Is chronic appendicitis serious?

Written by Li Jin Quan

General Surgery

Updated on March 06, 2025

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Chronic appendicitis can achieve good treatment outcomes through active surgical treatment or conservative treatment, and the cases of appendicitis here are not severe. However, a very small portion of patients with chronic appendicitis, especially those with underlying diseases such as diabetes, are at risk of developing a purulent infection of the appendix, which can lead to perforation of the appendix and result in diffuse peritonitis, sepsis, septic shock, and multiple organ failure. Thus, it can be said that there are indeed a few severe cases among patients with chronic appendicitis.

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Where does appendicitis hurt?

In general clinical practice, the pain associated with appendicitis mostly occurs in the lower right abdomen. Some patients experience very typical migratory right lower abdominal pain which usually starts in the upper abdomen, gradually moves around the navel, and finally localizes in the lower right abdomen. Direct pain in the lower right abdomen could also be indicative of appendicitis. In rare cases, if there is a reversal of organs or an abnormal position of the appendix, pain may occur in the upper right abdomen or lower abdomen as well. For pregnant women, the appendix may be positioned higher and could cause pain under the rib cage. Therefore, the diagnosis of appendicitis should be based on the specific condition of the patient and related diagnostic tests.

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How to relieve pain from acute appendicitis

For rapid pain relief in acute appendicitis, one can choose antispasmodic or sedative medications. However, it is important to note that acute appendicitis often requires surgical treatment clinically. If the pain is not particularly severe, conservative medication treatment can also be chosen, using sensitive antibiotics for anti-inflammatory pain relief. If surgery involves appendectomy, laparoscopic appendectomy is generally chosen, which has less intraoperative bleeding and quicker postoperative recovery. Only after the appendix is removed can the onset of acute appendicitis be effectively controlled or the transition from acute to chronic appendicitis prevented. (Specific medications should be used under the guidance of a physician.)

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Is appendicitis contagious?

Appendicitis is an inflammation that occurs in the lumen of the appendix, including acute appendicitis and chronic appendicitis. Appendicitis is not contagious, as it is not an infectious disease, but rather a purulent inflammation. Therefore, there is no need to isolate patients with appendicitis. Appendicitis usually requires surgical removal, but it is important to note that surgery should not be performed if acute appendicitis has been present for more than 72 hours, or if an abscess has formed. The majority of surgeries are performed using laparoscopic appendectomy, a method which allows for a faster recovery post-operation.

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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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Can appendicitis cause a fever?

Appendicitis can cause fever, and generally, it is considered an inflammatory condition. Besides fever, patients may experience abdominal pain, nausea, vomiting, etc. Typically, the abdominal pain manifests as lower right quadrant pain, which is referred pain. If a patient has fever and typical lower right quadrant pain, further investigations like abdominal ultrasound, complete blood count, and CT scans should be carried out. Diagnosing appendicitis is usually not difficult. The treatment of choice for appendicitis is generally surgical intervention, especially for early-stage patients with symptoms lasting less than three days, where an appendectomy is recommended. However, in some elderly patients with conditions like hypertension, diabetes, etc., who are not suitable for surgery, especially if the duration of the illness is more than three days, conservative medical treatment can be chosen. Conservative treatment primarily involves active anti-infection and anti-inflammatory measures and usually takes longer. (Medication should be administered under the guidance of a doctor.)