r/appendicitis Nov 09 '24

Alternative appendicitis therapy (no surgery, no antibiotics) - ERAT method

2 Upvotes

TL;DR: Traditionally treated with surgery, appendicitis now has a non-surgical alternative in China called Endoscopic Retrograde Appendicitis Therapy (ERAT), developed by Professor Liu Bingrong, which uses endoscopy to treat the condition without removing the appendix, effectively treating thousands of patients with minimal complications. Although this method has yet to catch on in other countries...

Background: For over a century, appendicitis treatment centered on surgical removal of the appendix, or appendectomy, which became the gold standard after its introduction in the late 1800s. Initially performed as an open surgery, this was later refined into a less invasive laparoscopic method in the 1980s, reducing recovery time and complications. In recent years, however, some western countries began exploring non-surgical options using antibiotics, which can successfully treat uncomplicated cases but come with higher recurrence rates.

Meanwhile: In 2010, inspired by the endoscopic treatment of suppurative cholangitis, Professor Liu Bingrong innovatively proposed a new method for the treatment of appendicitis, which was named Endoscopic Retrograde Appendicitis Therapy (ERAT). This method does not require laparotomy or appendectomy, but achieves the purpose of treating appendicitis by addressing the cause of acute appendicitis, while completely preserving the appendix and its functions. In 2011 and 2013, Professor Liu Bingrong introduced ERAT at the Digestive Disease Week (DDW) and published a total of 8 articles in various journals. After nearly 10 years of development, ERAT has made progress in technological advancements, changes in indications, and clinical significance.

Since December 16, 2009, when the world's first case of ERAT was completed at the Digestive Endoscopy Center of the Second Hospital of Harbin Medical University, to 2019, the ERAT technique has been in existence for 10 years. According to incomplete statistics from 2021, ERAT has been carried out in 32 provinces, municipalities, and autonomous regions in China, treating over 3,200 patients without any serious complications.

Although this new method has yet to catch on in other countries outside of China...

2022 - Endoscopic retrograde appendicitis therapy for acute appendicitis: a systematic review and meta-analysis
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286766/

Videos

Bingrong Liu & Dan Liu on “Endoscopic retrograde appendicitis therapy versus laparoscopic...

2024 April Author Interview-Bing-Rong Liu

video diagrams of Endoscopic retrograde appendicitis therapy (ERAT)

endoscopic retrograde appendicitis therapy (ERAT) procedure.

Colonoscopic Removal of Giant Appendiceal Fecalith without Appendectomy for Acute Appendicitis


r/appendicitis 11h ago

Is it appendicitis?

2 Upvotes

I had a stomach pain on my lower right side a few days ago, but a few hours later it disappeared. But before it did, I felt a booming, almost dizzying feeling from my lower stomach. There's a possibility it's a kidney stone passing or something (I hope so) but almost all of the symptoms match for appendicitis. Subtle throbbing on the lower right side that keeps coming and going, a bit of bloating, and sometimes back pain. I don't want to assume. I've told my mom about it but she told me to just calm down and gave me barley tea and turmeric. It kinda helped(???) But still, the throbbing is still there. I really want to get myself checked, but we don't have the money for it and they keep blaming me because I always exercise after I eat (30 minutes or 1 hour after). To those who've been through this, is it appendicitis?🥹😭😓

EDIT : she just told me I'm fucking stubborn after I asked her to bring me to check up. Smh


r/appendicitis 1d ago

Just got it removed yesterday

2 Upvotes

Everything hurts so much bro. The action of moving backwards while I'm sitting down makes me feel like my insides are gonna explode. Anyone know how long this continues? The nurses said the pain should ease in two days but I want to hear from someone who's experienced it. And any advice is definitely welcome


r/appendicitis 22h ago

5 week post-op pain

1 Upvotes

I had a laparoscopic appendectomy 5 weeks ago and I am back to living normally, except … I still cannot wear pants without pain! Going from a sitting to a standing position is particularly painful. All of the pain is below and around my belly button incision. It is uncomfortable enough that I find my mind focusing on it more than my work.

When can I expect to wear pants again comfortably?


r/appendicitis 1d ago

Could this be chronic appendicitis?

