Chronic Appendicitis

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is chronic appendicitis?

Chronic appendicitis is a disorder caused by inflammation of the appendix that extends over a period of time. There is controversy as to whether this actually represents a true disease, since acute appendicitis is the typical manifestation of an inflamed appendix. Some postulate that intermittent bouts of obstruction and inflammation are the root cause. Chronic appendicitis may cause symptoms related to abdominal discomfort or more generalized symptoms.

Chronic appendicitis may appear with mild abdominal tenderness, pain, and malaise or lethargy. Often, individuals with chronic appendicitis are undiagnosed until an acute episode of appendicitis occurs, resulting in symptoms that progress in severity.

Diagnosing chronic appendicitis can be difficult because the symptoms are mild, and individuals with chronic appendicitis often become used to the abdominal pain and discomfort. In addition, the diagnosis is sometimes missed or delayed because the symptoms of chronic appendicitis can be similar to those occurring with other conditions, including gastrointestinal disorders such as constipation or diarrhea.

Most people affected with chronic appendicitis require medical treatment to reduce the severity of their symptoms. Surgical removal of the appendix (appendectomy) can be performed to prevent complications such as acute appendicitis or perforated appendix. Surgical treatment (appendectomy) effectively alleviates the source of chronic appendicitis.

Left untreated, chronic appendicitis can lead to life-threatening complications such as a ruptured appendix and infection that spreads to other parts of the body. Seek immediate medical care (call 911) for serious symptoms such as high fever (higher than 101 degrees Fahrenheit), severe abdominal pain, abdominal swelling, or nausea with or without vomiting. Seek prompt medical care if you are being treated for chronic appendicitis but mild symptoms recur or are persistent.

What are the symptoms of chronic appendicitis?

Chronic appendicitis causes irritation and inflammation of the appendix that may result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of chronic appendicitis

You may experience chronic appendicitis symptoms daily or just once in a while. At times any of these common symptoms can be severe:

  • Abdominal tenderness
  • Diarrhea
  • Fever
  • Malaise or lethargy
  • Mild abdominal pain (in the right lower abdomen)
  • Nausea with or without vomiting

Serious symptoms that might indicate a life-threatening condition

In some cases, chronic appendicitis can be life-threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Abdominal swelling
  • High fever (higher than 101 degrees Fahrenheit)
  • Nausea with or without vomiting
  • Severe abdominal pain

What causes chronic appendicitis?

The cause of chronic appendicitis is not fully known, but it may be associated with fecal impaction of the intestines (coprostasis). Chronic appendicitis commonly may cause scarring of the appendix due to prolonged inflammation.

What are the risk factors for chronic appendicitis?

A number of factors increase the risk of developing chronic appendicitis. Not all people with risk factors will get chronic appendicitis. Risk factors for chronic appendicitis include a history of untreated acute appendicitis.

How is chronic appendicitis treated?

Your health care provider can develop a treatment plan tailored specifically to your needs. It is important that you follow your treatment plan for chronic appendicitis precisely to help minimize your symptoms and decrease the chance of your symptoms recurring over time.

Your doctor may prescribe analgesic medications for symptom relief. If chronic appendicitis is diagnosed, the most common and effective treatment is surgical removal of the appendix (appendectomy) to prevent potential complications such as infection or rupture of the appendix.

What are the potential complications of chronic appendicitis?

Complications of untreated chronic appendicitis can be serious, even life-threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care provider design specifically for you. Complications of chronic appendicitis include:

  • Acute appendicitis
  • Inflammation of the lining of the abdomen (peritonitis)
  • Ruptured appendix
  • Severe systemic infection (sepsis)
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Chichom Mefire A, Tchounzou R, Kuwong PM, Atangana JP, Lysinge AC, Malonga EE. Clinical, ultrasonographic, and pathologic characteristics of patients with chronic right-lower-quadrant abdominal pain that may benefit from appendectomy. World J Surg. 2011;35(4):723-730. http://www.ncbi.nlm.nih.gov/pubmed/21301834.
  2. Sgourakis G, Sotiropoulos GC, Molmenti EP, et al. Are acute exacerbations of chronic inflammatory appendicitis triggered by coprostasis and/or coproliths? World J Gastroenterol. 2008;14(20):3179-3182. http://www.ncbi.nlm.nih.gov/pubmed/18506922.