Lying As I lay down in bed at night, I experienced a sudden and intense pain on my stomach. The sensation was strange. It did not feel like food poisoning.

I felt a dull pain just above my navel. It was below my rib cage. I attempted to return to sleep by taking some paracetamol.

Last Friday, it was Friday morning and I had to finish work in time for the Ten O’Clock News. Because I would not finish work before 10.45pm, it was not ideal that my night be interrupted.

The pain was worsening and I couldn’t eat breakfast nor go for the planned swim. 

I rang the GP surgery where I have been a patient for about three years — although I have never met any of the doctors there, as, since Covid, all I’ve ever been offered is a phone consultation.

BBC newsreader Reeta Chakrabarti (pictured) has shared her experience with appendicitis, when she ended up hospitalised in Italy

Reeta, a BBC Newsreader (pictured), has written about her experiences with appendicitis. She was eventually admitted to hospital in Italy.

The locum physician called back very quickly. I told him where it was located and how intense it felt. When he asked whether there were any discomforts on one side or the other of my abdomen, I answered that there wasn’t. It was in the center.

The doctor thought the problem was gastritis.

It seemed that there was no way I could resist seeing him face-to-face. He suggested I do as he advised, but my pain didn’t let up and I was forced by him to cancel my shift.

The pain returned 24 hours later and it became quite severe. No difference had been made by the medication. 

I was in bed and unable to eat. I got in touch with NHS 111, who agreed that it was troubling, and they gave me an appointment at the A&E department of a local hospital.

As everyone else I waited for my turn, and waited for over three hours. A fellow patient saw that I was in a lot of pain, and volunteered to bring me some cold drinks, just like that — a good and kind man.

The newsreader (pictured) had a telephone appointment and was given a Gaviscon-type medicine for stomach pain, but was not given the option to see her GP in person due to Covid

Pictured: Newsreader. The telephone visit was for stomach pain. Gaviscon was administered to her, however she was not allowed to go to the doctor in person.

The doctor performed blood and urine tests, then I was finally examined. She told me the diagnosis of my GP. 

My inflammation markers were elevated, she said, as well as the number of white blood cells in my body (which fight infections) which was high.

After feeling my stomach, she stated that she could not feel any lumps. She agreed with the GP and said it was probably gastritis. 

No other tests were offered. There was no ultrasound. It’s not that I ever thought of asking that question back then. Gaviscon gave me more assurance and I headed home.

I felt worse over the following days. I was unable to return to work for the second shift and pulled out on the third day. As if I had the flu, I felt exhausted and wiped out.

My stomach pain became an unbearable, constant, and persistent discomfort. I also felt a terrible taste in my mouth.

The pharmacist at my local pharmacy advised me that it might be gastritis. I was prescribed proton pump inhibitor pills, which reduce stomach acid. I started using them.

While I thought I felt better, I started to believe I was hypochondriac.

The end of the week saw me present a BBC1 program about the Queen’s Baton Relay. It marked the start to preparations next year for the Commonwealth Games.

Next day, I took the Six O’Clock News and Ten O’Clock News. To keep my pain in check, I took lots of paracetamol and the pharmacy’s pills. The pain persisted and I was constantly afflicted.

The weekend I flew from Rome to meet with the charity of which I am a trustee. Paul, my husband and I took a little break.

Two days of walking slowly around this beautiful city. It hurt my stomach too badly.

Now, I started feeling nauseated and my taste buds were getting worse. My husband kept telling me that I wasn’t feeling well. However, neither one of us considered the possibility of gastritis.

I avoided any acidic food and drank very few alcohol.

After flying to Rome, the pain in her abdomen intensified and she passed out in a taxi before being rushed to hospital, where she was told she had appendicitis

After flying to Rome, the pain in her abdomen intensified and she passed out in a taxi before being rushed to hospital, where she was told she had appendicitis

Ten days later, the first signs of pain were still there. We took a taxi to get to our charity meeting. 

As we approached the gate of the building, the pain in my stomach had intensified. I knew I was going to faint. After muttering something about the pain to my husband, all of it went completely blank.

Next thing I noticed was his hand on my neck and the sound of his voice calling from faraway. After calling an ambulance, the taxi driver brought me in and was now in terrible pain.

Signs to be concerned 

While the exact role of an appendix’s function is not known, many believe it to be a repository for beneficial bacteria.

Symptoms of appendicitis are similar to those of many other conditions — but if you have abdominal pain that gradually gets worse over a period of hours or days, the NHS advises that you contact a GP or out-of-hours service immediately to get medical help.

These signs could indicate that you may have appendicitis.

  • A pain around the stomach button in the middle that causes discomfort and then moves to the right-hand side. This can often last for 24 to 48 hours.
  • This area can be aggravated by coughing, moving, laughing, or sneezing.
  • Feeling unwell.
  • A loss of appetite
  • A sickness or nausea.
  • Diarrhoea and constipation.
  • Fleezing and fever.
  • Colic pain that changes and comes.

