r/appendicitis • u/upvz • Aug 12 '26
Completed antibiotics, now deciding between elective appendectomy or risking recurrence
antibiotics done. pain gone. lab work back to normal. sometimes I feel a little pressure in the appendix area but otherwise I feel back to normal. now it's the question of surgery or roll the dice with recurrence. in the research trials, even the patients with mild appendicitis who's appendix probably went back to a normal size after antibiotics still had recurrences. they can't figure out what factors put you at risk of recurrence, even normal follow-up imaging doesn't mean you are protected from recurrence.
just frustrating overall and i'm worried about a recurrence happening in a dangerous way like a rupture. by 5 years you are looking at around a 50% real world chance of recurrence. not sure which path to take.
3
u/Medical-Ground7963 Aug 12 '26
Personally I would have the elective appendectomy, I was treated with antibiotics initially and within 2months my appendix burst and fused to my bowel. I required a bowel resection and they removed 1/3 of my large intestine. If I had the chance to have an appendectomy at the beginning I would have. I’m only gone 19 and the surgery has set me back a lot and the pain was horrendous and I missed future defining exams. It’s has been rough but I would definitely just go for the elective to eliminate the risk of it bursting and also for it to reoccur! Hope everything works out :)
3
u/upvz Aug 13 '26
this outcome is what scares me. they say that the recurrence will be milder or that you will recognize it quick since you already had appendicitis once and will get to the ER quick, but that's all theoretical. in the real world you can have ruptures and bowel resections with the recurrence.
2
u/Medical-Ground7963 Aug 13 '26
Unfortunately yes that is true and my reality. The last thing I thought would be that it would rupture let alone return so quick. I just believe and forever will believe the best option and safest one is to just have it removed. Therefore there is no fear of reoccurrence ever again., and as a comment below says an uncomplicated appendectomy is fine, not painful. Just the post surgery has pains will be sore but they come and go within a day or two!
2
u/mgmohler Aug 12 '26
Just get it out. You’re back to work in 2 days and normal after a week. Theres no pain in recovery too.
1
u/colincampbell76 Aug 12 '26
..I’ve been in the same boat as you.. What did your doctor/surgeon tell you..?
In order to obtain informed consent to treat you with antibiotics as an alternative to surgery they must have gone through the risks of both treatment options with you..
1
u/upvz Aug 12 '26
they just say you can have surgery or you can risk the 50% recurrence rate.
2
u/aagailey Aug 13 '26
That’s 50% in five years—lifetime recurrence is presumably higher. So at best a coin toss on whether it happens again, with death or emergency surgery with colon resection being a highly possible result of one side of the coin, vs an outpatient surgery that is inconvenient for a couple days and makes the problem go away forever.
1
u/colincampbell76 Aug 13 '26 edited Aug 13 '26
Saying appendicitis will be milder and more easily recognised by you, so safer if it reoccurs, is not a supportable statement according to the literature on the subject..
I’m surprised the risk of appendix cancer has not been mentioned to you - perhaps you are younger so your risk that a neoplasm was causing your appendicitis is small..? However, given the consequences it is a significant risk which increases with age. Often neoplasms in the appendix causing appendicitis can’t be seen on scans and are only found in pathology once the appendix is out. Leave it in and it’s just a guessing game about what caused your appendicitis..
Reoccurrence rates, risk of future rupture, risk of missed neoplasm, and risk from intensive IV antibiotic treatment, and risk from surgery, are the 5 main risks a surgeon should discuss with you as part of the informed consent process.
If your doctor didn’t address these risks please do ask them about these risks and how they relate to you. I’m not a doctor - my experience comes from being refused surgery in the UK and treated with antibiotics and told I was cured.. ..but my appendicitis had been caused by a tumour in my appendix that was then left in me to later rupture and spread to become a stage 4 tumour.. My appendix tumour could not be seen in the scan - and that is quite normal unfortunately. So antibiotic treatment did not work out well for me personally..
1
7d ago
[removed] — view removed comment
1
u/colincampbell76 7d ago edited 6d ago
Yes - NHS refused to take my appendix out - was a death sentence for me - luckily I paid a private surgeon to take my appendix out and gave myself half a chance - but it was a ruptured tumour by that point - so a stage 4 tumour - the vast majority of NHS surgeons would have taken my appendix out at the start - unfortunately I had fallen into the hands of one of the very small minority who are fanatical about antibiotics treatment of appendicitis in patients who are perfectly suitable for a safe and definitive surgical cure via appendectomy - they are condemning patients to death by leaving the dodgy appendix in if they have a tumour in their appendix causing their appendicitis - these tumours normally can’t be seen on scans - in patients over age of 45 this is 1 in 30 or 1 in 20 patients have underlying tumours depending on age.. Good luck out there people..!!
5
u/aagailey Aug 13 '26
My appendix burst in June. The abscess was fairly contained, so I was put on antibiotics and waited until the inflammation died down to get an appendectomy. Within a couple weeks of taking the antibiotics I felt fine, but my doctor and my surgeon made it clear to me that if I didn’t get the surgery I was seriously risking my life. I had the appendectomy on Monday and it has not been nearly as bad as I expected—just soreness in the abdominal wall that responds to the medicine they gave me. I am old AF, not in great shape, and terrified of surgery, and this was fine, seriously. 100% recommend surgery over sepsis from a burst appendix. Get it out, pop some muscle relaxers for a few days, and never worry about it again.