Is Appendicitis Always the Cause of Cecal Inflammation?

Is appendicitis always caused by appendicitis?

On November 26, I experienced bloating and pain in my lower right abdomen, along with nausea for 5-6 days.
Since I was on a business trip in Ho Chi Minh City, Vietnam, I visited a large hospital there.
The doctor performed a CT scan of my abdomen, blood tests, and a urinalysis, diagnosing me with appendicitis.
However, he mentioned that the inflammation did not reach the appendix.
When I asked the Vietnamese doctor if surgery was necessary, he said it wasn't and that medication would suffice.

I would like to know if it is possible to have only inflammation of the cecum without appendicitis, as my research indicates that appendicitis typically involves the appendix.
The Vietnamese physician prescribed a 7-day course of medication: antibiotics (Tinidazole and Ciprofloxacin) to be taken twice daily after breakfast and dinner, and probiotics (Bacillus clausii) to be taken 2 hours after the antibiotics.

I have been taking the medication for 5 days but still feel unwell.
My stools are fragmented and clay-colored.
Should I return for a follow-up examination, or is there a possibility that surgery may be needed? I am uncertain about the severity of this condition, as the Vietnamese doctor keeps insisting that the inflammation has not reached the appendix and that surgery is not required, just medication.
Is it sufficient to continue taking antibiotics for cecal inflammation?
I want to assess whether it is necessary to return to Taiwan for medical care, as flying back would require chartering a flight and a 14-day quarantine, meaning I wouldn't be able to see a doctor for at least a month.
Thank you, doctor.

BB, 20~29 year old female. Ask Date: 2020/12/01

Dr. Yang Zhichao reply Gastroenterology and Hepatology

Hello Ms.
BB, if diagnosed with appendicitis, I recommend surgery.
As for cecitis, it refers to inflammation in the cecum area.
If you continue to feel unwell, please return for a follow-up consultation.
Thank you for your question.

Reply Date: 2020/12/01

More Info

Appendicitis, or inflammation of the appendix, is often associated with cecal inflammation because the appendix is a small, tube-like structure that extends from the cecum, which is the beginning of the large intestine. However, it is important to note that cecal inflammation can occur independently of appendicitis. In your case, the diagnosis of "盲腸炎" (cecal inflammation) without appendicitis suggests that there may be inflammation in the cecum itself, which could be due to various reasons, including infections, inflammatory bowel disease, or other gastrointestinal issues.

The fact that the Vietnamese doctor indicated that the inflammation did not extend to the appendix is significant. It suggests that while there is inflammation in the cecum, the appendix may not be involved, which is not uncommon. Conditions such as cecal diverticulitis, cecal tumors, or even infections can lead to cecal inflammation without affecting the appendix.
Regarding your treatment, the antibiotics prescribed (Tinidazole and Ciprofloxacin) are appropriate for treating bacterial infections that could be causing the cecal inflammation. The addition of probiotics (Bacillus clausii) is also beneficial as it helps restore the natural gut flora, which can be disrupted by antibiotic use.
If you have been on antibiotics for five days and are still experiencing discomfort, it is essential to monitor your symptoms closely. The presence of fragmented stools and a change in color can indicate ongoing gastrointestinal issues. If your symptoms do not improve or worsen, it is advisable to seek further medical evaluation. This could involve imaging studies, such as a repeat CT scan, or laboratory tests to assess for any complications, such as abscess formation or other underlying conditions.

In terms of the severity of your condition, while cecal inflammation can be serious, it does not always necessitate surgical intervention. The decision to operate typically depends on the clinical presentation, response to medical treatment, and the presence of any complications. If the inflammation is localized and responds to antibiotics, surgery may not be required. However, if you develop severe pain, fever, or other concerning symptoms, it may indicate a more serious condition that could require surgical evaluation.

Given the complexities of your situation and the potential for complications, if you continue to feel unwell, it would be prudent to consult with a healthcare provider, either in Vietnam or upon your return to Taiwan. They can provide a more thorough assessment and determine if further intervention is necessary.
In summary, while appendicitis is a common cause of cecal inflammation, it is not the only cause. Your treatment with antibiotics is appropriate, but ongoing symptoms warrant further evaluation. If you have concerns about your health or the effectiveness of your treatment, do not hesitate to seek medical advice.

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