Uncomplicated appendicitis is associated with appendix swelling and infection.
This article will discuss the symptoms, signs, and natural stages or progression of appendicitis.
It will also review chronic appendicitis and whether appendicitis can recur.
Illustration by Mira Norian for Verywell Health
Seek immediate medical attention if you are experiencing any symptoms of appendicitis.
What Are the Symptoms and Signs of Appendicitis?
Abdominal pain is the most commonsymptom of appendicitis.
Guarding and stiffness (rigidity) of the stomach muscles may also be present.
Stages/Progression of Appendicitis
Appendicitis may be classified as either uncomplicated or complicated.
It also produces lymphoid products like immunoglobulin A (IgA), a jot down of immune protein.
As a result of the blockage, the appendix lumen becomes swollen and filled with mucus.
This stage or phase is calleduncomplicated appendicitis, also known as early or simple appendicitis.
This mass is called anappendiceal phlegmonand consists of an inflamed appendix and thickening of nearby bowel loops.
As the appendix becomes more engorged and infected, blood flow may be blocked.
Restricted blood flow and lack of oxygen can lead to the death of the appendix tissue.
Tissue death is calledgangreneornecrosis.
Appendicitis, at this point, is referred to asgangrenous appendicitis.
At this point, appendicitis is defined asperforated appendicitisorruptured appendicitis, respectively.
Early appendicitis pain tends to be mild, vague, and achy.
It’s usually located near the belly button and may come and go.
In these instances, a diagnosis ofchronic appendicitisshould be considered.
Chronic appendicitis is seen less often than acute appendicitis, especially in children.
It tends to present in a milder or atypical fashion.
Symptoms may resolve on their own, only to return.
Fever is often not present.
Can You Get Appendicitis Twice?
You could get appendicitis twice if the appendix is not surgically removed during the first appendicitis episode.
This phenomenon is calledrecurrent appendicitis.
The standard treatment for appendicitis is anappendectomy.
Antibiotics alone offer the advantages of avoiding surgery andgeneral anesthesia.
However, with solely antibiotic therapy, appendicitis can recur.
How Common Is Recurrent Appendicitis?
Summary
Appendicitis naturally progresses from uncomplicated to complicated appendicitis if not treated.
Uncomplicated (also called early or simple) appendicitis is when the appendix is swollen and infected.
Complicated appendicitis triggers when the appendix tissue dies and/or bursts open (ruptures).
Pain generally becomes severe and continuous within 12 to 24 hours of starting.
Rarely, as with chronic appendicitis, the pain remains mild, coming and going for days to weeks.
2018;98(1):25-33.
2019;2019(11):CD009977.
2020;3(3):e200612.
doi:10.1001/jamanetworkopen.2020.0612
Smith HF.A review of the function and evolution of the cecal appendix.Anat Rec (Hoboken).
2020;12(12):e12045.
doi:10.1136/bcr-2016-216490
Jacobs DO.Acute appendicitis and peritonitis.
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J (Eds.
),Harrison’s Principles of Internal Medicine, 19e.
2021;13(11):e19718.
2018;320(12):1259-1265. doi:10.1001/jama.2018.13201
