Table of ContentsView AllTable of ContentsTreatment Without SurgeryAppendectomy vs. AntibioticsMaking the Best Decision
Table of ContentsView All
View All
Table of Contents
Treatment Without Surgery
Appendectomy vs. Antibiotics
Making the Best Decision
Surgery is widely viewed as the standard course of treatment forappendicitis. For some people, it may not be the only way to solve the problem. Research shows that you may be able totreat appendicitiswithout surgery.
Certainantibiotics may work as well as surgery. These drugs may be used to treat severe symptoms in order to postpone or avoid surgery. Antibiotics may help when the appendicitis is not complex or the appendix does not pose the threat of bursting (rupturing).
This article describes what is involved in treating appendicitis without surgery, along with the pros and cons, and when it may be the right course of action.
SDI Productions / Getty Images
How Your Appendix Supports Gut HealthYour appendix is a small finger-shaped organ found in your lower right abdomen. While the long-held scientific theory has been that the appendix is unused, more recent studies suggest otherwise. There is evidence that the appendix may hold good gut bacteria that can be used to fight illness and bacterial imbalances. Even if your appendix serves a function, you can live a healthy life without one.
How Your Appendix Supports Gut Health
Your appendix is a small finger-shaped organ found in your lower right abdomen. While the long-held scientific theory has been that the appendix is unused, more recent studies suggest otherwise. There is evidence that the appendix may hold good gut bacteria that can be used to fight illness and bacterial imbalances. Even if your appendix serves a function, you can live a healthy life without one.
Appendicitis Treatment Without Surgery
Up to 70% of people with appendicitis choose treatment without surgery. Research indicates thatantibioticswork as all as surgery and may be an option for people with an uncomplicated appendix infection.
Surgery remains the first-line therapy for people with an appendix at risk of rupture due to inflammation or other complications, but people with uncomplicated appendicitis may be good candidates for the antibiotics option. This nonsurgical approach may also be valuable for people with severe symptoms whose age or other conditions may increase the risk of surgery.
While there is no standardized regimen, the following antibiotics are used in treating appendicitis:
Appendicitis treatment without surgery involves the following pros and cons:
Pros
The benefits of nonsurgical appendicitis treatment include:
Cons
The drawbacks of appendicitis treatment without surgery include:
Appendicitis Symptoms That Require Emergency Care
Seek emergency medical care if you experience continuous severe abdominal pain that does not improve within 30 minutes. This symptom can indicate acute appendicitis or another potentially life-threatening condition like anectopic pregnancy(the implantation of a fertilized egg outside the uterus) or acutepancreatitis(inflammation of the pancreas)
Appendectomy vs. Antibiotics: Which Is Better?
Whether an appendectomy or antibiotics is better depends on your symptoms and other factors regarding your overall condition.
You will likely have to choose between these two treatments soon after your diagnosis. An infected appendix can rupture 48 to 72 hours after symptoms begin. If this occurs, the appendix leaks the infected substance into the lining of your abdomen, which can damage other organs.
You can experienceacuteor chronic appendicitis. Knowing which type you have is important in determining the type of treatment that is the better option.
Natural Remedies for AppendicitisThere are no approved natural remedies for appendicitis. Consult your healthcare provider if you have signs of appendicitis before trying natural remedies, which might mask symptoms and cause a delay in diagnosis.
Natural Remedies for Appendicitis
There are no approved natural remedies for appendicitis. Consult your healthcare provider if you have signs of appendicitis before trying natural remedies, which might mask symptoms and cause a delay in diagnosis.
For Acute Appendicitis
Acute appendicitisis a sudden inflammation of the appendix. It is one of the most common surgical emergencies. People who have acute appendicitis usually have the following symptoms, which progress rapidly anywhere from a few hours up to two days:
Ultrasoundand/orCT (computed tomography) scansare the methods of diagnosis used to confirm appendicitis.
Acute appendicitis can be categorized as either complicated or not. Complicated appendicitis requires treatment with surgery. This condition usually has one of the following characteristics:
You may be eligible for antibiotic therapy if your condition is not deemed complicated or at risk of perforation for other reasons. While effective, the rate of recurrence is higher than surgery.
In a five-year follow-up of patients with uncomplicated acute appendicitis who were treated with antibiotics, researchers indicated that appendicitis recurred 27.3% at one year, 34% at two years, 35.2% at three years, 37.1% at four years, and 39.1% at five years.
For Chronic Appendicitis
Chronic appendicitisoccurs much less often than acute appendicitis and accounts for just 1.5% of all cases. Unlike acute appendicitis—which happens once and is often resolved—chronic appendicitis involves milder symptoms, though recurrent and chronic.
