Can appendicitis recur?

Written by Ren Zheng Xin
Gastroenterology
Updated on January 15, 2025
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Acute appendicitis, if not treated surgically, can relapse under poor lifestyle and dietary habits and then transform into chronic appendicitis. Therefore, appendicitis can recur. However, if the appendix is removed during an acute episode of appendicitis, then appendicitis will not recur. Currently, the primary clinical treatment for appendicitis is surgery, because without surgery, the recurrence rate of appendicitis is quite high, and ultimately, the appendix must be removed.

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Can appendicitis be contagious?

Appendicitis is a nonspecific inflammation occurring in the lumen of the appendix. It is not contagious, therefore, it is not an infectious disease. Once appendicitis is diagnosed, it is mostly treated surgically because the main blood supply to the appendix is the appendicular artery, which can easily lead to ischemic necrosis during inflammation. If controlled solely by medication, symptoms are likely to recur easily. Currently, appendectomy is commonly performed using minimally invasive techniques, under laparoscopy, which results in less bleeding during surgery and faster recovery afterward. Generally, if there is no suppuration or perforation, patients can be discharged three days after surgery. Postoperative care should be enhanced, including eating more vegetables to prevent constipation.

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What are the symptoms of appendicitis?

Appendicitis is an acute inflammation occurring in the lumen of the appendix. The primary symptoms include fever, nausea, vomiting, abdominal tenderness, and rebound pain. Migratory right lower abdominal pain is a common indicator used for diagnosing appendicitis. Additionally, appendicitis located posterior to the peritoneum may also present with radiating pain in the lower back. Once appendicitis is diagnosed, surgical treatment is required, except for elderly or frail individuals who cannot tolerate surgery and may opt for conservative treatment. Laparoscopic appendectomy is a commonly used surgical method, as it involves less bleeding during surgery and faster recovery afterwards. Postoperative care should be emphasized, with adjustments in diet, and an increased intake of vegetables to prevent constipation.

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Gastroenterology
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Acute appendicitis clinical classification

Acute appendicitis can be classified into four types based on the clinical course. The first type is acute simple appendicitis, where the lesions are mostly confined to the mucosa and submucosal layer, with small ulcers and bleeding spots on the mucosal surface. The symptoms and signs are relatively mild. The second type is acute suppurative appendicitis, where the lesion has spread through all the layers of the appendix wall, and pus may accumulate inside, also known as acute cellulitis appendicitis. The third type is gangrenous and perforated appendicitis, which occurs due to pus in the appendix cavity causing increased internal pressure and circulatory disturbances in the appendix wall, leading to mucosal ischemic necrosis and perforation, causing acute diffuse peritonitis. The fourth type is peri-appendiceal abscess, which forms an inflammatory mass encapsulated by the surrounding omentum during suppuration or perforation of acute appendicitis.

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Is surgery necessary for appendicitis?

Once appendicitis is diagnosed, most cases require surgical treatment because the blood supply to the appendix is quite unique, with only the appendicular artery providing blood flow. If appendicitis occurs, it can easily lead to ischemic necrosis of the appendix, resulting in gangrenous appendicitis. Currently, laparoscopic appendectomy is a common surgical procedure, which is a minimally invasive treatment. For elderly or frail individuals who cannot tolerate surgery, conservative treatment is the only option. Postoperative care should be enhanced, with regular dressing changes at the incision site, and stitches can generally be removed one week after surgery. A semi-liquid diet is recommended for one to two days after surgery, and a regular diet can be resumed three to four days post-operation.

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How long to rest after appendicitis surgery?

After an appendectomy, if there is no significant suppuration or infection, a recovery period of at least two weeks is required. During this period, it is important to rest, pay attention to diet, increase nutrition, and increase protein intake, such as eating more chicken, fish, and soy products. Also, consume more vegetables and fruits, engage in appropriate exercises to increase gastrointestinal motility. The surgical incision should be dressed regularly, and sutures can be removed after a week post-operation, then depending on the condition, decide whether to change the dressing again.