TUMMY TROUBLES: APPENDICITIS

Q. I suppose appendicitis is one of the most common causes for emergency surgery.

A. True, and most people are unaware that about 60 Australians die each year from this disorder, mostly from a delay in seeking medical attention. This should never happen.

Q. What are the symptoms?

A. Appendicitis commonly commences with pain around the epigastrium and navel. From 2-12 hours later, it slowly extends to the right lower side of the abdomen, the so-called iliac fossa. There may be some vomiting, increase in pain, mild fever and constipation, although often symptoms are minimum. The pain may be worse with coughing, walking or running.

Q. What treatment is advised?

A. Any symptom that could indicate appendicitis should receive prompt medical attention. Deep tenderness in the R.I.F. region is usually felt on firm pressure at the doctor’s examination. Sometimes tests are ordered, for urinary infections can often mimic a diseased appendix.

However, if there is any doubt, surgical removal is advised and this is often carried out promptly. An acute appendix may burst, causing serious symptoms. Uncomplicated cases recover well, the patient being up the next day and home a few days later. A light diet for a few days, reduced activity for a couple of weeks and the patient soon returns to normal.

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TREATMENT OF ULCERS: BISMUTH PREPARATIONS

Q. What other forms of medication are used?

A. The Histamine ft-receptor antagonists are currently the most widely used drugs for peptic ulcers. Nevertheless, a form of medication called tri-potassium di-citrato bismuthate (colloidal bismuth) is also claimed to produce very good results. It is said to be about as effective as cimetidine, but until recently the only form available was an unpleasant tasting liquid which had a strong ammoniacal odour. It is now available as a chewable tablet and this has improved patient compliance. There is little doubt that if a person does not like his medication, , he often will not take it. He will invariably lie to the doctor and say he is taking the prescribed medication!

Q. Does it have adverse side effects?

A. Every medication has some side effects in someone as we have already pointed out. However, like cimetidine, these are small and fairly unimportant, at least in the known short term. It may stain porcelain teeth fillings, colour the tongue and cause the stools to turn a strange dark grey. It is taken well before meals. Its effect is negated by the presence in the stomach of food, milk or antacids, so it is essential these are not taken at the same time, or indeed probably within an hour or two either way.

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