It’s normal for kids to get stomach aches, but some kids have bad stomach pain all the time. If your child has abdominal pain, cramping, gas, bloating, diarrhea or constipation, you may be wondering if your child has IBD or IBS (inflammatory bowel disease or irritable bowel syndrome). But do you know the difference?
While many of the symptoms are similar, IBD and IBS are very different. IBS can cause pain, but there is no inflammation of the intestine and it doesn’t lead to serious disease, as with IBD.
“It’s important to not diagnose either of these conditions yourself. If your child has these symptoms, you should take your child to a pediatrician, who can then refer your child to a pediatric gastroenterologist, if necessary” says Dr. Kenneth Grant, pediatric gastroenterologist at CHOC Children’s.
Inflammatory Bowel Disease
IBD is a chronic condition caused by inflammation in the digestive tract. There are two main types of IBD – ulcerative colitis and Crohn’s disease. Ulcerative colitis affects the colon, and Crohn’s disease can affect any part of the digestive system.
“No one knows for sure that causes IBD or why it appears when it does. We do know that people who have family members with IBD are more likely to develop the disease. There is evidence that patients with this disease have abnormal activity of the immune system. Diet, nutrition and the environment may all play key roles,” says Dr. Grant.
IBD is diagnosed by a pediatric gastroenterologist through complete medical history, physical examination and specialized diagnostic procedures, such as blood tests, stool tests, endoscopy, colonoscopy or radiology exams. IBD treatment usually consists of medication therapy or surgery with the goal of reducing inflammation.
Diarrhea, sometimes bloody
Urgency to stool
Loss of appetite
Irritable Bowel Syndrome
IBS is not a disease, but rather, a collection of symptoms. There is no damage or inflammation in the digestive system. When abdominal pain is accompanied with changes in bowel movement habits, either constipation or diarrhea, this is called irritable bowel syndrome.
Although the exact cause is not known, nerve signals or chemicals secreted by the gut or brain may cause the gut to be more sensitive to triggers that normally do not cause significant pain (such as stretching or gas bloating). The nerve dysfunction also results in change in bowel motility leading to constipation or diarrhea.
To diagnose IBS, a physician should rule out a diagnosis of IBD. IBS is usually treated with dietary change, medication and stress management.
Chronic or intermittent diarrhea
Chronic or intermittent constipation
Urgency to pass a bowel movement or sensation of incomplete passage of bowel movement
Passage of mucus in the stool
To make an appointment with a CHOC gastroenterology specialist, call 888-770-2462.
Shortly after birth, Angelina was diagnosed with polymicrogyria. She remains under the care of many CHOC Children’s clinicians. Part of her treatment includes working with a speech and language pathologist, ...
In recent years, gluten-free diets have risen in popularity and gluten-free products become more readily available—but not everyone who puts themselves or their children on a gluten-free diet has a ...
Johanna and her husband Graham were expecting a healthy baby. Already parents to one little girl, they were looking forward to expanding their family.
At Johanna’s 33-week anatomy scan, she and Graham were thrilled to learn they were expecting a girl, but shocked to learn she might have club foot, a birth defect where the foot is twisted out of shape or position. They learned there was a chance it could be due to a neurological defect since everything else was showing up as normal.
“We started mentally preparing ourselves for our baby to have a club foot,” Johanna said. “We had another anatomy scan, but they couldn’t say for certain what was going on.”
On January 26, 2018 Johanna delivered a baby girl named Angelina via c-section. A neonatologist was in the delivery room in case Angelina needed immediate medical attention after birth. She was having trouble swallowing and was monitored in that hospital’s neonatal intensive care unit (NICU).
Three days later, a CHOC neonatologist rounding at the delivery hospital recognized that Angelina needed a higher level of care and a bigger team of specialists. He suggested that she might need an MRI to give doctors a better look at her brain, and determine if her condition was neurological.
“Even though I’d never been to there, I knew that when it was an option to go to CHOC, you go to CHOC,” Johanna said.
Their older daughter Genevieve had been born at St. Joseph Hospital in Orange, next door to CHOC Children’s Hospital.
“I was so freaked out before I had my first child, because of all the things that can go wrong during childbirth. I delivered Genevieve at St. Joseph because I liked knowing that CHOC as right next door if we needed them” Johanna said. “When they gave us the option to send Angelina to CHOC, there was no question—we just immediately went.”
