Appendix Removal Might Be Avoided Thanks to Antibiotics, New Study Finds

A team of Finnish researchers just released a “new era of appendicitis treatment,” one that doesn’t require one of the most common surgeries in the world.

The full study conducted by Turku University Hospital in Finland was published in the Journal of the American Medical Association Network.

What's the point of an appendix, and why remove it?

Appendix removals are the most common emergency surgeries conducted around the world. In the United States alone, over 300,000 appendix removals happen each year.

But how does this incredibly small, “useless” organ contribute to so many surgeries? The actual function of the appendix remains one of the biggest mysteries of the human body. The 3.5-inch tube dangles from the large intestine, and certain theories boil down to it once playing a role in gut health.

However, the appendix can easily get inflamed, eventually bursting (perforating) and spill the infected material into the abdominal cavity and damage other organs. It’s because of this escalation of the issues in the infected areas that doctors consider anything involving an infected appendix as an emergency.

While appendicitis can strike at any age, it’s most commonly seen in people between the ages of 10 to 30. In the United States, one in 20 people will get appendicitis and need some sort of treatment option.

There are a handful of tell-tale signs of a ruptured appendix. In kids and adults, it can be seen in a strong pain around the belly button or in the lower right part of the belly. There’s often a loss of appetite, nauseated feelings, vomiting, and low-grade fevers. Appendicitis also makes it hard to pass gas. 

Due to the relatively low-risk nature of an appendix surgery, it’s the go-to treatment. Removal normally prevents subsequent infections.

Finding an alternative to going under the knife

In recent years, CT scans have made it easier for doctors to see what’s going on in an inflamed area and make better determinations as to whether the tiny appendage might burst.

A team from Turku University Hospital spent over five years seeing if those CT scan improvements could help doctors determine more effective ways to treat appendicitis -- ones that didn’t involve surgery.

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After ruling out the most severe cases of appendicitis, the Turku researchers studied 500 Finnish adults over the course of five years of treatment. Half of them received antibiotics as their treatment, getting prescription antibiotics doled out to them at regular intervals. The other half had traditional surgery.

Of the antibiotics patients, 100 needed surgery within five years of the treatment. A majority of those surgeries were due to possibly getting appendicitis again within the first year of treatment. Seven of those 100 did not have appendicitis, however, and could have avoided surgery. According to the researchers, antibiotic treatments had a 64 percent success rate among subjects.

Patients who had surgical treatments had their share of complications. One in four patients who had an appendectomy had complications and infections as a result of the surgery. They also had 11 more sick days than the average of the antibiotic group. (It is important to note that the study indicates Finnish patients had conventional incisions rather than the less invasive options now found in the United States.)

Other researchers told media outlets the Finnish researchers’ study gives them an important alternative. However, it might not have the final solution.

Giana Davidson is a surgeon at the University of Washington in the US. She told reporters the Turku study is a “critical piece to the puzzle, but I don’t think it answers all of the questions.”