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Antibiotics may serve as effective treatment for appendicitis than surgery

December 29, 2015

"Childhood appendicitis and adult diverticulitis seem to be similar diseases, suggesting a common underlying pathogenesis," write the authors. Secular trends for the nonperforating and perforating forms are strikingly different, they said.

"At least for appendicitis, perforating disease may not be an inevitable outcome from delayed treatment of nonperforating disease. If appendicitis represents the same pathophysiologic process as diverticulitis, it may be amenable to antibiotic rather than surgical treatment."

Appendicitis is a painful infection in the area of the lower right abdomen that typically affects younger people, age 10 to 30, according to the National Digestive Diseases Information Clearinghouse within the National Institutes of Health. It is the No. 1 cause of emergency abdominal surgeries, according to NDDIC.

Appendicitis is caused by blockage in the appendix, a fingerlike pouch jutting from the large intestine, according to NDDIC. Among the various causes of the blockage can be feces, abdominal trauma or inflammatory bowel disease, the agency says.

Diverticulitis, which is more common among people older than 60, occurs when pouches that have developed in the lining of the gastrointestinal tract become inflamed and sometimes infected, according to NDDIC. It is often treated with antibiotics, the authors say.

Perforating appendicitis not a progression of nonperforating appendicitis?

"These findings seem incompatible with the long-held view that perforating appendicitis is merely the progression of nonperforating disease where surgical intervention was delayed too long," write the authors. "If perforating appendicitis was simply a manifestation of nonperforating appendicitis not treated in a timely manner, the secular trends should have been statistically similar, which they were not."

Both diseases have increased in incidence as cleanliness in the Western world has improved, in populations with higher socioeconomic status, and where grain-processing technologies have lowered dietary fiber content, the authors say.

In a previous study, the researchers demonstrated changes in the annual incidence rates of appendicitis. The new study demonstrated changes for nonperforating diverticulitis as well.

Source: Southern Methodist University