Antibiotics for appendicitis may be as effective as surgery

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(CBS News) Appendicitis sparks fear of surgery in many. But a new study shows a course of antibiotics may be just as effective as an operation.

Medical emergencies: When to go to the ER

For the study, published April 5 in the British Medical Journal, researchers at the Nottingham Digestive Diseases Center compared antibiotic therapy and surgery. The study involved four trials of 900 adult patients diagnosed with uncomplicated acute appendicitis - 470 patients received antibiotics, 430 underwent surgery.

What did the researchers find? Antibiotic therapy was successful in 63 percent of the patients who received the treatment - with 31 percent fewer complications compared with surgery. And there was no significant difference in the length of hospital stay or risk of developing complicated appendicitis between the two groups.

An appendectomy - a surgical operation to remove an inflamed appendix - has been the standard treatment for appendicitis for more than a century. Antibiotic treatment was "often considered as a bridge to surgery in patients with suspected appendicitis," study authors wrote - but its role in treatment has been "overlooked mainly on the basis of tradition."

The study looked only at the effects of antibiotics in acute uncomplicated appendicitis. Researchers stressed that an early appendectomy is still the gold standard for those whose abdominal walls are punctured or inflamed. An appendix that has a hole in it can leak and infect the entire abdominal area, which can be life threatening.

According to the researchers in a written statement, antibiotic therapy "is a safe initial therapy for patients with uncomplicated acute appendicitis [and] merits consideration as a primary treatment option for early uncomplicated appendicitis."

Not everyone is on board with the new discovery - Dr. Olaf Bakker, from the University Medical Center Utrect, in the Netherlands, said in a corresponding editorial: "The use of antibiotics as first line treatment for appendicitis has major disadvantages." Bakker said "more convincing" longer term studies need to be published - with which Dileep Lobo, study author and professor of gastrointestinal surgery at the Nottingham Digestive Diseases Center, agreed.

[skeezix06]

It sounds a little like playing russian roulette with your life. I would insist that they remove my appendix if it ever gave me a problem.

[m0u5y]

Prevention
Countries with lower incidences of appendicitis also tend to have more fiber in their people's diets, compared to other countries. It would therefore be logical to assume that a high fiber diet may help reduce your chances of developing appendicitis. One theory is that with a high fiber diet the resulting softer stools are less likely to get trapped in the appendix.

[m0u5y]

I've had a few flame ups but nothing my body couldn't handle. Prevention is key -- bad diet is one problem. Don't abuse your appendix because it is actually an essential part of your body, just like your tonsils. I have both and am glad I kept them.

[skeezix06]

Sometimes body parts don't work the way they should. If we're lucky its only an appendix or tonsils and adenoids. If we're not, it could be the heart, the liver, or the brain. A person can live without their appendix, or (in my case) tonsils very well. In fact, my mother said I stopped getting sick once they took out my tonsils and I have to admit I've spent the last 50+ years with minimal, non-serious illnesses. Perhaps, just perhaps, removal of my tonsils is the reason I have had what a lot of people would consider an abnormally healthy life so far.

[rwsmith29456]

Medicine may be better now but some years back a guy I knew had his appendix bust on him. He was desperately ill and as far as I could tell never really recovered.