Paramedic laid me down on her stomach and gently massaged my stomach. She reached the right side of my stomach and I gasped.

“Ah,” she replied, “appendice.” “I don’t hope so,” she continued, “but possibly.”

As the driver drove through the city and the car bounced on old cobbled streets, the vehicle sped along, and the vehicle screamed at me.

There followed another three-hour wait on my own in A&E — my husband couldn’t be with me, just like at home, because of Covid restrictions. I was left in an unoccupied waiting room on a bed with no water and painkillers.

At least, I was still horizontal. But now I was disoriented and feeling a lot of discomfort. 

It could have been appendicitis. But why did it become so severe? Is it possible that the burst occurred? I realized that it was a sign of my imminent death. 

I don’t know why no one came to my aid. It was hard to learn Italian, and I only have 30 words. Most of my Italian is restaurant-speak.

We kept messaging each other in an effort to keep our spirits up, but as we waited for the right time, I was haunted by dark thoughts, wondering if my husband had forgotten me.

This was not the case. After a few blood tests I was taken to the hospital for an ultrasound and CT scan. Then, the next morning, an X-ray.

The appendicitis was severe. It was apparent that my appendix had become very inflamed. I also received an infection diagnosis.

Next day, I was able to have my appendix removed. I then spent 8 days in hospital receiving powerful intravenously administered antibiotics.

The doctors and nurses at the hospital provided excellent care and helped me grow from 30 to 40 words. 

But along with the relief at being treated, and knowing that I was going to recover, came one big question — why was this not picked up before? Without knowing, I would have never dreamed of travelling abroad.

The surgeon that operated on my body was very kind and helpful. I was told appendicitis can be difficult to diagnose. He also said that it is not common for them to operate on patients only to discover their appendixes are perfectly healthy. 

However, he said, my condition was now much more severe because it had been delayed ten days.

You can be wise following an incident. Appendicitis is a condition that begins with pain in your stomach. This is the same as what I reported to my two London doctors.

How would that have affected my decision if the first GP examined me? That’s all I know.

The A&E doctor did examine me, but perhaps she had in her head the diagnosis of the GP. Although I wasn’t in agony, like I was in Rome, my condition had significantly deteriorated by that time. She did not give me any advice on how to respond to future or ongoing symptoms.

They both probably missed it. I won’t know. The Italian doctor explained that it is difficult to diagnose. However, I suffered severe anxiety and pain as a result.

I’ve written the surgeon and hospital trust. They are looking into the matter and have both apologised. I am grateful.

I’m old enough that I have experienced positive encounters with NHS before.

A serious health problem was identified in my body three years ago. I received prompt, expert care. Although some pregnancies were difficult, my three children are healthy and happy.

Und ich komme aus a medical background. My dad was a surgeon and worked for the NHS over many decades. Both my brother and stepson are doctors. Trust in NHS medics is a part of my DNA. I have a deep loyalty to it.

Do my past experiences show that the system is suffering, as some of my colleagues in health reporting continue to say? Was I just unlucky?

My editor pointed out very cleverly to me that each case is the one being judged by NHS. Although it might do 95 percent of the work correctly, that does not compensate the 5% who were wrongly served.

My recovery is going well. I will be able to regain my faith in the system. However, it is taking a knock at the moment.

HERE’S WHY KEEPING YOUR APPENDIX MAY BE VITAL 

Rachel Ellis is the Daily Mail’s Editor 

Appendicitis is notoriously difficult to diagnose — particularly if a patient is unable to see a doctor face-to-face — which may help explain why surgery to remove the appendix is the most common emergency operation in the UK, with 50,000 procedures carried out in England alone every year.

But now, there is evidence to suggest that antibiotics in some cases may be a better option — helping to retain an organ thought to play a role in our immunity.

The appendix is a finger-like pouch that hangs off the large intestine, around 3½ in (8.8 cm) long. Appendicitis is a condition that causes inflammation in the appendix.

DON’T WAIT TO GET THE RIGHT DIAGNOSIS

Appendicitis is a condition that affects approximately 7 per cent. Your age, constipation, and sexual activity are all risk factors. However, it is more common in women than in men.

It is unclear what exactly causes these risk factors. However, it is known that with age the appendix opening tends to shrink, decreasing the likelihood of infection.

The problem with diagnosing it is that the symptoms (see box, bottom left) are also associated with a wide range of other conditions, such as an upset tummy, irritable bowel, urinary tract infection, pregnancy and some cancers — and not everyone with appendicitis experiences the same symptoms.

So it can take more than one visit to the GP or A&E to get an accurate diagnosis, says Barry Paraskeva, a consultant surgeon at Imperial College Healthcare NHS Trust in London.