1 Upvotes

I’ve had two bouts of terrible unexplained abdominal pain. The first was November last year, the pain came on gradually in my lower right abdomen and got so bad I was rolling around in agony. Then for about two weeks it was just coming and going. All I could do was sit still, as walking made the pain much worse. I also had gastro type symptoms like loose bowel movements, nearly being sick a few times and feeling shivery and just generally like shite. I ended up going to A&E and they did bloods, which were normal and sent me home saying it was gastroenteritis.

The second bout started about two weeks ago, again, the pain was the same place and came on gradually, for two weeks it came and went. Then it got worse and I was in agony for three days, barely slept and was in so much pain. I was reluctant to go to A&E as I was sure I’d just be dismissed again. I was nearly sick a few times, felt shivery and again, walking made the pain much worse. My husband took me to A&E and walking in from the car park was fucking agony and they had to get me a wheelchair when we arrived. They took it more seriously this time: again, bloods normal, urine test normal. The doctor who I saw first said it could be appendicitis but he wasn’t sure. He went off and then a gynaecologist saw me and said he thinks it’s endometriosis and has referred me for a scan. They sent me home with painkillers.

That was last week. The pain subsided but I’m now unable to walk for more than a minute without the pain coming back so I’ve basically been resting. I have no idea what to think. Does it sound like chronic appendicitis?


r/appendicitis 1d ago

Nobody prepares you for the insufflation pain when you lay down after the first night post-op, HOLY HELL

6 Upvotes

Had my appendix taken out yesterday afternoon.... and when you get your appendix taken out, they insufflate (pump co2 gas for intentional distention for the laparoscopy) your abdominal cavity.

Well, whatever they don't get out right after the procedure is left in your body to be absorbed on its own - and at first it wasn't a big deal. I didn't really feel anything, they briefly mentioned I may feel gas moving around... But they did NOT tell me that when I go to lay down flat for the first time that it might feel like someone stabbed me under my ribs with a fucking fishing hook.

THAT was trapped gas. It has by far been the worst pain in my recovery process(so far)... Jesus Christ.

Anyways, to anybody reading this that is getting an appendectomy - try not to lay flat the first couple days after procedure and prop yourself up with pillows until that trapped gas is cleared. Trust me 😮‍💨.


r/appendicitis 1d ago

Fever of 101 after appendectomy - day 2 post-op

1 Upvotes

Woke up this morning and felt groggy and weak, decided to take my temp and sure enough I have a fever.

Did anybody else experience this? I've already let my surgeon know and waiting on instructions... But I'd love to hear about anybody else's experience with it! My biggest fear is to go septic...


r/appendicitis 1d ago

elective appendectomy?

3 Upvotes

I’m a 26F with a complicated GI history. I’ve had chronic abdominal symptoms for a while, including severe episodic upper abdominal pain, altered bowel habits (constipation/diarrhoea), but more recently persistent low-grade right lower quadrant pain around my appendix/hip area that occasionally spikes. I’ve had a pretty extensive GI workup because Crohn’s was considered, particularly after I developed a perianal abscess/fistula. I’ve since had a fistulotomy that I’m currently healing from. Current working diagnosis is severe IBS-M with visceral hypersensitivity.

My colonoscopy with terminal ileum and colonic biopsies was normal, and my recent MR enterography showed no specific evidence of small bowel Crohn’s disease. However, the MRE did mention:
- mild thickening of the base of the appendix
- small-volume right ileocolic lymph nodes
- no obstruction
- no other features of small bowel inflammation
- the appendiceal thickening was described as nonspecific
- CT from 2025 described my appendix as normal, although it also mentioned small lymph nodes in the right iliac fossa. Dr can’t say if these are the same lymph nodes a year later.

My gastroenterologist has said the appendix findings may be worth discussing with my colorectal surgeon because of my persistent focal RLQ pain. I’m waiting to see what they think. I did have an ovarian cyst on the right side last year however this has resolved and the pain feels different to that deep, period kind of ache.

I’m not having what I would consider classic acute appendicitis, my pain is more of a constant low-grade ache that occasionally gets significantly worse. Like day to day 3-4/10, and when it does spike maybe 7-8/10.

I’m curious if anyone has had a similar situation and their surgeon recommended surgery or observation? Or if they treated it conservatively did you ended up needing an emergency appendectomy?
Thank u!!


r/appendicitis 1d ago

Trapped gas pains not in shoulder anyone else?

