Everything You Should Know About Chronic Appendicitis

Medically reviewed by Graham Rogers, MD on June 28, 2017Written by Lana Bandoim on June 28, 2017

Overview

Chronic appendicitis is a rare medical condition. It can be difficult to diagnose because the symptoms may come and go, and they can also be mild. The most common symptom is abdominal pain. The likely cause is inflammation or an obstruction in your appendix.

It’s important to get the correct diagnosis because chronic appendicitis can be life-threatening in some cases.

Read on to learn more about this condition.

Symptoms

The symptoms of chronic appendicitis may be mild. In some cases, abdominal pain is the only symptom with chronic appendicitis. The pain is usually in the lower right side of the abdomen. It may also appear near the belly button and move to the lower right side of the stomach in some cases. The pain can vary from sharp to dull, but it’s more common for it to be dull.

Other symptoms of chronic appendicitis include:

  • abdominal pain
  • fever
  • abdominal swelling and tenderness
  • fatigue or lethargy, which is a lack of energy
  • malaise, which is a general feeling of discomfort or illness

Some people might also experience nausea or diarrhea. Symptoms may come and go, which can make the condition more difficult to diagnosis.

If you have any of these symptoms and they continue to become more severe, consider going to the doctor. They may be a sign of a serious medical problem.

Chronic appendicitis vs. acute appendicitis

Chronic appendicitis and acute appendicitis are sometimes confused. In some cases, chronic appendicitis isn’t diagnosed until it becomes acute appendicitis.

Chronic appendicitis can have milder symptoms that last for a long time, and that disappear and reappear. It can go undiagnosed for several weeks, months, or years.

Acute appendicitis has more severe symptoms that appear suddenly within 24 to 48 hours. Acute appendicitis requires immediate treatment.

Causes

The cause of chronic appendicitis is often unknown. Inflammation and obstruction of the appendix are sometimes the cause.

Other possible causes of chronic appendicitis include:

  • accumulation of fecal matter
  • calcified fecal deposits
  • tumors
  • enlarged lymphoid follicles
  • worms
  • trauma
  • accumulation of foreign objects, like stones, marbles, or pins

When you have an obstruction or inflammation in your appendix, it can allow bacteria to grow and multiply. In chronic appendicitis, the obstruction may be partial.

It’s not clear if you can do anything to prevent chronic appendicitis. Eating a diet rich in fiber may lower the risk of appendicitis, but research on diet, nutrition, and eating patterns for the prevention of chronic appendicitis is inconclusive. High-fiber foods include whole grains, vegetables, and fruits.

Diagnosis

Diagnosis of chronic appendicitis can be difficult. To diagnose your condition, your doctor will begin by doing a physical exam, and discussing your symptoms and medical history. Symptoms of chronic appendicitis are similar to symptoms of other medical conditions, so your doctor will likely run tests to rule out other conditions. These may include:

Some conditions that share similar symptoms with chronic appendicitis, and which your doctor may be trying to rule out, include:

Treatment

Your doctor will provide you with a specific treatment plan. It’s important to follow all the instructions and take any medication as recommended. Sometimes antibiotics are used to treat chronic appendicitis. Your doctor may also drain the pus that forms in your appendix.

The most common treatment for chronic appendicitis is an appendectomy, which is surgery to remove the appendix. That can be done using laparoscopic surgery or laparotomy. Laparoscopic surgery has fewer complications and uses smaller incisions. A laparotomy is abdominal surgery through one incision.

Discuss surgery options with your doctor, and ask them which type they recommend and why.

Complications

Several complications can develop because of chronic appendicitis. It’s important to get immediate treatment and follow all of your doctor’s recommendations to reduce their risk.

The most common complications of chronic appendicitis include:

  • acute appendicitis
  • ruptured appendix
  • abscess, which is a pocket of infection
  • sepsis, which is your body’s serious response to infection
  • peritonitis, which is inflammation of the abdomen’s lining

It’s important not to ignore your symptoms and to get medical help. The complications of appendicitis can be life-threatening. A ruptured appendix can spread an infection throughout your body. If this isn’t treated immediately, it can be very dangerous.

Learn more: Emergency signs and symptoms of appendicitis »

Outlook

Chronic appendicitis is different from acute appendicitis. The symptoms of chronic appendicitis tend to be milder. Abdominal pain is the most common symptom of this condition.

It’s easy to confuse chronic appendicitis with other medical problems. However, it’s important to get the right diagnosis. Serious complications can develop from chronic appendicitis if it’s left untreated.

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