Angelina was admitted to CHOC’s NICU and evaluated by neonatologist Dr. John Tran, of CHOC’s neurocritical NICU. Special rooms of CHOC’s NICU are designated for the neurocritical NICU, where neonatologists and neurologists have the expertise and equipment to carefully treat babies with neurological issues.
An MRI showed that Angelina had polymicrogyria, a condition characterized by abnormal brain development. Johanna and Graham had never heard of this condition and had a hard time processing the diagnosis. Then they met with Dr. Donald Phillips, a pediatric neurologist at CHOC.
He explained to the family that typically, the surface of the brain has many ridges and folds, called gyri. In babies born with polymicrogyria, their brain surface has too many folds that are too small to process information received, which leads to problems with body functioning, similar to the effect a stroke can have on the brain.
Dr. Tran explained the spectrum of care for polymicrogyria. Some patients are nonverbal, some go to school, and some even live with this condition and never know. It was too soon to tell where on that spectrum Angelina would fall.
“Caring for babies with neurological conditions can be difficult. Not only are you medically treating a newborn baby, but you are also counseling a family and giving them an uncertain prognosis,” says Dr. Tran. “In the neurocritical NICU, our first goal it to treat the baby’s underlying condition. The second goal is to educate the most important members of our care team― the parents. We know that the NICU is not a part of the birth plan, but our job is to help alleviate some of the anxiety that comes with uncertainty. We strive to optimize the potential of our patients, whatever it might be, as they go home.”
The diagnosis was a lot for her parents to take in.
“We knew we were getting the best care for our daughter, but it was such heavy news,” Johanna said. “Even with a typical kid, we don’t really know what their life will be like. Every life is a gift. Once I started going towards that mentality, I realized that nothing is certain, even with typical kids.”
At her delivery hospital, one of the red flags that Angelina needed a higher level of care was that she kept crashing when she was breastfeeding.
“It made me freaked out to feed my daughter,” Johanna said.
Soon after coming to CHOC, Angelina began swallowing therapy. When someone experiences swallowing difficulty, they are at risk for food or liquid entering their lungs, called aspiration, which may lead to pneumonia. Karin Mitchell, a speech and language pathologist who specializes in the NICU setting, worked with Angelina on swallowing safety. Karin guided baby Angelina through exercises for her mouth and tongue to learn how to properly swallow saliva. Then, they could work on breastfeeding support and syringe feeding.
Angelina couldn’t move her legs when she was born, and her parents weren’t sure if she ever would. Thanks to physical therapy, today she can bend her legs more than 90 degrees.
Throughout their stay in the NICU, Johanna and Graham were thankful to have the ability to sleep overnight in their daughter’s private room. Because Angelina was born during flu season, her 3-year-old sister couldn’t visit the NICU. Her parents would stay at CHOC all day, go home to do their older daughter’s bedtime routine, and then one parent return to CHOC to sleep alongside their new baby.
“We had the privacy we needed, and I felt comfortable doing kangaroo (skin to skin) care,” Johanna said. “I hadn’t planned on my baby staying in the hospital, and at least having our own room, and even something as small as being able to watch TV gave me a small sense of normalcy.”
Johanna and Graham also appreciated the sense of normalcy provided by a Super Bowl party thrown for parents on the unit. An infant CPR class offered on the unit helped them feel more prepared to eventually take their baby girl home.
For big sister Genevieve, CHOC offers an innovative webcam system so family members can be together and bond with their newborns when they can’t be at the bedside. The system allows families to see real-time, live video of their infant remotely, from anywhere they can securely log onto the internet.
“CHOC had a lot of things in place, like the secure camera in Angelina’s room, to make things easier on us as a family,” Johanna said.
A month after she was born, Angelina got to go home for the first time.
“We were so ready to take her home, and finally be together as a family,” Johanna said. “But it was still a little nerve-wracking. We bought four different types of baby monitors; we were used to seeing her surrounded by machines.”
A few weeks later, Angelina began swallowing therapy twice per week and physical therapy three times per week. Now 15 months old, the amount of progress she has made has made her parents proud.
She couldn’t move her legs at birth, but a year later she is rolling and reaching. Her parents credit her CHOC physical therapist Lauren Bojorquez.
“Lauren didn’t just think of what Angelina was doing now; she was always thinking ahead about what would benefit her in the future,” Johanna said.
