Appendicitis is typically treated with surgery to remove the appendix. The surgery is performed in a hospital; general anesthesia is needed. If appendicitis is suspected, especially in patients who have persistent abdominal pain and fever, or signs of a burst appendix and infection, a health care provider will often suggest surgery without conducting diagnostic testing. Prompt surgery decreases the chance that the appendix will burst. Surgery to remove the appendix is called an appendectomy. A surgeon performs the surgery using one of the following methods:
• Laparotomy. Laparotomy removes the appendix through a single incision in the lower right area of the abdomen.
• Laparoscopic surgery. Laparoscopic surgery uses several smaller incisions and special surgical tools fed through the incisions to remove the appendix. Laparoscopic surgery leads to fewer complications, such as hospital-related infections, and has a shorter recovery time.
With adequate care, most people recover from appendicitis and do not need to make changes to diet, exercise, or lifestyle. Surgeons recommend limiting physical activity for the first 10 to 14 days after a laparotomy and for the first 3 to 5 days after laparoscopic surgery.
What are the complications and treatment of a burst appendix?
A burst appendix spreads infection throughout the abdomen—a potentially dangerous condition called peritonitis. A person with peritonitis may be extremely ill and have nausea, vomiting, fever, and severe abdominal tenderness. This condition requires immediate surgery through laparotomy to clean the abdominal cavity and remove the appendix. Without prompt treatment, peritonitis can cause death. Sometimes an abscess forms around a burst appendix—called an appendiceal abscess. A surgeon may drain the pus from the abscess during surgery or, more commonly, before surgery. To drain an abscess, a tube is placed in the abscess through the abdominal wall. The drainage tube is left in place for about 2 weeks while antibiotics are given to treat infection. Six to 8 weeks later, when infection and inflammation are under control, surgeons operate to remove what remains of the burst appendix.
What if the surgeon finds a normal appendix?
Occasionally, a surgeon finds a normal appendix. In this case, many surgeons will remove it to eliminate the future possibility of appendicitis. Occasionally, surgeons find a different problem, which may also be corrected during surgery.
Can appendicitis be treated without surgery?
Nonsurgical treatment may be used if surgery is not available, a person is not well enough to undergo surgery, or the diagnosis is unclear. Nonsurgical treatment includes antibiotics to treat infection.
What should people do if they think they have appendicitis?
Appendicitis is a medical emergency that requires immediate care. People who think they have appendicitis should see a health care provider or go to the emergency room right away. Swift diagnosis and treatment can reduce the chances the appendix will burst and improve recovery time.
Eating, Diet, and Nutrition
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing appendicitis. If a health care provider prescribes nonsurgical treatment for a person with appendicitis, the person will be asked to follow a liquid or soft diet until the infection subsides. A soft diet is low in fiber and is easily digested in the GI tract. A soft diet includes foods such as milk, fruit juices, eggs, puddings, strained soups, rice, ground meats, fish, and mashed, boiled, or baked potatoes. People can talk with their health care provider to discuss dietary changes.
Points to Remember
• Appendicitis is inflammation of the appendix.
• The appendix is a fingerlike pouch attached to the large intestine and located in the lower right area of the abdomen. The inside of the appendix is called the appendiceal lumen.
• An obstruction, or blockage, of the appendiceal lumen causes appendicitis.
• The most common symptom of appendicitis is abdominal pain. Other symptoms of appendicitis may include loss of appetite, nausea, vomiting, constipation, diarrhea, an inability to pass gas, a low-grade fever, abdominal swelling, and the feeling that passing stool will relieve discomfort.
• A health care provider can diagnose most cases of appendicitis by taking a person’s medical history and performing a physical exam. If a person does not have the usual symptoms, health care providers may use laboratory and imaging tests to confirm appendicitis.
• Appendicitis is typically treated with surgery to remove the appendix.
• Nonsurgical treatment may be used if surgery is not available, a person is not well enough to undergo surgery, or the diagnosis is unclear. Nonsurgical treatment includes antibiotics to treat infection.
• Appendicitis is a medical emergency that requires immediate care.
• If a health care provider prescribes nonsurgical treatment for a person with appendicitis, the person will be asked to follow a liquid or soft diet until the infection subsides.