Chronic appendicitis - signs, diagnosis and treatment

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Chronic appendicitis symptomsPreviously suffered acute appendicitis attack in women or men in a number of cases can go into a chronic form, as evidenced by the presence of pathological processes in the appendix.Acute phenomena subsided, but the inflammatory process remains, and passes into a chronic. This should distinguish between chronic recurrent appendicitis.

With this form, after suffering an acute attack of appendicitis, the pain subsides. After a while there is a new attack - a relapse of appendicitis. Consequently, this form is characterized by repeated attacks of acute inflammation of the process. In between the attacks, patients experience constant pain in the region of the cecum.

In connection with prolonged inflammation in the appendix, sclerotic changes are observed, possibly also its gradual ulceration, deformation, the appearance of adhesions and scars, which leads to a decrease in the intestinal lumen and even to fusion with nearby organs.


There are three forms of chronic appendicitis: residual, recurrent, primary-chronic.

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  1. The development of residual (residual) form of chronic appendicitis occurs immediately after an attack of acute appendicitis, since in the vermiform appendage fertile soil remains for the occurrence of repeated attacks.
  2. The recurrent form of the disease is characterized by periods of exacerbation and remission.
  3. Primary chronic appendicitis is characterized by inflammatory phenomena developing in an erased chronic form.

Recurrent type of chronic appendicitis usually occurs in those patients who did not receive appropriate medical care in the acute course of the disease. In this case, scars and adhesions appear in the appendicitis tissues, the lumen narrows, which is why when intestinal contents come in here it stagnates and, as a result, the inflammatory process that lasts for years can resume.

Symptoms of chronic appendicitis

Chronic appendicitis can be accompanied by a blurred pattern of symptoms in both women and men. The main sign of the disease in this case is a regularly occurring aching pain in the right side, at the location of the appendix.

Also, signs of chronic appendicitis include:

  • heaviness, flatulence, the presence of uncomfortable sensations in the abdomen;
  • mild nausea;
  • indigestion disorder;
  • lack of appetite;
  • frequent stool disorders - diarrhea or constipation;
  • chronic subfebrile body temperature.

Soreness can increase with heavy loads (due to increased pressure inside the peritoneum), at the time of emptying, with coughing. There are changes in the work of the digestive tract - constipation and diarrhea. In case of an exacerbation, vomiting and nausea occur.

It is very important to diagnose and start treating chronic appendicitis as soon as possible, because the constant presence in the body of the foci of infection, certainly not the most favorable effect on his work. Moreover, it is fraught with perforation of the appendix with the subsequent development of peritonitis, which can cause the death of the patient.

Chronic appendicitis - symptoms in women

Initially, signs of appendicitis in women are manifested by pain sensations from the digestive tract. Pain spreads to the right lower abdomen and is strengthened by gynecological examination.

In the period of hormonal changes (for example, during pregnancy or menstruation) pain is pronounced, localized in the ovaries and vagina. Against the background of appendicitis there is a failure in the cycle. In the process of making love, as well as after it, spasms occur, there are severe pains in the vaginal area.

Diagnosis and treatment

Since chronic appendicitis is manifested by common symptoms characteristic of a number of other diseases of the internal organs, a set of laboratory and instrumental diagnostic methods is used to establish an accurate diagnosis.

Diagnostic measures for the detection of chronic appendicitis:

  1. Soreness in the right iliac region, increased pain when lying down on the left side, when flexing the right leg- these signs cause suspicion of chronic appendicitis. Gangrenous appendicitis may not be accompanied by painful sensations due to the death of innervation in the affected tissues. With peritonitis, the pain passes over the entire abdomen.
  2. Clinical blood and urine tests. They are not sufficient for the diagnosis, but they are still important concomitant methods, allowing to confirm or exclude the disease.
  3. X-ray diffraction with contrast medium. This study helps to identify the obstruction of the opening connecting the process with the cecum. Also, radiography can show fibrous adhesions, clumps of stool.
  4. Ultrasound diagnosis. A simple and safe method of research, which allows you to quickly confirm the diagnosis. In the course of the study, not only the condition of the appendix, but also of other abdominal organs is assessed.
  5. CT scan. With the help of this study, it is possible to exclude diseases that have a similar symptomatology.
  6. Laparoscopy. Surgical diagnostic method consisting in the introduction of a thin probe with a chamber at the end into the abdominal cavity of the patient through a small incision in the anterior abdominal wall. This method not only makes it possible to make an accurate diagnosis, but also allows you to immediately perform removal of the appendix when an inflammatory process is detected.

Since the symptoms of chronic appendicitis are not specific, it is very important to be able to distinguish this ailment from pathologies of other abdominal organs, in particular:

  1. Cholecystitis;
  2. Acute pancreatitis;
  3. Perforation of the stomach ulcer;
  4. Kidney disease;
  5. Gynecological diseases.

Treatment of chronic appendicitis is prescribed the same as in the acute form of the disease - surgical removal of the inflamed process. Appendectomy can be performed both by laparoscopic and by open method - the surgeon takes the decision depending on the patient's condition and the clinical picture of the disease.

If a patient with chronic appendicitis has unexpressed symptoms, conservative treatment is used - taking antispasmodics, physiotherapy, eliminating intestinal disorders.

Postoperative period

Within two days after the appendicitis was excised, the patient was prescribed a bed rest. Prescribe antibacterial therapy for the prevention of surgical infections. During this period, nursing care is very important for the prevention of possible complications.

The suture is removed 10-12 days after the operation. Until then, sudden movements, tension of the muscles of the abdominal wall should be avoided in order to avoid cutting out the seam. Restoration of muscle tissue takes several months. On the skin there is a small pale scar, as seen in the photo.

The time when one can return to the habitual way of life depends on the type of appendectomy and the nature of the course of the postoperative period: after endoscopic interventions healing is faster. On average, the physical load is limited to 2 months, then running, swimming, supreme riding is permitted, and lifting weights only after 3-6 months. From visiting the sauna or sauna, refrain at least 3-4 weeks.


With conservative therapy and during the rehabilitation period after the operation, a special diet must be observed:

  1. Refuse spices, smoked foods, canned food, sweet fizzy drinks.
  2. It is recommended to exclude strong black tea and coffee. It is worth using green tea, fruit drinks and compotes.
  3. It is necessary to adhere to a fractional diet - 5-6 times a day in small portions.
  4. It is necessary to exclude sharp, salty, fatty, fried foods.

As for folk remedies, it is strictly forbidden to avoid a visit to a doctor or inattentively treating "signals" of one's own organism in the form of bouts of pain, hoping for folk remedies! Phytotherapy and home recipes are useful in the role of additional measures to strengthen the body and improve bowel function, and also in the fight against pathogenic microorganisms.

Prevention of disease

There are no special preventive measures. It is recommended to lead a healthy lifestyle, eat rationally, avoid stressful conditions, abandon bad habits, lose weight.

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