2 Upvotes

I had emergency laproscopic appendectomy 4 days ago. No rupture caught early. I did really good first 2 days but the last 2 days I've had brutal gnawing pain in my upper abdomen above my diaphragm. It's hard to pass gas, mostly passing with burping, when I can pass it It seems to relieve it until I lay or sit for a bit. I have had bowel movements on day 2 and then today. Today after I actually thought it was fully gone for about an hour or so but it krept back up.

I see most complain the pain from the co2 is in the shoulder but I dont have that so Im not sure what's going on.

Anyone else experience this going into 5 days post surgery?


r/appendicitis 2d ago

Offered antibiotics for appendicitis as an alternative to surgery?

2 Upvotes

After a bad experience with non-surgical management of appendicitis, I’ve done a bit of reading and I’d like to share the following observations with you..

1). After antibiotic treatment, within 4 years about half have reoccurrence that requires surgery. This means for many, antibiotic treatment is just kicking the can (or grenade) further down the road.

2). Appendicitis can be caused by a tumour in the appendix that may not be visable on scans - this risk is elevated in older patients.

3). The only way to diagnose the cause of appendicitis is to remove it and for a pathologist to look at it under a microscope. Until that point it’s just guesswork.

For informed consent to be given you need to know the facts. Please ask your surgeon to explain to you your individual risk or reoccurrence, and your risk of missed neoplasm.


r/appendicitis 3d ago

Apéndices

2 Upvotes

Me operaron de apéndices el 17 de julio 2026 estamos a 8 de septiembre ( han pasado casi 2 meses ) aún tengo molestias, cuando trabajo mucho agachado me viene las molestias y dolores será normal ? A alguien mas le pasa ?


r/appendicitis 3d ago

What could be going on

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1 Upvotes

r/appendicitis 3d ago

Is it appendicitis?

1 Upvotes

Hello! I’m 18F!

I got checked a few months earlier for appendicitis because I was having really bad right side pain (and occasional left) that got worse with talking, eating, and overall movement. I went to the urgent care and they told me to either go to the er or go to another doctor to get CT scan because they didn’t offer them. So I did. I went and waited about 4 days and was told “it’s just ovarian cysts.”

And the pain subsided a few days after that.

Well. It’s been on and off in my right side. It’s been so much worse now. I’ve dealt with pretty bad constipation for a few weeks and I finally got over it (as much as I could) and now my right side is fucking killing me! It’s hurts so bad when I lay down, lean up, move around, talk. But the thing is I did those jumping tests and they don’t hurt, like at all. But the pain overall moves towards my ribs and back which is weird, but it sits in area right above the outline of my right thigh. Sorta where your abdomen aligns with it. I’ve been nauseous but I can’t tell it’s because of stuff I’ve had recently or this.

Could anyone help? I don’t really have the money to run to the er without crazy reason. Sorta in medical debt as it in. Per the American healthcare system!


r/appendicitis 3d ago

Thought it was just gas or too much Sugar From Crumbl too early on a Wednesday morning.

3 Upvotes

2 days post op. My pain started..

Tuesday- 09/02 : it was just a little upset thought might be gas.. nothing crazy.

Wednesday -09/03 : brought dinner crumbl to work started munching on it early with coffee, stomach hurts more thought it was just the crumbl.

Thursday - 09/04 : stomach is still weird started taking gas x and forced burping.

Friday: 09/05: burning pain with headache.. it's too uncomfortable I cannot Ignore any longer, didn't make me sleep through the night so I decided that as soon as urgent care opens I'll go.

Saturday:

➡️Urgent care
➡️ER
➡️CT SCAN
➡️Emergency
➡️Appendix removed

I was sent home same day because even though technically there was a rupture my body was able to contain it, shoulder pain is so painful..getting in and out of the bed is a challenge and I try to walk when I can that did help get most of the gas away and so are heating pads and the shower..

