From the Guidelines
After having an appendix removed, a person should follow their surgeon's specific post-operative instructions carefully, which typically include resting for 1-2 weeks, avoiding strenuous activities and heavy lifting (over 10 pounds) for 4-6 weeks, and taking prescribed pain medications such as acetaminophen or NSAIDs as directed, with postoperative antibiotics suggested for only 3-5 days in cases of complicated appendicitis, as evidenced by the 2020 update of the WSES Jerusalem guidelines 1. The recovery process involves keeping the incision site clean and dry, watching for signs of infection like increased redness, swelling, warmth, or drainage.
- A gradual return to normal diet is recommended, starting with clear liquids and advancing as tolerated, while staying well-hydrated.
- Follow-up appointments with the surgeon should be attended to ensure proper healing.
- Most people can resume normal activities within 2-4 weeks, though recovery time varies based on whether the procedure was laparoscopic (shorter recovery) or open surgery (longer recovery). The appendix is not essential for normal bodily function, so no long-term lifestyle changes are necessary after recovery, as supported by the guidelines 1. However, any persistent pain, fever, vomiting, or incision problems should prompt immediate medical attention as these could indicate complications, and the use of antibiotics should be limited to the recommended duration to prevent unnecessary antibiotic exposure and promote antibacterial stewardship, as demonstrated in a recent RCT comparing short and extended postoperative antibiotic therapy in complicated acute appendicitis 1.
From the Research
Post-Appendectomy Care
After having their appendix removed, patients should consider the following adjustments to their daily routine:
- Follow a comprehensive management modality, such as the Enhanced Recovery After Surgery (ERAS) protocol, to promote recovery 2
- Take oral probiotics to modulate the gut microbiota, reduce inflammation, and enhance recovery 3
- Limit antibiotic treatment to 3-6 days for complicated appendicitis cases, as longer treatment may not provide additional benefits 4
Dietary Considerations
Patients should:
- Start drinking water on the first day after surgery, and consider taking probiotics supplemented with Bacillus licheniformis capsules for 5 consecutive days 3
- Gradually introduce solid foods into their diet, as tolerated
Monitoring and Follow-up
Patients should be aware of the potential risks of post-appendectomy complications, such as:
- Small bowel obstruction (SBO), which has an overall rate of 2.8% over an average 4.1-year follow-up period 5
- Factors that increase the risk of SBO, including perforated appendicitis, midline incisions, and nonappendicitis pathology 5
Surgical Approach
The choice of surgical approach, such as laparoscopic or open appendectomy, may not significantly impact the risk of SBO 5
- Laparoscopic appendectomy has been shown to be a feasible, rapid, and safe approach, with minimal pain and rapid postoperative mobilization 6