For example, Lauren and Angelina worked on rolling because it would eventually help her learn to sit. When babies roll, it helps develops muscles that will later help them sit.
Meanwhile, Angelina was working with CHOC speech and language pathologist Annie Tsai to learn how to cough, swallow, and accept food by mouth. Swallowing therapy focused not on quantity of food consumed but on quality of how the child feeds or swallows safely. Angelina’s work with Annie focuses on movement, strength and coordination within the mouth to prepare for eventually swallowing food.
Angelina still receives most of her nourishment through a feeding tube, also called a g-tube. The tube can stay in a patient’s stomach for months or years and allows the child to receive fluids, medicines and nutrition when they can’t take in enough nutrition by mouth. Every few months, Angelina sees gastroenterologist Dr. Jeffrey Ho for follow-up appointments for nutrition, feedings and g-tube care. Dr. Ho remains in close contact with Annie, her speech and language pathologist.
“Being able to eat in a typical manner is always the goal,” says Dr. Ho. “Every baby and child are different. Right now, we are focusing on what we can do to better optimize her potential to orally feed.”
Now, Angelina can sit in a highchair, bring her hands to her mouth, accept small tastes by mouth and better clear her congestion especially when she’s sick.
“Something I hadn’t realized before Angelina was how big a part food plays in our culture. As people get older, going out to eat or meeting for coffee is a social activity. I was sad that she wouldn’t get to have those same experiences,” Johanna said. “When she started to accept tastes by mouth, it made me think of her in the future, and being able to go out with friends and at least taste something, and still participate socially.”
To further practice feeding therapy at home, Angelina has a mesh pacifier typically used to soothe teething babies. Her parents often put the same foods in her pacifier as the rest of the family is eating. So far, there hasn’t been a food she’s tried that she hasn’t liked.
Angelina’s paternal grandma was an adult speech and language pathologist by training. When Angelina started speech therapy, she updated her license and certification to help her granddaughter at home. She comes to some of her sessions at CHOC and learns from Angelina’s care team.
Also participating in therapy is big sister Genevieve, who helps hold the pacifier and can even spoon-feed her baby sister, with a little bit of help.
“I am super grateful for CHOC,” Johanna said. “That’s why our family started participating in CHOC Walk when Angelina was born.”
These days, Angelina likes playing with toys, playing with her big sister, and listening to all types of music.
“I had a lot of preconceptions about disabilities and special needs,” Johanna said. “Having a child with special needs is not what I thought it would be. It’s better than that.”
From the very beginning, Melissa and Kris knew their twins were fighters—they were also a surprise; the couple hadn’t been sure if they were going to be able to have more children.
“We knew these twins had a purpose and a reason. From the very beginning of their lives, they were a miracle all around.”
Melissa experienced hyperemesis gravidarum also known as HG, a rare condition characterized by extreme nausea and vomiting. Most pregnant women experience morning sickness, but less than 3% experience HG, which can lead to near-constant vomiting, dehydration, weight loss and malnutrition.
“From the second I was pregnant, I was extremely ill. The three of us shouldn’t have lived through my pregnancy, but we did,” Melissa says. “The twins are little fighters. From the womb until now, they’re just little fighters.”
Her body was so depleted that she was put on extended bedrest and hospitalized on and off throughout her pregnancy. She needed a PICC line, or peripherally inserted central catheter, for two-thirds of her pregnancy. PICC lines are sometimes needed when intravenous (IV) medications are required over a long period of time.
“The babies were getting all their nutrients from me, and I was so sick. It was really scary,” she says. “One night while on hospitalized bedrest I needed four blood transfusions. My body was shutting down. The babies were ok through everything—the blood transfusions, me getting IVs, copious amounts of potassium, medications, everything. They just kept going.”
Showing signs of gastroesophageal reflux disease (GERD)
A few days after they were born, Bowie and Finley started showing signs of gastroesophageal reflux (GER). This occurs when a small amount of acidic stomach fluid or food in the stomach goes back up into the esophagus or swallowing tube. Two-thirds of healthy infants experience gastroesophageal reflux.
When the reflux causes intolerable discomfort or complications, children may be experiencing gastroesophageal reflux disease (GERD). Nurses at the delivery hospital told the parents the babies were spitting up and throwing up more than they should be. By the time they went home a couple days after they were born, they had lost a bit more of their birth weight than they were supposed to. Melissa and Kris’ older children Scotlynd and Kingston had GER when they were younger, so they thought they knew what to expect.
