to calm down before a meal. Children may be too excited to eat if they go right from playtime to mealtime.
- When your child becomes able to feed himself or herself, always let him or her do so. Most children can feed themselves by the time they are 15 months old.
- Make mealtime only for eating and family. Keep toys and books away from the table, and keep the television off.
- Make
meals pleasant. Try to:
- Eat together as a family as much as possible.
- Avoid arguing or scolding during mealtime.
- Avoid talking about your child’s eating habits.
General Tips
- Let your child choose foods. Doing that often makes children less picky.
- Set a good example by eating many different types of foods.
- Include new foods along with old favorites.
- Limit milk to less than 2–3 cups each day, and limit juice to less than 1 cup per day.
- Offer your child 1–2 small, nutritious snacks each day.
When should I seek medical care?
Seek medical care if your child:
- Does not seem to have enough energy.
- Is losing weight or has not gained weight in 6 months.
- Shows signs of eating problems, such as gagging, choking, or vomiting.
- Has stomachaches, nausea, constipation, or diarrhea. These could be signs of a digestive problem.
