Key takeaways

Appendectomy, the surgical removal of the appendix, is often performed urgently due to appendicitis, with the choice between an open or laparoscopic procedure depending on various factors including the surgeon’s preference and the patient’s health history.
Recovery from a laparoscopic appendectomy is typically faster, averaging around one to three weeks, compared to two to six weeks for an open appendectomy, with activities and lifting heavily restricted during recovery.
Following surgery, a diet of bland, low-fat, and high-fiber foods is recommended until normal bowel function resumes, and patients are advised to avoid alcohol if taking antibiotics or opiate painkillers.
Post-appendectomy care involves managing pain with medication, preventing incision infection by keeping the area clean and dry, and monitoring for signs of complications such as worsening pain, fever, or unusual discharge from the incision site.

An appendectomy is the surgical removal of the appendix, a small tube that attaches to your large intestine and sits in the lower right portion of your belly. You may need to have your appendix removed if you have symptoms of appendicitis (an inflammation or infection of the wall of the appendix caused by bacteria, viruses, or an intestinal blockage). The main symptom is abdominal pain, which usually occurs in the right lower abdomen, but can also start around the belly button and then travel to your lower right abdomen. You might also have fever, bloating, nausea, diarrhea, or even constipation.

Types of appendectomies

There are two types of surgery for appendicitis—open appendectomy, in which a several-inch incision is made in the abdomen to remove the appendix, or laparoscopic appendectomy, in which the appendix is removed using thin, lighted instruments inserted into the belly through small incisions. With both surgeries, you’ll receive general anesthesia, but which surgical procedure your provider chooses will depend on a number of factors, such as your surgeon’s experience, whether you have had abdominal surgery before, and your preference. In general, the laparoscopic approach is preferred as it has a faster recovery and less pain.

Is appendicitis serious?

Appendicitis is usually a medical emergency and, as such, an appendectomy is often emergency surgery. If an infected appendix bursts (also referred to as a perforated or ruptured appendix), the infection can spread to other parts of the body. When the infection spreads within the inside of the abdomen and irritates the lining of the abdominal wall, for example, it can cause a life-threatening condition called peritonitis. If the infection gets into the bloodstream, a potentially deadly infection called sepsis can occur. An appendix can burst within 48-72 hours of first showing signs, so it’s important you don’t delay seeking medical treatment.

How common is appendicitis?

Overall, about 1 in 1,000 people per year in this country experience appendicitis, and it’s most common in young people between 10 and 30 years of age. It is not known why some people get appendicitis while others do not. It’s also not entirely clear what function the appendix serves (some experts say it might house healthy gut bacteria); however, a person can live a healthy life without one.

Appendectomy recovery time

How quickly you recover from an appendectomy depends on whether you have an open or laparoscopic procedure. Other factors include your health before the procedure, your age, and whether or not your appendix has ruptured.

Most people leave the hospital within a day or two, and, in fact, many people who have an uncomplicated laparoscopic appendectomy can leave the hospital the same day as their procedure.

When it comes to pain, though, those who experience an open appendectomy typically report a harder recovery than those who undergo laparoscopic surgery. “This is because an open appendectomy involves cutting the skin and fascia [connective tissue in the abdominal wall] and splitting abdominal muscles,” explains Rana Pullatt, MD, a professor of surgery at the Medical University of South Carolina. “You might have a good bit of pain for about a week. A laparoscopic appendectomy, on the other hand, involves using mainly puncture holes. You might have some pain [around holes] for about 24 hours and some shoulder pain from the gas we use.” This is because the carbon dioxide gas used to distend your abdomen can irritate nerves traveling from your diaphragm to your neck and shoulder.

And as Joanna Grudziak, MD, a general surgeon with University of Utah Health, notes, people undergoing a laparoscopic appendectomy may feel better after surgery than before, because the inflamed appendix is removed.

Lifestyle adjustments

Everyone is different when it comes to their recovery period. In general, though, hospital stays range from a few hours (many laparoscopic patients are released the same day of their procedure) to a few days (for open surgery). Overall recovery takes about one to three weeks for a laparoscopic appendectomy (average recovery time is 13 days) and about two to four weeks—sometimes up to six weeks for an open appendectomy, says Dr. Grudziak.

