Appendicitis: Antibiotics Vs Surgery

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Although since 1889, appendicectomy, which involves removing the inflamed appendix surgically, has been the standard treatment for acute appendicitis but surgery need not be the first line of treatment for acute uncomplicated appendicitis. Instead, the use of antibiotics may be a safe and a viable alternative. Antibiotic therapy results in fewer problems and complications than surgery for patients with uncomplicated appendicitis. Appendicitis is swelling or inflammation of the appendix. The appendix is a small pouch attached to the beginning of your large intestine. Appendicitis is one of the most common causes of emergency abdominal surgery worldwide. It usually occurs when the appendix becomes blocked by feces, a foreign object, or rarely, a tumor.

The symptoms of appendicitis can vary. It can be hard to diagnose appendicitis in young children, the elderly, and women of childbearing age. The first symptom is often pain around your belly button. The pain may be minor at first, but it becomes more sharp and severe. Your appetite will be reduced, and you may have nausea, vomiting, and a low fever. As the swelling in the appendix increases, the pain tends to move into your right lower abdomen. It focuses right above the appendix at a place called McBurney’s point. This most often occurs 12 to 24 hours after the illness starts. If your appendix breaks open or ruptures then you may have less pain for a short time and you may feel better. However, once the lining of your abdominal cavity becomes swollen and infected (a condition called peritonitis), the pain gets worse and you become sicker. Your pain may be worse when you walk or cough. You may prefer to lie still because sudden movement causes pain.

If you do not have complications, a surgeon will usually remove your appendix soon after your doctor thinks you might have the condition. This is called appendicectomy. In appendicectomy the surgeon makes a small cut in the lower right side of your belly area and removes the appendix. The appendix can also be removed using small surgical cuts and a camera. This is called a laparoscopic appendectomy. However, Antibiotic therapy is linked to a 63% success rate at twelve months, and a 31% relative reduction in complications. Antibiotic therapy is a safe initial therapy for patients with uncomplicated acute appendicitis. It merits consideration as a primary treatment option for early uncomplicated appendicitis. Patients with uncomplicated appendicitis, plus those whose diagnosis is not certain, should perhaps receive a ‘wait, watch and treat’ approach.