Appendicitis Treatment
Assessment and treatment of inflammation of the appendix, with surgery considered when clinically required
What is appendicitis treatment?
The appendix is a narrow blind-ended tube coming off the start of the large bowel, low on the right side of the abdomen. It has no function that can be identified in an adult.
Appendicitis begins when the opening of that tube blocks, usually with a small hard piece of stool or with swollen lymphoid tissue in its wall. Mucus goes on being made behind the block, so pressure rises inside the tube, bacteria multiply, and the wall becomes inflamed and then starved of its blood supply.
The sequence runs to a timetable. Most appendices that are going to burst do so between one and three days after it starts, so appendicitis is handled as an emergency instead of a wait-and-see illness.
What you might notice
- Pain low down on the right side of the belly
- Nausea
How it is diagnosed
The diagnosis is largely clinical. A surgeon presses on the abdomen and watches how the wall behaves under the hand, checks whether the tenderness has settled to one point low on the right, and repeats the examination a few hours later, since the picture in the first hours is often not yet definite.
Blood tests show how strong the inflammatory response is. An ultrasound, or in adults a CT scan, is used where the picture stays unclear, and in women it also rules out an ovarian cause.
A second examination by the same surgeon a few hours after the first is worth more than any single test.
Recovery
Keyhole surgery for an appendix that has not burst means one night in hospital, normal food the next day and desk work within a week.
If it had already burst, the stay is longer and antibiotics run for several days, because the concern shifts from the appendix itself to the contamination it left behind. Getting back to normal then takes three to four weeks.
The wounds are small and the abdomen is sore to sit up from for about ten days. There is no dietary restriction afterwards and nothing to avoid in the long run.
If it is left untreated
Untreated appendicitis is not something to watch. The inflamed tube perforates and the infection spreads into the abdominal cavity.
Sometimes the body walls the perforation off into a contained collection, which is treated with antibiotics and drainage first and surgery later. More often it does not, and generalised infection follows, which carries a real risk to life and needs a much larger operation than the one avoided.
Tenderness that has settled to one spot low on the right, in someone who has gone off their food, is a reason to be examined the same day.
Questions about appendicitis treatment
Can appendicitis be treated with antibiotics alone?
Sometimes, and it is a genuine option in selected cases of early, uncomplicated appendicitis. The trade-off is that around one in three people treated that way are back with it inside a year and have the operation anyway. Antibiotics are also used deliberately where the inflammation has already walled itself off, with surgery arranged once things have settled. Where the appendix has perforated, antibiotics alone are not an option.
How urgent is it?
It is a matter of hours instead of days. Most appendices that perforate do so between twenty-four and seventy-two hours from the start, and both the operation and the recovery are far simpler before that happens. Once a surgeon has confirmed the diagnosis, the appendix comes out on the same admission.
Will I miss the appendix afterwards?
No. It has no function that can be identified in an adult, and removing it changes nothing about digestion, diet or immunity in any way you would notice. There is no long-term restriction and no medication to take.
Other general surgery treatments
Treatment of abdominal wall hernias that cause pain, swelling or functional discomfort
Day CareManagement of gallstones and related gallbladder problems, including surgery when indicated
Day CareTalk to a care coordinator about appendicitis treatment
Leave a number and a care coordinator calls you back with what the treatment involves and which hospital it would be at. They book a consult only if you want one