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After century of removing appendixes, doctors find antibiotics can be enough

arstechnica.com

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Re: After century of removing appendixes, doctors find antibiotics can be enough

#191

Post by bitexploder »

thomasfedb wrote: post #186
bitexploder wrote: post #90

Earlier quoted context omitted.

Heh, yeah. It is traditional. And ineffective (of course). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071072/ I was kind of out of it. Maybe there was a lot of pain, but my memory of it was just so much discomfort, what is something minor like that?

That's an excellent article you link - to paraphrase the conclusion: digital rectal examination should not be performed routinely for abdominal pain, but should be considered an investigation to consider when diagnosis is unclear.

Thanks. I guess it isn’t fair to say it is ineffective, it can give some information.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#192

Post by mmirate »

owenversteeg wrote: post #190
redial wrote: post #171

Earlier quoted context omitted.

Glad you are feeling better...but after reading your comment I too am craving bbq ribs. I was indifferent to them before.

After his comment I was curious, but still indifferent to bbq ribs. After yours, I too am craving bbq ribs. Some sort of ripple effect?

I read all three of these comments and I still dislike bbq ribs.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#193

Post by krrrh »

sureaboutthis wrote: post #34

This reminds me of when tonsils were removed at the first sign of trouble. When I was in my early 20s, in the 1970s, I went to my doctor about a bad sore throat. He advised me to see an ENT who barely bothered to look down my throat for more than a second and automatically declared I needed mine removed. That bothered me but I very much respected my personal doctor who said he respected this ENT. When I mention this…

Another example of this is how frequently ENTs will combine septoplasty to fix a deviated septum with turbinectomy. This has resulted in a lot of people suffering from Empty Nose Syndrome which is so distressing that some kill themselves over it [1]. My wife recently consulted with an ENT, and he said that he rarely does turbinectomies, since enlarged turbinates are often just a result of a deviated septum and will revert to a normal size months or years after septoplasty alone. He said with some dismay that lots of other ENTs haven’t changed their approach.

[1] https://www.buzzfeed.com/joeloliphint/is-empty-nose-syndrome...

Re: After century of removing appendixes, doctors find antibiotics can be enough

#194

Post by simcop2387 »

testplzignore wrote: post #113
logfromblammo wrote: post #107

Earlier quoted context omitted.

I was taught by a computer game that it's diagnosed by palpating the four quadrants of the abdomen and doing an ultrasound. A lot of the decoy cases were just gas; hold for observation until they fart it out. This wasn't in the game, but I presume it may also be necessary to do a pregnancy test (ectopic?), urinalysis for urinary tract infection, swabs for genital tract infection, blood draw for white blood cell count…

Was it "Life & Death"? That game was difficult as a kid. If surgery was involved, the patient always died.

There's videos of people doing the surgery, but I've never managed it either

Re: After century of removing appendixes, doctors find antibiotics can be enough

#195

Post by klipt »

krrrh wrote: post #193
sureaboutthis wrote: post #34

This reminds me of when tonsils were removed at the first sign of trouble. When I was in my early 20s, in the 1970s, I went to my doctor about a bad sore throat. He advised me to see an ENT who barely bothered to look down my throat for more than a second and automatically declared I needed mine removed. That bothered me but I very much respected my personal doctor who said he respected this ENT. When I mention this…

Another example of this is how frequently ENTs will combine septoplasty to fix a deviated septum with turbinectomy. This has resulted in a lot of people suffering from Empty Nose Syndrome which is so distressing that some kill themselves over it [1]. My wife recently consulted with an ENT, and he said that he rarely does turbinectomies, since enlarged turbinates are often just a result of a deviated septum and will r…

That's horrifying. At least wikipedia says it can be fixed in many cases by a surgery that replaces the missing turbinate parts with artificial structures that serve the same function.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#196

Post by pazimzadeh »

smaddox wrote: post #148
jawns wrote: post #98

Earlier quoted context omitted.

About 10 years ago, one study set forth an interesting hypothesis: The appendix is a place where "good" bacteria can safely hide during infection. I'm not sure if there's been any work since then to confirm the hypothesis, but it sure is an interesting idea. Source: https://www.nytimes.com/2008/06/17/health/research/17appe.ht...

I think I remember reading at some point that another hypothesis is that it acts as a repository for bad bacteria, so that your immune system doesn't forget how to make antibodies for those bacteria. I think I remember the sinuses being posited as serving the same role.

What if the appendix is an attempt to "tame" bad bacteria into being good? Does giving bacteria access to nutrients from our food and mucus remove the selective pressure to evolve virulence factors?

Re: After century of removing appendixes, doctors find antibiotics can be enough

#197

Post by bwldrbst »

teekert wrote: post #53

I also know 3 people that went to the doctor after some time of belly aches and the doctor telling them: "You probably had an inflamed appendix but it's ok now."

As a kid in the mid-80's I once woke up with a bit of a belly ache and thought "I can milk this for a day off school to play with Lego"

Ended up having an emergency appendectomy that night.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#198

Post by mscasts »

deskamess wrote: post #86
mscasts wrote: post #64

The removed mine while I had another surgery just in case.

Just in case of ...? I do not usually think of surgeons having the mentality of 'I was in the neighborhood... so.... yeah, why not!'.

Well, they were fiddling around with my intestines, moving them around (I have / had intestinal malrotation) and they told me that it could be an issue if they didn't remove it.

Although they told me afterwards, but the surgeons were extremely competent so I don't question their judgement.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#199

Post by arwhatever »

It would be interesting if someone were to compile a list of surgical procedures that have been performed too proactively throughout history. Uteruses, molars, tonsils, breasts, I think some cases of prostate cancer, now appendixes. My list might contain huge errors - I am not a medical professional, but even as a medical layperson, it's really remarkable how common this general type of situation occurs.

Re: After century of removing appendixes, doctors find antibiotics can be enough

#200

Post by cimmanom »

sandworm101 wrote: post #187
cimmanom wrote: post #158

Earlier quoted context omitted.

Pretty sure the whole point of this article is that often enough patients arrive in the emergency room at a point where it's NOT too late to treat successfully with antibiotics.

Look at the people in the thread who ruptured. They certainly did not make it in time.

That’s correct. There’s a difference between “often” and “always”. There are also several people posting in this thread who had their appendicitis successfully treated with antibiotics.
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