Appendicitis is one of the most common surgical emergencies in Australia, and timely treatment is crucial to prevent complications. If you or a loved one is facing appendicitis, understanding the available treatments and what to expect can help you feel more prepared and confident in your care decisions.
The Mainstay: Surgery to Remove the Appendix
The gold standard for treating appendicitis in Australia is surgical removal of the appendix, known as an appendicectomy (or appendectomy). This operation is highly effective and has a very low risk of serious complications or death, especially in younger patients.
Types of Surgery
- Laparoscopic (Keyhole) Appendicectomy: Most appendicectomies in Australia are performed using minimally invasive keyhole surgery. This approach uses small incisions and a camera, leading to less pain, smaller scars, and faster recovery times.
- Open Appendicectomy: In some cases-such as when the appendix has ruptured, there is widespread infection, or keyhole surgery isn’t suitable-an open operation with a larger incision may be needed.
Both types of surgery are performed under general anaesthetic. Most patients recover quickly, with hospital stays typically ranging from one to a few days, depending on the complexity of the case and the patient’s overall health.
What About Antibiotics Instead of Surgery?
There has been growing international interest in treating mild or “uncomplicated” appendicitis with antibiotics alone, especially in children. However, recent large studies-including those referenced in Australian practice-show that antibiotics are less effective than surgery. In children, for example, about one-third of those treated with antibiotics alone will eventually need surgery due to recurrence or treatment failure.
Australian experts remain cautious about using antibiotics as the sole treatment, especially since it can be difficult to distinguish between uncomplicated and complicated appendicitis without surgery6. For now, surgery remains the gold standard, with antibiotics used as a supportive measure before and after the operation, or in rare cases where surgery is not possible.
Care Before and After Surgery
- Pre-operative Care: Patients are usually given intravenous fluids and antibiotics before surgery to reduce infection risk and prepare the body for the procedure.
- Pain Management: Pain relief is tailored to each patient, with options ranging from oral medications to patient-controlled analgesia (PCA) via a drip, especially in children.
- Diet and Recovery: After surgery, patients start with clear fluids and gradually return to a normal diet as tolerated. Most are encouraged to get up and move as soon as possible to speed up recovery.
- Discharge and Follow-up: Many hospitals in Australia use criteria-led discharge, meaning patients can go home as soon as they meet certain recovery milestones, sometimes without waiting for a doctor’s review.
Outcomes and Safety
Appendicectomy is considered a very safe procedure in Australia, with an overall mortality rate of just 0.02%-even lower in young people. Most complications, when they occur, are related to delayed treatment or occur in elderly patients with other health conditions. Prompt surgery and good post-operative care are key to excellent outcomes.
In Australia, surgery to remove the appendix is the mainstay of appendicitis treatment and offers excellent results for most patients. While antibiotics may play a role in select cases, especially when surgery is not possible, they are not as effective as surgery for long-term cure. If you or your child experiences symptoms of appendicitis-such as sudden, severe abdominal pain, fever, nausea, or vomiting-seek medical attention immediately. Early treatment is the best way to ensure a smooth and safe recovery.