Chronic appendicitis – Symptoms, Causes and More

Chronic appendicitis is defined as prolonged inflammation of the appendix. It is rare condition for inflammation of the appendix and it may become extremely painful and, in some cases, it may be fatal.

In this article, we will look at the symptoms and diagnosis of chronic appendicitis, and the treatment of the condition.

What is chronic appendicitis?

The appendix is a small structure in the form of a tube or finger. It is fixed at the bottom of the large intestinal tract. Appendicitis occurs because the appendix becomes inflamed and infected. The primary observable symptom of appendicitis is generally abdominal pain.

People who suffer from chronic appendicitis have longer-lasting complications. It is an appendicitis which lasts for more than a week.

Chronic appendicitis is relatively rare, with only about 1.5 percent of all appendicitis occurring as chronic appendicitis.


Chronic appendicitis has a number of reasons. Although there are many cases with no clear cause.

Usually, chronic appendicitis occurs because the appendix becomes inflamed and obstructed. Additional possible causes include:

  • fecal build-up, which can occur because of constipation.
  • calcified fecal deposition also known as “appendix calculations”
  • abdomen trauma or injury.
  • tumors
  • enlarged or swollen nodes and lymphatic glands.
  • worms or microbes
  • a deposit of foreign objects, such as stones, marbles and so on.


Chronic appendicitis can be more difficult to diagnose because the symptoms can generally be mild and easily confused with another condition.

Many people experience slight abdominal pain at first, and this can be their first and last symptom.

The pain is usually localized on the right lower side of the abdomen but can spread to the umbilical reason. The pain may be mild, strong or serious.

In addition to abdominal pain, people suffering from chronic appendicitis can also have other symptoms, such as:

  • fever
  • abdominal swelling and tenderness.
  • feeling tired and not so energetic.
  • nausea and diarrhea
  • malaise or general sense of discomfort.

Not everyone suffering from chronic appendicitis will know all these symptoms. Symptoms can also decline by themselves, and then return, making it harder for doctors to give a real diagnosis if someone doesn’t have the symptoms right now.

Chronic appendicitis may put people at risk or fatal, it is important that persons suffering from repeated abdominal pain and the above symptoms require medical attention, especially when the symptoms get more serious.

Chronic vs. acute appendicitis

While chronic and acute appendicitis present similar symptoms, there are notable differences between them.

Chronic appendicitis is the condition where symptoms last for a long time, and these symptoms usually occur and disappear. If chronic appendicitis is undiagnosed, the person may continue to exhibit symptoms for years.

Acute appendicitis is a condition that occurs when someone suddenly develops severe symptoms, usually within 24 to 48 hours. Such symptoms cannot be neglected and require immediate and urgent medical attention.

The most common symptom of acute appendicitis is abdominal pain, which begins around the umbilical zone and moves down the right side of the abdomen. At first, the pain may be mild or soft, but it may be acute or more severe.

Other acute appendicitis symptoms include the following:

  • nausea
  • Vomiting
  • low-grade fever
  • constipation/diarrhea
  • loss of appetite
  • difficult to pass the gas.

Appendicitis typically occurs when a blockage or obstruction, such as a foreign substance or a calcified stool, obstructs the inner cavity or the appendage light.

Chronic appendicitis can occur when there is only partial obstruction of the appendiceal lumen. However, the obstruction may worsen over time through pressure.

When it occurs in persons with chronic appendicitis, pressure can control partial blockage and symptoms decrease in intensity or go away completely.

Symptoms will reappear the next time the blockage causes the appendix to become inflamed.

Diagnosis and treatment

Earlier, a physician will conduct a physical examination to determine if there is sensitivity in the abdomen and where the pain is. They will also inquire about a patient’s symptoms and medical history.

In most cases, a physician will make so many tests to rule out other medical problems with the same symptoms.

Conditions which the physician may attempt to exclude include:

  • urinary tract infection
  • kidney infection
  • Crohn’s disease
  • ulcerative colitis
  • ovarian cysts
  • pelvic inflammatory disease (PID)
  • irritable bowel syndrome (IBS)
  • other gastro-intestinal problems.

Tests used for the elimination of these conditions include:

  • a pregnancy test
  • urine analysis or examination of a person’s urine.
  • blood tests
  • a pelvic examination
  • computerised tomography (CT) scan
  • abdominal ultrasound
  • magnetic resonance imaging (MRI)

If chronic appendicitis is diagnosed, the physician may recommend antibiotics or may suggest draining pus that has formed around the appendix as a result of infection.

However, the most commonly used treatment is to completely eliminate appendicectomy.

An appendicectomy is usually performed using laparoscopy surgery, which is minimally invasive surgery. It is also called keyhole surgery and is done after the administration of general anaesthetics.


The most common complications related to chronic appendicitis are:

  • acute appendicitis
  • a rupture of the appendix or a breakdown of the appendix of a person.
  • where an abscess which is a pus pocket forms around the appendix.
  • sepsis (severe infection) or when chemicals are released into the bloodstream, causing the entire body to become inflamed.
  • peritonitis or inflammation of the abdomen cavity or mucous membrane.

The above conditions are severe and require immediate medical attention. It is important that you do not ignore the symptoms of appendicitis and get treatment as soon as possible.

Chronic appendicitis is a long-term illness characterized by symptoms of appendicitis that develop and disappear over time. It differs from acute appendicitis but may also result in severe complications.

Although a person can live with chronic appendicitis for years, they need not ignore the symptoms. Repetition of pain in the lower abdomen can be a symptom of numerous possible conditions, so it is very important to make a proper diagnosis.

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