Chronic appendicitis – Symptoms, Causes and More

Chronic appendicitis is long term inflammation of the appendix. It is rare condition of appendix inflammation and it can become extremely painful and, in some cases, it can be fatal.

In this article, we will know about the symptoms and diagnosis of chronic appendicitis, as well as how the condition is treated.

What is chronic appendicitis?

The appendix is a small blind ended tube like or finger shaped structure. It is attached to the bottom of the large intestine. Appendicitis occurs due to inflammation and infection of appendix. The first observable symptom of appendicitis is usually abdominal pain.

People with chronic appendicitis have complications that lasts for larger periods of time. This means appendicitis that is present for longer than a week.

Chronic appendicitis is comparatively rare, with just approximately 1.5 percent of all appendicitis cases being considered as chronic appendicitis.


There are several reasons behind chronic appendicitis.Although many cases don’t have a clear cause.

Usually, chronic appendicitis occurs due to inflammation and blockage of the appendix. Other possible causes are:

  • accumulation of fecal matter, which can occur due to constipation.
  • calcified fecal depositions also called as ‘appendix stones’
  • abdominal trauma or injury
  • tumors
  • enlarged or swollen lymph nodes and glands
  • worms or microbes
  • a deposition of foreign objects, like stones, marbles etc.


Chronic appendicitis can be harder to diagnose, as symptoms usually may be mild and easily mistaken for a different condition.

Many people experience mild abdominal pain at first, and this symptom may remain as their first and last symptom.

The pain is generally located on the lower right side of the abdomen but can spread towards the umbilical reason. The pain can either be mild or sharp or severe.

Along with abdominal pain, people with chronic appendicitis may also experience other symptoms including:

  • fever
  • swelling and tenderness of the abdomen
  • feeling tired and less energetic
  • nausea and diarrhea
  • malaise or a general feeling of discomfort

Not all people with chronic appendicitis will experience all these symptoms. Symptoms may also diminish on their own and then return, making it more difficult for doctors to give an actual diagnosis if a person is not having the symptoms at the time.

As chronic appendicitis can become life-threatening or fatal it is important that people with repeating abdominal pain and the above symptoms need medical attention, especially if the symptoms become more severe.

Chronic vs. acute appendicitis

Although chronic and acute appendicitis have similar symptoms, there are remarkable differences between them.

Chronic appendicitis is the condition in which symptoms last for a long duration, and these symptoms usually appear and go. If chronic appendicitis is not diagnosed, the person can continue to have symptoms for years.

Acute appendicitis is a condition when person suddenly develops severe symptoms, usually over the course of 24–48 hours. These symptoms can’t be neglected and need immediate and emergency medical attention.

The most typical symptom of acute appendicitis is abdominal pain that starts around the umbilical area and moves to the lower right side of the abdomen. Initially this pain may be mild or soft, but is probably can be sharp or harder.

Other symptoms of acute appendicitis are:

  • nausea
  • Vomiting
  • low-grade fever
  • constipation or diarrhea
  • loss of appetite
  • difficulty in passing gas

Appendicitis usually occurs when an obstruction or blockage, such as a any foreign substance or calcified stool, obstructs the inner cavity or appendiceal lumen of the appendix.

Chronic appendicitis may happen when the appendiceal lumen is only partially obstructed. However, the blockage can worse with time by causing pressure to build.

When this happens in people with chronic appendicitis, the pressure may control the partial blockage and the symptoms will lower in intensity or disappear altogether.

The symptoms will then come back the next time the obstruction results in the inflammation of the appendix.

Diagnosis and treatment

Earlier a doctor will perform a physical exam to find out whether there is tenderness in abdomen and where the pain is located. They will also ask questions about the symptoms and a patient’s medical history.

In most cases, a doctor will do so many tests to exclude other medical issues having the similar symptoms.

The conditions the doctor may try to exclude are:

The tests used to rule eliminate these conditions include:

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

If chronic appendicitis is diagnosed, the doctor may recommend antibiotics or may suggest to drain the pus that has formed around the appendix because of the infection.

However,the most common treatment is to complete removal of the appendix which is known as appendectomy.

An appendectomy is generally performed using laparoscopic surgery, which is minimally invasive surgery. It is also called as key hole surgery and is done after giving general anesthetics.


The most common complications of chronic appendicitis includes the following:

  • acute appendicitis
  • a ruptured appendix or when a person’s appendix bursts
  • when an abscess which is a pocket of pus develops around the appendix
  • sepsis (severe infection) or when chemicals are released into the bloodstream, resulting in the inflammation of the whole body.
  • peritonitis or inflammation of the lining of the abdominal cavity.

The above complications are serious and need immediate medical attention.It is very essential not to ignore symptoms of appendicitis, and to seek medical treatment as soon as possible.

Chronic appendicitis is a long-lasting condition characterized by appendicitis symptoms that appear and disappear with time. It is different from acute appendicitis, but it can also lead to serious complications.

While a person may live with chronic appendicitis for years, it is necessary that they don’t ignore the symptoms. Repeating pain in the lower abdomen can be a symptom of many possible conditions, so it is very essential to do a proper diagnosis.

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