Appendicolith

What is an appendicolith?

An appendicolith is a hard lump made when poop (feces) and minerals clump together. They form inside your appendix. Appendicoliths are usually less than 1 centimeter in diameter and typically don’t cause any symptoms. Your provider often discovers them accidentally during a CT scan (computed tomography scan) or an ultrasound.

By themselves, appendicoliths aren’t dangerous. But if an appendicolith blocks the opening of your appendix, it can cause severe inflammation, known as appendicitis.

Is an appendicolith an emergency?

Not usually. An appendicolith by itself isn’t an emergency. But if it leads to complications, like appendicitis, then it becomes an emergency.

Appendicitis can make your appendix swell and lead to severe stomach pain. Left untreated, a swollen appendix can burst. It can lead to peritonitis, abscesses and septic shock, which can be fatal.

What are the symptoms of appendicoliths?

If you have appendicoliths, you either have no symptoms at all or the symptoms of appendicitis, which include:

• Stomach pain.
• Nausea.
• Loss of appetite.
• Fever.

What causes appendicoliths?

Healthcare providers aren’t sure why appendicoliths develop. Some think they might form if you swallow hard particles that go through your intestines without being digested.

What are the risk factors for developing appendicoliths?

Risk factors for developing appendicoliths include:

• Being assigned male at birth.
• Eating low-fiber meals.
• Having a family history of appendicitis.
• Being 30 years old or younger.
• Having constipation issues.

How are appendicoliths diagnosed?

Usually, providers find appendicoliths during imaging scans done for other reasons. For example, your healthcare provider might order a CT scan or abdominal ultrasound after an accident to check for injuries inside your body.

Sometimes, providers find appendicoliths during imaging to diagnose appendicitis.

If your provider finds an appendicolith, but you're not showing signs of appendicitis, they’ll discuss if you need treatment.

Is there any lab work I need to check for an appendicolith?

Lab work can show signs of infection or inflammation often related to appendicoliths and appendicitis. These tests include:

• Complete blood count (CBC): This blood test shows healthcare providers a lot about your health. But in the case of appendicoliths, they look to see if you have an increased white blood cell count. This is a sign of infection.
• C-reactive protein (CRP): CRP is a marker of inflammation in your body. It’s usually elevated in cases of appendicitis.

Although lab work itself doesn’t diagnose appendicoliths, it helps your provider understand your overall health and develop a treatment plan.

How will my provider treat my appendicolith?

How your provider treats your appendicolith depends on the size of your appendicolith, how much pain it’s causing you and if it has led to appendicitis.

Some providers suggest having all appendicoliths removed regardless of their size because they increase your chances of getting appendicitis. And even though appendicitis has several causes, having an appendicolith can make it worse.

How will my provider treat my appendicolith if I don’t have appendicitis?

If you have an appendicolith but no appendicitis, treatment is generally watchful waiting. People often pass the appendicolith through their colon without any intervention.

What is the treatment if my appendicolith has led to appendicitis?

Your provider will usually treat appendicitis by removing your appendix (appendectomy) through either open surgery or laparoscopic surgery. The faster your surgeon performs the appendectomy, the better. A quick appendectomy will help you avoid serious infections that can lead to septic shock.

If your provider does remove your appendix, they’ll also give you antibiotics to prevent more infection.

What are the complications of treatment for appendicolith?

It’s important to talk to your provider about the specific risks based on your health condition and the type of treatment you have.

Antibiotics

Complications from taking high doses of antibiotics are common but usually not severe. These can include:

• Rash.
• Dizziness.
• Nausea.
• Diarrhea.
• Yeast infections.

Open surgery

Complications from open surgery can include:

• Pain.
• Anesthesia side effects like sore throat, nausea and vomiting or an allergic reaction.
• Bleeding.
• Sore throat.
• Infection.
• Wound re-opening.
• Scarring.
• Fever.

Laparoscopic surgery

There tend to be fewer complications with laparoscopic surgery than with open surgery, and the recovery time is usually quicker. But there’s a risk of complications with any surgery. The risks of laparoscopic surgery include:

• Injuries from surgical instruments.
• Gas getting trapped in your stomach. (During laparoscopic surgery, your surgeon will pump gas into your belly to make room for the instruments they use during the procedure.)
• Anesthesia side effects.
• Bleeding.
• Infection.

How long does it take to recover from treatment?

Length of recovery depends on your overall health, the severity of your illness and the type of treatment you had for appendicolith. If your provider removes your appendicolith laparoscopically, it takes about one to three weeks to recover. If you have open surgery, it may take up to six weeks.

How can I lower my risk of appendicolith?

You can’t really prevent appendicoliths or appendicitis. But you can take steps to keep your bowels healthy, which may lower your risk of developing these conditions. Keep things moving by:

• Eating more high-fiber foods.
• Making sure you drink enough water.

What can I expect if I have an appendicolith?

Having an appendicolith isn’t necessarily dangerous, but it does put you at a higher risk of developing appendicitis. Removing the appendicolith greatly reduces that risk.

If you develop appendicitis, you’ll likely require surgery to remove your appendix. But you can expect to make a full recovery.

When should I go to the ER?

If you have intense stomach pain, especially coming from the area around your belly button and spreading down the right side of your stomach, call your healthcare provider immediately. Additional signs of appendicitis alerting you to seek emergency care include:

• Vomiting.
• Nausea.
• Fever.

What questions should I ask my doctor?

Some questions you should ask your provider if you have an appendicolith include:

• What are the chances that my appendicolith will cause appendicitis?
• What symptoms should I watch out for that mean I have a problem?
• Do I need more tests or watching because of my appendicolith?
• What kind of treatments can I get if my appendicolith starts causing problems?
• Are there any changes or other things I can do to lower my chance of complications?
• How often should I see you or get medical attention for this condition?
• What should I do if I have sudden pain or other symptoms?

Can you have appendicolith without appendicitis?

Yes, you can have an appendicolith without having appendicitis. Some people have them and don’t even know because they don’t feel sick.

What is the general size of an appendicolith?

Think of appendicoliths like pebbles. Some are as tiny as a grain of sand, while others are as big as a pea or marble. Smaller ones might not cause any problems and might sit there without you noticing. But bigger ones can block your appendix, which can lead to serious issues like appendicitis.

How common are appendicoliths?

Appendicoliths are very common and occur in 3% of the general population. Usually, they don’t cause any symptoms (asymptomatic).

How do I know if my appendicoliths will lead to appendicitis?

The answer to that question depends on several factors, including your:

• Symptoms: Are you having any pain in your navel and then moving to your lower right side, nausea, vomiting and symptoms of appendicitis? If so, you probably have appendicitis and need to see a provider right away.
• Imaging tests: Your provider needs to measure the size of your appendicolith to see if there are signs of infection. If they’re more than 10 millimeters large, there’s a bigger chance they’ll cause a blockage and cause appendicitis.
• Medical history: If you or your family members have had stomach problems or appendicitis before, the risk of your appendicoliths leading to appendicitis increases. 

If you know you have an appendicolith, your healthcare provider might want to see you regularly to keep an eye on it. They’ll help you decide what to do next based on your overall health and the size and location of the appendicolith.

Should my provider remove my appendicolith?

Your provider will decide whether to remove your appendicolith based on levels of inflammation and whether you have symptoms of appendicitis. They’ll discuss the best treatment for you.