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Why You May Not Need Surgery for Appendicitis

July 22, 2015

Every year, more than 300,000 Americans get an emergency appendectomy for appendicitis. Appendicitis occurs when inflammation occurs in the appendix—a small, worm-like structure attached to the right side of the colon. Appendicitis can cause nausea, vomiting, abdominal swelling and pain. Surgery is currently the primary treatment for most cases of appendicitis.

However, a recent study indicates that antibiotics may be just as effective in treating mild appendicitis in order to prevent the need for surgery for more severe complicated cases. A European study conducted with 1,000 patients showed that 70 percent of study participants who took antibiotics did not need surgery, while about 30 percent of people in the study still had to get surgery after a year. It isn’t clear why antibiotics worked really well in some people and not others. Patients who ultimately needed surgery even after taking antibiotics also did not experience any more complications that those who were treated successfully with just antibiotics.

Researchers plan to do a larger clinical trial to learn more about how antibiotics actually treat appendicitis. This will help us understand how often appendicitis happens again in people initially treated with antibiotics and how well it helps people avoid hospital stays long-term. Depending on severity of the case, an appendectomy (short low risk procedure usually done with small incisions) may be better than taking a pill.

This discovery was born out of necessity. In the mid-1900s, doctors used antibiotics to treat American sailors who were serving duty on nuclear submarines for months at a time. Because they couldn’t perform surgery in that environment they used antibiotics instead, which cured patients without leading to any complications. This news encouraged the European study mentioned above, which suggests that appendectomies may be reduced if mild cases are treatable by antibiotics. Appendicitis is always urgent, but antibiotics may be an option in the future if you have to wait for surgery or if you don’t need surgery at all.

We will need more trials before this becomes a typical practice. Because about one-third of appendixes can rupture and cause complications and long hospital stays, surgeons rightly continue to be proactive in treatment by removing the organ. At this time, an appendectomy is still the more popular treatment option for treating appendicitis. If you experience symptoms like nausea, vomiting and abdominal pain, it’s best to go to the emergency room and get checked out.

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