Symptoms of chronic appendicitis last for seven days or longer or come and go for longer.
The condition is believed to occur due to a partial and/or short-term obstruction in the appendix. Since people do not often present with typical appendicitis, misdiagnosis is common. It is also complicated because there are no diagnostic criteria for chronic appendicitis.
While chronic appendicitis is not well-understood, it is thought to occur due to the appendix’s partial and/or transient obstruction. With frequent misdiagnosis, complications that require surgery can develop.
When chronic appendicitis does not advance to the need for emergency surgery, antibiotics may be used as a first-line treatment to resolve the problem without surgery. If the problem persists, an appendectomy is recommended.
Appendix Stones
Appendix stones—also known as fecaliths or coprolites—are hardened deposits in the appendix. They can develop as dry compact feces or hard stony masses obstructing the appendix and leading to appendicitis.
If you want a cure despite a longer recuperation time, you may be more comfortable with immediate surgery. However, if your goal is to avoid surgery as your initial treatment, and you are comfortable with the possibility of a second round of treatment or surgery at a later date, you may choose antibiotic treatment.
As you weigh your options, ask your healthcare provider the following questions about your treatment choices:
Can You Prevent Appendicitis?
Summary
The first-line treatment for appendicitis (an inflamed appendix) has long been surgery. Recent research shows that some people may be able to solve the problem with certain drugs.
Your healthcare provider can advise you on which treatment may be better for you. You may have to choose whether you prefer surgery without the worry of repeat disease or drugs without the risk of surgery.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. Pharmacist.Antibiotics, not surgery, for uncomplicated appendicitis now routine.Lane Regional Medical Center.Warning signs you may need your appendix removed.Global Alliance for Infections in Surgery.An evidence-based approach to acute appendicitis.Bolakale-Rufai IK, Irabor DO.Medical treatment: an emerging standard in acute appendicitis?Niger Med J. 2019 Sep-Oct;60(5):226-233. doi:10.4103/nmj.NMJ_65_19Mount Sinai.Appendectomy.Fan SM, Grigorian A, Smith BR, et al.Geriatric patients undergoing appendectomy have increased risk of intraoperative perforation and/or abscess.Surgery. 2020;168(2):322-327. doi:10.1016/j.surg.2020.04.019Alhamdani YF, Rizk HA, Algethami MR, Algarawi AM, Albadawi RH, Faqih SN, Ahmed EH, Abukammas OJ.Negative appendectomy rate and risk factors that influence improper diagnosis at King Abdulaziz University Hospital.Mater Sociomed. 2018 Oct;30(3):215-220. doi:10.5455/msm.2018.30.215-220Vanderbilt University Medical Center.Treating appendicitis with antibiotics instead of surgery may be good option for some, but not all, patients.Haijanen J, Sippola S, Tuominen R, Grönroos J, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Salminen P.Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial.PLoS One. 2019 Jul 25;14(7):e0220202. doi:10.1371/journal.pone.0220202The New England Journal of Medicine.Antibiotics versus appendectomy for acute appendicitis – longer-term outcomes.American College of Emergency Physicians.Stomach pain.Johns Hopkins Medicine.Appendicitis.JAMA Network.Acute appendicitis.Mariage M, Sabbagh C, Grelpois G, Prevot F, Darmon I, Regimbeau JM.Surgeon’s definition of complicated appendicitis: a prospective video survey study.Euroasian J Hepatogastroenterol. 2019 Jan-Jun;9(1):1-4. doi:10.5005/jp-journals-10018-1286Salminen P, Tuominen R, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Mecklin JP, Sand J, Virtanen J, Jartti A, Grönroos JM.Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial.JAMA. 2018 Sep 25;320(12):1259-1265. doi:10.1001/jama.2018.13201Shah SS, Gaffney RR, Dykes TM, Goldstein JP.Chronic appendicitis: an often forgotten cause of recurrent abdominal pain.The American Journal of Medicine. 2013;126(1):e7-e8. doi:10.1016/j.amjmed.2012.05.032Lee CK, Pelenyi SS, Fleites O, Velez V, Alaimo KL, Ramcharan DN, Tiesenga F.Chronic appendicitis, the lesser-known form of appendiceal inflammation: a case report.Cureus. 2021 Nov 18;13(11):e19718. doi:10.7759/cureus.19718Adhikari R, Simkhada P, Mandal D, Kunwar A, Dhital SP.Appendicular and caecal fecalith causing perforation: a case report.JNMA J Nepal Med Assoc. 2020 Apr 30;58(224):255-257. doi:10.31729/jnma.4711Prevention.9 things you need to know about your appendix.
