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Questions for Dr. Kennedy
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Posted by: tonyna
Date: August 22, 2000 5:41 PM

What causes appendicitis, especially in a nine year old child? Is it uncommon for a child? Does diet and exercise contribute to this?

RE: appendicitis
Posted by: Ron Kennedy, MD
Date: August 23, 2000 5:15 AM

The incidence of appendicitis gradually rises from birth, peaks in the late teen years, and gradually declines in the geriatric years. Although rare, cases of neonatal and even prenatal appendicitis have been reported. Appendicitis is an inflammatory process. The appendix is a worm-like extension of the caecum which is the beginning section of the colon. It contains lymphoid tissue and is part of the immune system. Its job is, apparently, to sample what is passing through the intestinal tract to see if an immune response is needed. It becomes inflamed when the material it samples reaches a certain level of toxicity. That level would have to be such as to created a break in the basement membrane which underlies the cells facing the lumen of the appendix. This allows the escape of bacteria into the wall of the appendix. Appendicitis is the inflammatory response to those toxin producing bacteria. Infection of the gut wall occurs at other levels of the intestine, but the problem with the appendix is that it is so small that when it swells it chokes off its own blood supply and thus the path through which the body can send help is eliminated. If the appendix then dies and as a result it can burst and cause infection throughout the abdomen. This is called peritonitis and can be fatal. That is why appendicitis, at a certain stage, should be dealt with surgically. (Exercise would be irrelevant in the causation of appendicitis - lucky for me.)

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