Appendicitis: Is surgery the only solution?

Antibiotics could be a solution to treat some uncomplicated appendicitis.

Recently, Rafael Nadal had to give up competing in a tennis tournament with Paris Bercy and go back to Spain to undergo surgery for appendicitis. On antibiotics for several weeks, the champion was hoping to escape surgery.

APPENDICITIS OR PERITONITIS?

From 1999 to 2012, the number of appendicitis surgeries fell by 34%. The reason?  Better screening procedures thanks to medical imaging, which removes the need for surgeons to intervene when it is not necessary. From now on, scans and ultrasounds can detect if the appendix is swollen, and can also precisely measure the level of inflammation. In the case of peritonitis (a condition in which the appendix breaks and thus causes an infection of the abdominal cavity), an emergency surgical operation is essential. But most of the time appendicitis does not get worse, provided that it is treated in time. And researchers might have found an alternative to surgery.

IS IT POSSIBLE TO TREAT APPENDICITIS WITH ANTIBIOTICS?

According to a meta-analysis of 2012, published in the British Medical Newspaper, antibiotics are as effective as surgery on less serious appendicitis cases. Medicine would moreover be particularly effective in helping to avoid the risks of infections after surgery. But after one year, 20% of the people treated by antibiotics relapsed. As this therapy is still a recent development, it is from now on impossible to estimate its long-term efficacy. Are antibiotics a real alternative to the appendectomy (ablation of the appendix) or are they only delaying the need for surgery? While waiting for the answer to this question, treatment by antibiotics is a real revolution in the management of this infection, which affects 1 in 15 people. Logically, the number of surgeries should decrease significantly in the coming years.

Source: report of the High Authority of Health, in November, 2012.

Maureen Diament