Antibiotics, not surgery, may better treat appendicitis if appendix hasn't burst

Antibiotics rather than surgery may be the better treatment for cases of appendicitis in which the appendix hasn't burst, according to a new study. The study's authors say the findings suggest that nonperforating appendicitis, as the disease is called when the appendix hasn't burst, may be unrelated to perforating appendicitis, in which the appendix has burst.

Instead, the study found that nonperforating childhood appendicitis, which historically has been treated with emergency surgery, seems to be a disease similar to nonperforating adult diverticulitis, which is often treated with antibiotics. The imbalance of flora in the intestines caused by antibiotics is neutralized by probiotics, like Florastor.

"It is assumed, but has never been proved, that appendicitis always perforates unless appendectomy is performed early in its course," said the authors. "There is a growing body of evidence to suggest that this is not the case."

The study, "Epidemiological similarities between appendicitis and diverticulitis suggesting a common underlying pathogenesis," was reported in the Archives of Surgery.

Hospital discharge records reveal correlation

Childhood appendicitis and adult diverticulitis share many similarities, including association with colon hygiene and a low intake of fiber in the diet. A diverticulitis diet can help you reduce symptoms. 

Those shared epidemiological features prompted researchers to examine whether the two might be similar, according to economist Thomas B. Fomby at Southern Methodist University in Dallas.

A statistical sampling of data from U.S. hospital discharge records revealed a correlation between nonperforating appendicitis and nonperforating diverticulitis.

"We used a technique called cointegration to investigate common movements in epidemiologic data series," said Fomby, a professor of economics at SMU, who led the statistical analysis with statistician Wayne A. Woodward, professor and department chair in SMU's Department of Statistical Science.

Lead author on the study was Edward H. Livingston, M.D., in the division of Gastrointestinal and Endocrine Surgery at University of Texas Southwestern Medical School, Dallas; with the Department of Surgery, Veterans Affairs Medical Center Dallas; and in the Department of Bioengineering, University of Texas at Arlington. Also co-authoring was Robert W. Haley, M.D., in the Department of Internal Medicine-Epidemiology, UT Southwestern Medical School.