Most cases of GER resolve without medication. In rare cases, treatment of GERD requires surgery.
“The older kids just got through it and was never life-threatening,” Melissa said. “With the twins, it went from ‘all babies spit up, they will be ok like their siblings’ to failure to thrive and life-threatening episodes.”
Each twin had life-threatening episodes of GERD. Melissa recalls an especially frightening night with Finley.
“After one middle of the night feeding, Finley threw up and that time, I wasn’t sure if she was ok. I went back in her nursery to check on her and she wasn’t breathing. It was the most terrifying moment. She was limp. I screamed for my husband. We tried everything to wake her up.”
Their pediatrician referred them to CHOC pediatric gastroenterologist Dr. Greg Wong. The two physicians worked together to improve GERD symptoms. Despite trying to change feeding times, amount and type of formula, and medication, the symptoms just weren’t going away.
“We wanted to stay within the CHOC network. That was important to me because our older son had been treated at CHOC, and we fell in love with the CHOC family,” Melissa says. “We know how not only wonderful and caring they are, but from a medical perspective too. We wanted the best for them and we felt CHOC was the best.”
Bowie and Finley’s path to surgery
The family hadn’t wanted to prematurely jump to surgery as an option, but in the end, it was the right decision. They were referred to Dr. Peter Yu, a pediatric general and thoracic surgeon at CHOC.
“Dr. Yu made us feel so comfortable. He really knew what he was doing,” Melissa said. “The CHOC team felt that we had exhausted all other options, and that surgery was the best option for the twins.”
Bowie and Finley underwent surgery when they were about 6 months old. Dr. Yu performed a minimally invasive procedure known as laparoscopic Nissen fundoplication to repair the twins’ GERD. At the same time, he repaired their hernias.
“They are not identical babies, but they had identical surgeries,” Melissa says.
Surgery was performed on one baby at a time. Afterwards, they were brought to recovery rooms right next to each other, so one parent could be with each twin, and they could be close by.
“Before surgery, the babies were so sickly,” Melissa said. “After surgery, they are completely different babies.”
The twins are now feeding, growing and thriving. One of many benefits of this surgery has been less laundry. Melissa and Kris used to have a full hamper of laundry every day because the twins went through clothes and sheets so often.
Celebrating holidays in the hospital
Melissa’s birthday was the day after surgery.
“It was another birthday spent in the hospital, but it put things in perspective,” she said. “The best gift I could’ve gotten was for them to be healthy and thrive again. You think about the important things, and everything else fades away.”
Helmet therapy and physical therapy
Part of the family’s efforts to control the twins’ side effects of GERD had been to keep them in one position to limit their acid reflux. Because of this, they weren’t able to do tummy time which helps prevent flat spots on the back of the head.
After surgery, Finley and Bowie wore helmets for three months that helped correct the growth and shape of their skull.
Because of GERD, the twins’ backs were strong, but their cores and trunks were weak. They are in physical therapy to strengthen their bodies and help them roll and move around using the correct muscles.
A message to other moms
Melissa’s advice for other moms taking care of babies with GERD is to just keep asking questions and remember that every baby is unique.
“There are a lot of levels of GERD, and I didn’t know how severe it could be until it happened to us,” she said. “I learned not to compare my babies to anyone else’s. Every kid is different.”
She added that this experience taught her that trials are temporary, and things will get better.
“Even in the heart of it when you can’t get through another day, and you have to take it minute by minute,” she said. “I always say it’s only temporary. It might not get better right away, but it will.
Last Mother’s Day, Melissa was on bedrest in the hospital, days away from giving birth to her twins. This year, she’s looking forward to celebrating her family being complete—and healthy.
“You have to look back and see where you’ve come from to see how wonderful it is. Last year wasn’t this way. I spent last Mother’s Day with them in the hospital preparing to give birth,” she recalls. “It’s amazing to see how far we have come in a year. We are moving forward, and we can truly enjoy them and enjoy our time as a whole family.”
The twins’ first birthday falls right after Mother’s Day. The family is planning a big celebration in their neighborhood.
“We want to include everybody that was there for them from my pregnancy through the first year of life,” Melissa says. “We want to celebrate that they made it and thank everyone for their help. Everything has been so up and down and up and down, and now were in the clear.”