‘There are lots of things that mimic appendicitis, and most people who go to A&E with tummy ache will not have a diagnosis when they leave,’ he says.

He says remote consultations are even more challenging to diagnose patients.

‘There are tell-tale signs an experienced doctor will pick up when they see a patient face-to-face with appendicitis — a certain odour to their breath, flush of the cheeks and how they move and hold their bodies,’ says Mr Paraskeva. You can’t see that via video, or by phone.

Prof. Jeremy Sanderson is a consultant gastroenterologist at Guy’s & St Thomas’ Hospitals NHS Foundation Trust, London. He says: ‘If they’re young and tender on the lower right side, it’s relatively simple to diagnose appendicitis. 

It is more complicated for older patients because symptoms can be linked to other conditions.

“The absence of face-toface assessment is what’s letting people down. The majority of gastroenterology assessments are done over the phone.

“This method can be very effective, but it’s not possible to examine a person’s stomach or check for signs of inflammation. This is essential in diagnosing appendicitis remotely.

CASES ARE HARDER DURING LOCKDOWN 

The Lockdown seems to have caused more severe forms of appendicitis and higher rates of complications in those who are admitted to hospital. According to Dutch researchers published in BMC Emergency Medicine, May, a study that included 1,200 patients from 21 hospitals.

Another study published in March found that hospitalizations for appendicitis were much less common. 

According to the U.S. researchers who wrote in Annals of Surgery Open in which they cited a variety of reasons, some of them include misdiagnosis of Covid-19, which can cause gastric symptoms, or the patient simply becoming clearer. 

Researchers concluded that the condition could be “over-treated” in the U.S.

For more than a century, the standard treatment for an inflamed appendix has been surgery to remove it to prevent it bursting — a condition called peritonitis, which can be fatal in up to 20 per cent of cases.

However, this conventional wisdom has been challenged by a series of recent studies that have proven the effectiveness of antibiotics in treating simple appendicitis.

ANTIBIOTICS ELIMINATES THE NEED FOR SURGY

A review of four studies involving uncomplicated appendicitis was published by the BMJ in 2012. It included 900 patients. Of these, 430 underwent surgery and the remaining received antibiotics. 

A majority of the patients (63%) were successful in getting antibiotics.

Dileep Lombo, an associate professor at Nottingham University of Gastrointestinal Surgery, conducted the review and advised that anyone with early appendicitis be administered antibiotics immediately. He also recommended monitoring patients. They should be operated if they don’t improve within 48 hours.

He states that the approach would reduce the need for surgery by up to two-thirds, and could also cut down on complications. 

When the first wave of Covid was over, appendicitis treatment became more common out of necessity. This proved to have been a huge success.

The UK published a study on 500 people with Covid appendicitis earlier in the year. This was published in Techniques in Coloproctology.

Professor Sanderson says, “There was concern that patients would come back with problems with their appendixes after having been treated with antibiotics.” 

“But, we didn’t see any wave of people returning. The question is whether appendicitis might be a self-limiting disease that can be more easily treated with antibiotics.

WHAT ELSE PATIENTS ARE NOT SCANNED?

Appendix patients may not be routinely scanned so many people might have their appendixs removed. 

A CT scan is not required for 15% of UK women and 23% of UK men with suspected appendicitis. Nearly all Americans undergo scans prior to having surgery. In the UK however, the decision on whether you need a scan or not is up to your doctor.

Appendicitis can be suspected and may proceed without confirmation. This is to avoid complications. However, healthy appendixes can also be removed.

According to a British Journal of Surgery study, 28% of appendicitis patients in the UK are women while 12% of appendicitis sufferers in the UK have their normal appendixes removed.

REMOVAL OF IT, LINKED TO THE GUT INFECTION 

Appendix care has many benefits. It has been considered redundant for decades. However, new research suggests that it is a crucial part of our gut microbiome. This colony of bacteria has been linked to our immune system.

Heather Smith, an American professor of anatomy, conducted research in 2017 that suggested the appendix might be used as a reservoir to support beneficial gut bacteria.

Her research revealed that some kinds of beneficial bacteria can be stimulated by lymphatic tissue. This means the appendix could help’repopulate the gut’ with the good bacteria destroyed by infection.

Research has shown that those who had their appendix taken out are more susceptible to developing gut infections like C. difficile. These can lead to death.

The risk of developing Parkinson’s Disease is threefold higher if the appendix has been removed, as it strongly associates with a protein within the gut. According to U.S. researchers, an analysis of 62,000,000 records was done in 2019.

Professor Sanderson states, “While we understand that the body can function without the appendix (and it does), the common wisdom that it is redundant is incorrect.”

With prevention better than cure, Mr Paraskeva offers the following advice on how to reduce the risk of appendicitis: ‘Eat plenty of fibre to prevent constipation and keep well hydrated — everyone can be better at that,’ he says.