Appendicitis and antibiotics

In the 1994 film “Dumb and Dumber,” after Lloyd (Jim Carrey) gets robbed by an old lady on a motorized cart, he says to Harry (Jeff Daniels), “I didn’t even see it coming.”

Well, folks who get appendicitis rarely see it coming, even though we can safely assume that they’re a lot smarter than Lloyd or Harry. But if you’re fortunate enough to have acute yet uncomplicated appendicitis diagnosed (as opposed to being surprised with a ruptured appendix), it’s good to know that recent research shows that antibiotic treatment has outcomes equal to surgery, which makes it a good option, because you avoid surgery!

Abdominal pain, fever and nausea are symptoms of an infected appendix, the small fingerlike tube located near the juncture of the large and small intestines. It can be diagnosed using ultrasound, a rectal exam, and urine and blood tests. When an infected appendix ruptures, it can cause abdominal peritonitis with scarring and runaway infection.

Although antibiotics sometimes are used in mild cases of appendicitis, many doctors have been concerned that they were just a temporary fix and that if surgery were needed later they could worsen surgical outcomes. But a fiveyear study published in JAMA has delivered good news on both fronts.

First, two-thirds of the patients with uncomplicated cases who were treated with antibiotics ended up not needing surgery, and the one third who did were no worse for wear for the surgical delay. So if you think you may have symptoms of appendicitis, quick action may prevent surgery altogether!