In recent years, gluten-free diets have risen in popularity and gluten-free products become more readily available—but not everyone who puts themselves or their children on a gluten-free diet has a medical reason for doing so. About 30 percent of the US population is on a gluten-free diet, but all patients requiring this diet (celiac, gluten-free sensitivity, etc.) combined are less than 30 percent of the US population.
Shouldn’t everyone just go gluten free?
Many people assume that since gluten can have such strong negative effects on some of us, that it would be safer if we all just avoided gluten. Wrong.
Gluten-free foods may be safe to eat, but they’re not calorie-free. Many gluten-free foods and snacks are higher in fat and calories. Also, very few gluten-free products are enriched with essential vitamins and minerals that most gluten-containing products contain. This means if you’re on a gluten-free diet not managed by a registered dietitian, you could be missing out on essential nutrients your body needs. At CHOC, our team of pediatric gastroenterologists work in tandem with registered dietitians to care for children who require a gluten-free diet.
What is gluten?
Gluten is a general name for the proteins found in wheat, rye, and barley and triticale (a cross between wheat and rye). It can be found in many types of foods, but is primarily made up of two different types of proteins:
Gliadin- gives bread the ability to rise
Glutenin- responsible for dough’s elasticity, acting as a glue to hold the food together, affecting the chewiness and maintaining the shape of baked products
Here’s a few cases where I would recommend a gluten-free diet to my patients:
If you are diagnosed with celiac disease, it means you have an autoimmune reaction to gluten. Whenever you eat something containing gluten, your small intestine is hyper sensitive to that gluten, which leads to difficulty digesting food. Some common symptoms of celiac disease are diarrhea, decreased appetite, stomachache and bloating, poor growth, and weight loss.
Many kids are diagnosed with celiac disease when they’re between 6 months and 2 years old, which is when most kids get their first taste of gluten in foods. Girls are twice as likely to have this disorder than boys.
For some people, the problems start slowly and the symptoms may be terrible one week and not as bad the next. Because of this, some people aren’t diagnosed with celiac disease until they’re older. The problem is chronic, which means that although symptoms may come and go, people who have celiac disease will always have it.
If celiac disease is not treated, patients will develop weight loss and malabsorption (a condition that prevents the absorption of nutrients through the small intestine).
No one is sure why celiac disease happens, but it appears to run in families. You have a five percent to 10 percent chance of getting celiac disease if someone in your family has it. Others at higher risk for celiac disease include those with Type I diabetes, an autoimmune thyroid or liver disease, Trisomy 21 (Down syndrome), Williams syndrome, Turner syndrome, IGA deficiency or juvenile chronic arthritis. If your child falls into this at-risk group, they should be tested for celiac disease even if they don’t currently show symptoms. Celiac disease can harm the digestive system if no obvious symptoms are present.
Some children with celiac disease do not respond to the Hepatitis B vaccine. They will respond to the vaccine once they are on a gluten free diet. If your child was vaccinated for Hepatitis B prior to their celiac disease diagnosis and starting their gluten-free diet, they may need to be revaccinated for Hepatitis B. Consult your pediatrician about your child’s vaccination history.
In addition to a complete medical history and physical examination, diagnostic procedures for celiac disease may include blood work or a biopsy.
The only treatment for celiac disease is a lifelong adherence to a strict gluten-free diet.
You might be hypersensitive to wheat proteins without having celiac disease. People living with a wheat allergy have an immune reaction to the proteins found in wheat. A type of white blood cell attacks the wheat, alerting the body that there is a problem. Reactions can occur within a few minutes to a few hours, and can include nausea, abdominal pain, itching, swelling of the lips and tongue, trouble breathing or anaphylaxis. People with wheat allergies cannot ingest wheat, but they have no trouble ingesting gluten from non-wheat sources.
Children with a wheat allergy may eventually outgrow it, but the only treatment is eating a wheat-free diet.
Non-celiac gluten sensitivity
Non-celiac gluten sensitivity is not well-defined, but it is not an autoimmune response (like Celiac disease) or immune response (like a wheat allergy). There are no tests to diagnose a gluten sensitivity, but your doctor can do a biopsy or allergy test to rule out Celiac disease and wheat allergy. If a child’s symptoms improve by following a gluten-free diet, then gluten sensitivity may be diagnosed.