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.U.S. Pharmacist.Antibiotics, not surgery, for uncomplicated appendicitis now routine.Lane Regional Medical Center.Warning signs you may need your appendix removed.Global Alliance for Infections in Surgery.An evidence-based approach to acute appendicitis.Bolakale-Rufai IK, Irabor DO.Medical treatment: an emerging standard in acute appendicitis?Niger Med J. 2019 Sep-Oct;60(5):226-233. doi:10.4103/nmj.NMJ_65_19Mount Sinai.Appendectomy.Fan SM, Grigorian A, Smith BR, et al.Geriatric patients undergoing appendectomy have increased risk of intraoperative perforation and/or abscess.Surgery. 2020;168(2):322-327. doi:10.1016/j.surg.2020.04.019Alhamdani YF, Rizk HA, Algethami MR, Algarawi AM, Albadawi RH, Faqih SN, Ahmed EH, Abukammas OJ.Negative appendectomy rate and risk factors that influence improper diagnosis at King Abdulaziz University Hospital.Mater Sociomed. 2018 Oct;30(3):215-220. doi:10.5455/msm.2018.30.215-220Vanderbilt University Medical Center.Treating appendicitis with antibiotics instead of surgery may be good option for some, but not all, patients.Haijanen J, Sippola S, Tuominen R, Grönroos J, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Salminen P.Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial.PLoS One. 2019 Jul 25;14(7):e0220202. doi:10.1371/journal.pone.0220202The New England Journal of Medicine.Antibiotics versus appendectomy for acute appendicitis – longer-term outcomes.American College of Emergency Physicians.Stomach pain.Johns Hopkins Medicine.Appendicitis.JAMA Network.Acute appendicitis.Mariage M, Sabbagh C, Grelpois G, Prevot F, Darmon I, Regimbeau JM.Surgeon’s definition of complicated appendicitis: a prospective video survey study.Euroasian J Hepatogastroenterol. 2019 Jan-Jun;9(1):1-4. doi:10.5005/jp-journals-10018-1286Salminen P, Tuominen R, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Mecklin JP, Sand J, Virtanen J, Jartti A, Grönroos JM.Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial.JAMA. 2018 Sep 25;320(12):1259-1265. doi:10.1001/jama.2018.13201Shah SS, Gaffney RR, Dykes TM, Goldstein JP.Chronic appendicitis: an often forgotten cause of recurrent abdominal pain.The American Journal of Medicine. 2013;126(1):e7-e8. doi:10.1016/j.amjmed.2012.05.032Lee CK, Pelenyi SS, Fleites O, Velez V, Alaimo KL, Ramcharan DN, Tiesenga F.Chronic appendicitis, the lesser-known form of appendiceal inflammation: a case report.Cureus. 2021 Nov 18;13(11):e19718. doi:10.7759/cureus.19718Adhikari R, Simkhada P, Mandal D, Kunwar A, Dhital SP.Appendicular and caecal fecalith causing perforation: a case report.JNMA J Nepal Med Assoc. 2020 Apr 30;58(224):255-257. doi:10.31729/jnma.4711Prevention.9 things you need to know about your appendix.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
U.S. Pharmacist.Antibiotics, not surgery, for uncomplicated appendicitis now routine.Lane Regional Medical Center.Warning signs you may need your appendix removed.Global Alliance for Infections in Surgery.An evidence-based approach to acute appendicitis.Bolakale-Rufai IK, Irabor DO.Medical treatment: an emerging standard in acute appendicitis?Niger Med J. 2019 Sep-Oct;60(5):226-233. doi:10.4103/nmj.NMJ_65_19Mount Sinai.Appendectomy.Fan SM, Grigorian A, Smith BR, et al.Geriatric patients undergoing appendectomy have increased risk of intraoperative perforation and/or abscess.Surgery. 2020;168(2):322-327. doi:10.1016/j.surg.2020.04.019Alhamdani YF, Rizk HA, Algethami MR, Algarawi AM, Albadawi RH, Faqih SN, Ahmed EH, Abukammas OJ.Negative appendectomy rate and risk factors that influence improper diagnosis at King Abdulaziz University Hospital.Mater Sociomed. 2018 Oct;30(3):215-220. doi:10.5455/msm.2018.30.215-220Vanderbilt University Medical Center.Treating appendicitis with antibiotics instead of surgery may be good option for some, but not all, patients.Haijanen J, Sippola S, Tuominen R, Grönroos J, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Salminen P.Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial.PLoS One. 2019 Jul 25;14(7):e0220202. doi:10.1371/journal.pone.0220202The New England Journal of Medicine.Antibiotics versus appendectomy for acute appendicitis – longer-term outcomes.American College of Emergency Physicians.Stomach pain.Johns Hopkins Medicine.Appendicitis.JAMA Network.Acute appendicitis.Mariage M, Sabbagh C, Grelpois G, Prevot F, Darmon I, Regimbeau JM.Surgeon’s definition of complicated appendicitis: a prospective video survey study.Euroasian J Hepatogastroenterol. 2019 Jan-Jun;9(1):1-4. doi:10.5005/jp-journals-10018-1286Salminen P, Tuominen R, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Mecklin JP, Sand J, Virtanen J, Jartti A, Grönroos JM.Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial.JAMA. 2018 Sep 25;320(12):1259-1265. doi:10.1001/jama.2018.13201Shah SS, Gaffney RR, Dykes TM, Goldstein JP.Chronic appendicitis: an often forgotten cause of recurrent abdominal pain.The American Journal of Medicine. 2013;126(1):e7-e8. doi:10.1016/j.amjmed.2012.05.032Lee CK, Pelenyi SS, Fleites O, Velez V, Alaimo KL, Ramcharan DN, Tiesenga F.Chronic appendicitis, the lesser-known form of appendiceal inflammation: a case report.Cureus. 2021 Nov 18;13(11):e19718. doi:10.7759/cureus.19718Adhikari R, Simkhada P, Mandal D, Kunwar A, Dhital SP.Appendicular and caecal fecalith causing perforation: a case report.JNMA J Nepal Med Assoc. 2020 Apr 30;58(224):255-257. doi:10.31729/jnma.4711Prevention.9 things you need to know about your appendix.
U.S. Pharmacist.Antibiotics, not surgery, for uncomplicated appendicitis now routine.
Lane Regional Medical Center.Warning signs you may need your appendix removed.
Global Alliance for Infections in Surgery.An evidence-based approach to acute appendicitis.
Bolakale-Rufai IK, Irabor DO.Medical treatment: an emerging standard in acute appendicitis?Niger Med J. 2019 Sep-Oct;60(5):226-233. doi:10.4103/nmj.NMJ_65_19
Mount Sinai.Appendectomy.
Fan SM, Grigorian A, Smith BR, et al.Geriatric patients undergoing appendectomy have increased risk of intraoperative perforation and/or abscess.Surgery. 2020;168(2):322-327. doi:10.1016/j.surg.2020.04.019
Alhamdani YF, Rizk HA, Algethami MR, Algarawi AM, Albadawi RH, Faqih SN, Ahmed EH, Abukammas OJ.Negative appendectomy rate and risk factors that influence improper diagnosis at King Abdulaziz University Hospital.Mater Sociomed. 2018 Oct;30(3):215-220. doi:10.5455/msm.2018.30.215-220
Vanderbilt University Medical Center.Treating appendicitis with antibiotics instead of surgery may be good option for some, but not all, patients.
Haijanen J, Sippola S, Tuominen R, Grönroos J, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Salminen P.Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial.PLoS One. 2019 Jul 25;14(7):e0220202. doi:10.1371/journal.pone.0220202
The New England Journal of Medicine.Antibiotics versus appendectomy for acute appendicitis – longer-term outcomes.
American College of Emergency Physicians.Stomach pain.
Johns Hopkins Medicine.Appendicitis.
JAMA Network.Acute appendicitis.
Mariage M, Sabbagh C, Grelpois G, Prevot F, Darmon I, Regimbeau JM.Surgeon’s definition of complicated appendicitis: a prospective video survey study.Euroasian J Hepatogastroenterol. 2019 Jan-Jun;9(1):1-4. doi:10.5005/jp-journals-10018-1286
Salminen P, Tuominen R, Paajanen H, Rautio T, Nordström P, Aarnio M, Rantanen T, Hurme S, Mecklin JP, Sand J, Virtanen J, Jartti A, Grönroos JM.Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial.JAMA. 2018 Sep 25;320(12):1259-1265. doi:10.1001/jama.2018.13201
Shah SS, Gaffney RR, Dykes TM, Goldstein JP.Chronic appendicitis: an often forgotten cause of recurrent abdominal pain.The American Journal of Medicine. 2013;126(1):e7-e8. doi:10.1016/j.amjmed.2012.05.032
Lee CK, Pelenyi SS, Fleites O, Velez V, Alaimo KL, Ramcharan DN, Tiesenga F.Chronic appendicitis, the lesser-known form of appendiceal inflammation: a case report.Cureus. 2021 Nov 18;13(11):e19718. doi:10.7759/cureus.19718
Adhikari R, Simkhada P, Mandal D, Kunwar A, Dhital SP.Appendicular and caecal fecalith causing perforation: a case report.JNMA J Nepal Med Assoc. 2020 Apr 30;58(224):255-257. doi:10.31729/jnma.4711
Prevention.9 things you need to know about your appendix.
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