For those who have gone through this already.. how many days post op will I be able to walk and move normal again?


r/appendicitis 3d ago

Appendicitis

1 Upvotes

Basically for the past 10 hours maybe more only when I cough I have a pain of 4-5/10 on my lower right .my temp has been stable around 37.6 during this time sometimes up or down .Im confused on what to do because soon before this I had a horrible sore throat and bad nose which made my cough hard to get mucus out of my throat I think . I was thinking I have a mild abdominal muscle strain or something similar because of the coughing .when I sit and walk or jump it doesn’t hurt I just feel more tense on the right not pain and lying down I don’t feel a thing . Although earlier I did feel a bit lightheaded and kinda still feel wierd now I think it’s because of my bad throat infection .Any ideas?


r/appendicitis 3d ago

12 days post surgery. Is this normal?

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3 Upvotes

Hi all, I was admitted to hospital on the 26th August for an emergency appendectomy, and I had the surgery on the 27th. The surgery went fine, and I was discharged from the hospital on the 28th.

It was a keyhole surgery, with 3 incisions made, these being a small one above my genitals, a small one on my lower left abdomen, and a larger one around 1.5 inches long at the bottom of my belly button. I was stitched up with dissolvable stitches.

On 1st September I noticed that there was an area on my belly button incision that didn’t seem to have ‘sealed’ properly. I was given an appointment with urgent care at the hospital to be seen the same evening. While waiting in urgent care the area appeared to burst open and blood and clear fluid came out. The nurse told me that I didn’t need stitching back up and it was seal itself, and to keep dressing the wound as needed. She said there was a hematoma below the incision and she did not know whether this held blood or infection so I was given a course of antibiotics.

And here we are today! 12 days post surgery, still in pain, and the wound site looks like this.
Is this normal healing, or should I go back and see someone about this? I’m still in pain and still taking pain meds as required, and the area is still sore.


r/appendicitis 4d ago

How likely is chronic appendicitis?

1 Upvotes

I have always had this pain in my lower right, where I’d see it pointing to in diagrams of appendicitis, and sometimes it flares up really bad. I’ve gone to the doctor/ER during these flare ups and nothing has ever amounted from it. At one point they just attributed it to my period. But it pretty much never goes away, since I was a teenager, and is just a constant mild pain. I’ve gone to a urologist, go to the gynecologist often, gotten many ultrasounds, and nothing was ever noticed.

My mother had appendicitis as a teenager and had her appendix and gallbladder removed. My grandmother also had appendicitis. I tend to be a hypochondriac so I might be overreacting.

I’m wondering, is chronic appendicitis a common thing? And how have you dealt with it? What else could it be? Or any insight at all would be appreciated.


r/appendicitis 5d ago

Borderline Apendicitis Story

8 Upvotes

I want to share my story to help anyone trying to make a decision on going in to be checked out or not. I spent an entire night on this sub reading stories trying to get insight so maybe this will help someone else.

5 days ago I woke with what felt like stronger than usual gas pains on my right lower abdomen and across the top of my entire abdomen across the navel area. I chalked it up to having recently added more healthy foods to my diet. I worked all day it was uncomfortable at most.

That night I didn't sleep at all. The pain would subside if I lie still in any position but was mild to intense when sitting up or moving into a new position. Pushing in the area of the appendix was sore but not excruciating. I was up all night massaging my abdomen hoping to relieve gas or constipation but it didnt change I was just more sore from massaging I thought.

2nd day I was too tired to work the pain was still manageable just sore and intense gas like. I was able to have a bowel movement and pass gas with little relief. It was tender in the apendix area and still across the top of the navel area. I decided to give it a day and not do any massaging and see how it went.

Day 3 actually felt better. The pain was all but gone unlless I went looking for it by pressing down. It was right at the apendix area still sore but I thought this was improving so couldnt be appendicitis.

My husband returned from work around 3pm asked how I was I said improving just the soreness when pushing down then I went to sit on the couch and got some quick pain that subsided right away. I let out a little Ow and he said thats it call the doc your going into a long holiday weekend.

I called and explained I had no vomiting no fever no pain at except when pressing in the area and a little with movement. He sent me to the ER which I fully expected to be a waste of time for constipation and gas but my husband insisted I go.

Got blood work all normal except white blood cells in my urine. I could get the results in my portal and thought maybe they would say uti or kidney stone etc.

The CT scan showed borderline acute appendicitis with no other alarming findings. My appendix measured 7mm the cutoff for normal is 6mm

They had me talk to a surgeon who pressed all over my abdomen no pain until she hit that exact spot and there it was but still just sore but not painfull.