The only treatment for non-celiac gluten sensitivity is adhering to a gluten-free diet.
Shortly after birth, Angelina was diagnosed with polymicrogyria. She remains under the care of many CHOC Children’s clinicians. Part of her treatment includes working with a speech and language pathologist, ...
More than 700 kids are treated for appendicitis at CHOC Children’s every year. The appendectomy is one of the most commonly performed surgeries in the world. But just what is the appendix, and why does it send so many people to the emergency room with stomach pain?
Dr. Peter Yu, CHOC Children’s pediatric general and thoracic surgeon, explains everything you’ve ever wondered about the appendix, and more.
What does the appendix do?
The appendix is a small, finger-like projection that sticks out of the large intestine, located in the right side of the abdomen. It weighs about as much as an earthworm. In fact, its old-fashioned name is vermiform appendix, which means worm-like, Dr. Yu explains.
Everyone’s appendix is different. Some are long, some are short and stubby. But one thing they all have in common is that they are not necessary for a happy, healthy life.
“We are not sure if the appendix has a purpose. Some doctors don’t believe it does anything,” Dr. Yu says. “Some think it plays a role in the development of the immune system, and some believe it harbors ‘good bacteria’ that helps intestinal health. The bottom line, though, is that appendicitis is common, and patients do extremely well after removal of their appendix.”
What causes appendicitis?
Bacteria naturally live in the large intestine and flow in and out of the appendix. Sometimes, the opening to the appendix gets blocked. Either constipation, a hard piece of stool called a “fecalith,” or enlarged lymph nodes cause these blockages.
The blockage traps the bacteria inside where it festers and multiplies. This leads to inflammation of the organ. If left untreated, the appendix can burst, releasing the infectious bacteria into the body.
Symptoms of a Burst or Inflamed Appendix
What are signs of appendicitis?
sudden severe pain
pain that starts near the belly button and moves to the lower abdomen on the right side
fever, nausea or vomiting
To diagnose appendicitis, the Julia and George Argyros Emergency Department at CHOC Children’s Hospital will check your child’s blood for signs of an infection and will do an ultrasound of the abdomen. While many hospitals use a CT scan to diagnose appendicitis, CHOC radiologists and sonographers have the training and experience to make a diagnosis using ultrasound, in order to minimize your child’s exposure to radiation. If the ultrasound is inconclusive, the radiologist may conduct a CT scan.
How does the surgeon remove the appendix?
The surgeon will perform a procedure called a laparoscopic appendectomy to remove the appendix. A pediatric anesthesiologist will put your child to sleep using general anesthesia. The procedure takes about 30 minutes, though CHOC’s pediatric general surgeons can remove the organ in less than 10 minutes if needed.
During surgery, three tiny incisions are made on the abdomen. Carbon dioxide is blown into the belly to create a dome, giving the surgeon room to work. Small surgical tools are inserted in two of the incisions and a laparoscopic camera is inserted in the third. The appendix is identified, stapled or tied off, and removed.
The surgeon closes the incisions with surgical glue and dissolvable strips. In most cases, children will stay in the hospital for one day before the doctor discharges them. They should have no heavy activity or sports for two weeks after surgery and can usually return to school quickly, often even the next day.
What do you do with the appendix after you take it out?
Pathologists then inspect the removed appendix in the pathology department under a microscope. This inspection is important because it will confirm the diagnosis of appendicitis and rule out other conditions such as ulcerative colitis, Crohn’s disease and carcinoid. Your surgeon will update you with the results during your follow-up appointment.
What if my appendix bursts?
“Fortunately, perforated appendicitis is less common than non-perforated appendicitis, but it can happen,” Dr. Yu says. “For some, the appendix can burst quickly, and for others it does not burst at all. There are many factors that a surgeon will consider before deciding whether to operate immediately, or to wait.”
If your surgeon decides to wait, then treatment can include antibiotics, placement of a drain in the abdomen, and nutrition through an IV if needed. Most patients improve in several days, after which the doctor discharges them. Your surgeon will then schedule your child for an interval appendectomy, which is removal of the appendix 8-12 weeks later. This gives the body time to recover from the infection and inflammation, making surgery safer and less complicated.
The CHOC Emergency Department, equipped to treat appendicitis 24 hours a day, with pediatric surgeons ready for all situations is mainly for kids and teens.