pox Hospitalization and forced feeding may be necessary if the disease has led to severe malnutrition. However, most anorexics can be treated on an outpatient basis by a family physician, a psychiatrist, or a specialist in eating disorders. The psychological problems that underlie anorexic behavior should be exposed and resolved. In the meantime, however, the youngster must be persuaded to gain weight and reassured that her doctor and parents will not allow her to become overweight. Healthy attitudes toward body weight and normal eating patterns must be restored. Emergency Quick Reference Appendicitis KEY SYMPTOM • Persistent pain in the abdomen, usually in the lower right quarter POSSIBLE SYMPTOMS • Tenderness in the abdomen • Nausea and vomiting • Fever IMPORTANT • Call your doctor as soon as you suspect appendicitis. The condition can worsen rapidly and can be fatal if not treated by a doctor. HOME CARE • Allow only clear liquids by mouth. If you strongly suspect appendicitis, do not give the child any food or drink until you have consulted your doctor. • Do not apply cold to the abdomen. Gentle heat may ease a stomachache. If pain continues or gets worse despite home treatment, call your doctor. PRECAUTIONS • Do not give painkillers (including aspirin). • Do not give a laxative or an enema.? Appendicitis is an inflammation of the appendix, caused by infection. The appendix is a blind pouch about the size of your little finger that is located where the small intestine joins the large intestine. In 99 percent of all children, the appendix lies in the lower right quarter of the abdomen. Appendicitis can occur at any age. If the appendix is not surgically removed, the infection worsens until the appendix bursts. Then the infection spreads throughout the abdomen. An infected appendix may perforate (rupture) within hours of the initial pain or may not rupture for a day or two. A ruptured appendix can lead to death. SIGNS AND SYMPTOMS The key symptom of appendicitis is pain in the lower right quarter of the abdomen. Persistent abdominal pain in your child should be considered a symptom of appendicitis until proved otherwise. Typically, the pain of appendicitis is constant; it does not come and go like the pain from cramps. Once it starts, it grows continuously worse. The pain may start in the pit of the stomach, but it usually soon moves to the lower Upper right Lower right ? •ght quarter of the abdomen. The pain is made worse by walking or Г st moving about. The abdomen is tender to a gentle pressure in the lower right quarter, more tender than in other areas. There may be nausea and vomiting, but these symptoms usually appear only after the pain has started. Generally, there is a lowgrade fever (100°F oral, 101°F rectal), but the temperature may range anywhere from normal to 104°F. Bowel movements are usually normal, but there may be diarrhea. Diagnosis may be difficult because not all of these signs are present in all cases. scarlet