After you’ve been discharged from the hospital, you can help speed your healing process along by following some of these tips:

Rest when you’re tired. Your body is working hard to repair itself. You may need more sleep than usual.
Avoid lifting or doing any strenuous activity for three to five days after a laparoscopic appendectomy and 10-14 days after an open one. “You can lift things with your hands,” says Dr. Pullatt, “but don’t do anything that might strain your core.” That includes lifting children, pets, heavy bags of groceries, or anything you have to bend over to reach.
Try to walk a little bit every day, gradually increasing your distance. In addition to helping relieve constipation, it can help prevent blood clots that can be associated with surgery and immobility.
Don’t swim or soak in a tub (although you can shower) until after your stitches or surgical strips are removed, or any glue covering flakes off.
Follow your doctor’s medical advice for cleaning and bandaging your wound.
Don’t wear clothing that could rub against your incision.
Don’t drive until you’re off pain medication and recovered enough to handle an emergency situation.

Most people can return to their normal activities like work or school within one to two weeks if they’ve had an uncomplicated procedure. “If it feels good, you can do it,” Dr. Grudziak says.

Diet after appendectomy

Once you start having normal bowel movements, experts say you can resume your usual diet (including coffee and spicy foods, says Dr. Pullatt). Avoid alcohol, however, if you’re taking antibiotics or are on opiate pain killers.

But until you get to that point, some doctors suggest a bland, low-fat, and high-fiber diet (the fiber will promote regular bowel movements and counteract the constipating effects of some pain medications). Some suggestions:

Broiled chicken
Dry toast
Low-fat yogurt
Plain rice

And to encourage regular bowel movements and stay hydrated, it’s also important to drink six to eight glasses of water a day.

How to prevent an appendectomy incision infection

Appendectomies are considered fairly safe surgeries, but complications like incision infections can arise. Open appendectomies are more apt to result in an incision infection because they use a larger incision and take more time to perform. In fact, research shows that appendectomy surgical incisions can become infected in nearly 21% of open appendectomies and just 1.5% of laparoscopic ones.

Regardless of which procedure you have, it’s important to keep your incision clean and dry to help prevent infection. “It’s generally okay to shower 24-48 hours after the surgery, but you should not swim or submerge yourself in water until you have full recovery, which can take up to six weeks,” Dr. Grudziak says. “Good nutrition will also help and smoking makes all healing more difficult, so it should be avoided for at least six weeks—or preferably forever.”

Follow your healthcare provider’s instructions about when—or if—you can remove bandages, and when any staples or stitches will be taken out, etc. Additionally, make sure whomever is caring for the wound (whether that’s you or some helping you) always washes and dries their hands before touching the incision.

Signs of infection include redness, pain, pus, or a foul odor coming from the wound as well as a fever or chills.

Medications after appendectomy

What medications you receive after your appendectomy will depend a lot on what procedure you have.

Mostly everyone will receive some kind of pain medication after appendectomy surgery. “For a laparoscopic appendectomy, we give Tylenol and Motrin [ibuprofen]. But for an open appendectomy, it’s more likely we’ll prescribe a few days of narcotics, such as oxycodone or Vicodin,” Dr. Pullatt says. “It all depends on the person’s pain tolerance.” To help prevent the constipation that often accompanies surgeries and the use of painkillers, your healthcare provider may also recommend using a laxative.

If you’ve had a ruptured or perforated appendix, you’ll also receive antibiotics post surgery. Most doctors prescribe the antibiotics for four to seven days to help prevent infection at the incision site as well as elsewhere in the body. Research shows that postoperative abscesses (a painful collection of pus) occur in 3% to 20% of appendectomies.

When to see a doctor for pain after an appendectomy

Most people recover from an appendectomy just fine, even when the appendix ruptures or you’ve had an open appendectomy. But problems can arise. Call your doctor or seek medical care if you experience any of the following:

Pain that gets worse or doesn’t improve after taking pain medication
Fever of 100.4 degrees F or above
Vomiting
Redness, pain, or pus oozing from the incision that’s getting worse, not better
Difficulty breathing
Inability to eat or drink within one day of surgery
Not having a bowel movement within two days of surgery
Diarrhea

These can be signs of possible complications.