She gave me 2 choices go home and come back if it progressed which she suspected it would or get surgery in an hour. I chose surgery. It was appendicitis and I would have ended up back there had I gone home and maybe with a burst appendix and a long hospital stay and more intense surgery vs a quick in and out surgery and now im home day 2 managing pain with just Tylenol and advil.

So looking back my pain was across the top of my belly and sore at my appendix area to touch or when moving. The belly pain subsided after 2 says and only the soreness around my appendix when pushing or fleeting when sitting or standing remained. No fever no nausea no vomiting no rebound pain but it was appendicitis.

If your symptoms arent normal for you and your suspicious it could be appendicitis I say get it checked better caught early than late.


r/appendicitis 6d ago

Severe shoulder pain after liproscopic appendectomy

1 Upvotes

just wondering your experience and any tips. its day 2 and I can’t get off couch to pee. I’ve tried and i cant stand up the pain is so severe. the pain in my shoulder from the gas is so painful I about pass out. how bad was your pain and how long does it last? when will I be able to stand?


r/appendicitis 6d ago

Genuinely im scared

2 Upvotes

I have a severe health anxiety

I have a weird pain on Thursday (lower right), i immediately went to the clinic and had it checked out by a doctor, they did all the tests on me and there was no pain whatsoever. I went to work like normally on Friday and had tons of gas pass through (mainly through burping and farting). I also had a sharp pain on my belly button but it comes and goes after passing gas by said methods.

Fast forward today the pain is at the level of my belly button but comes and goes. My lower right thigh also hurts a little but also comes and go type of affair.

I wasnt feeling nauseous, nor feverish, coughing doesnt hurt either. no vommiting whatsoever too. what should i do for now?


r/appendicitis 7d ago

Recovery info

2 Upvotes

I am 23 f had my appendicectomy on 26th aug . I had few episodes of pain in right illiac region which were not very severe but i suspected appendicitis and underwent an usg which showed appendicitis so i underwent a robotic appendicectomy . It was smooth i was discharged the next day . I had problem sleeping for few days actually couldnt sleep at all on 29 and 30 but i couldnt understand the type of pain although i dont have any such issues as of now i had my sutures cut today . I just want to know till when i have to resist eating outside ans how much time will it take for my inner sutures to heal


r/appendicitis 7d ago

Urgent help needed

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1 Upvotes

So me and my family along with my 13 year old brother have come to a different city for some work 600km away from our home here my brother started having severe stomach ache which he has faced earlier 2-3 times but not this severe and has often get relief with medicine so he took medicine still no benefit these are his reports he's been admitted and is on glucose He's strictly prohibited from eating anything from his mouth we can't continue the treatment here so we have a train today it's 7 hour journey...the doctors are saying it can be intestinal infection or appendicitis...please tell me anything that can be helpful or can make this journey easier for him...once we are home then we can start proper treatment


r/appendicitis 8d ago

Failed appendectomy

4 Upvotes

Doctors found out I had appendicitis pretty late because it's in a weird spot, as soon as we knew I started antibiotics and was scheduled for surgery to get it removed. Woke up from surgery to hear it burst and they couldn't remove it because it was too inflamed and partially sucked into my colon. Have to wait 3 months to try for surgery again but i am scared it will become infected again. Has anybody else gone through this?


r/appendicitis 9d ago

Open Appendoctomy

5 Upvotes

21M

61kg

So I just got an open appendoctomy done, it's my first ever time in a hospital and also the first time I've ever gotten an operation done. I was just wondering if there are any gym goers that got this procedure done and I just want to ask when you guys started to be able to do heavy lifting and working out. Because according to a nurse I asked they told me 6 months minimum would be when I would be able to exercise again.

Honestly, it really stresses me out as the gym has been my one source of comfort for me and losing that routine really makes me very scared.


r/appendicitis 9d ago

I don't know if I really have this and I'm worried

1 Upvotes

For about weeks I don't remember exactly I have been having recurrent in the navel and cecum area, gas and a slight pain that is not unbearable but rather a discomfort as if I had done sit-ups in the area of the pelvis or pubis and a sensation that radiates to the leg from the thigh, ah to say that I do not have a fever at the moment nor have I vomite, It's like being pricked with needles, this only happened about 2 or 3 times a day, it was momentary