Colin Campbell

[Colin Campbell @ColinCampb81615]

@fvguima You might find the study below a bit more realistic..!

https://t.co/ue3d4HCmWW

[Colin Campbell @ColinCampb81615]

@alexmd55 @StequaviousB @dp_oneill @TheEconomist ..and don’t forget the tumours in the appendix left in to cause appendix and PMP..!

[Colin Campbell @ColinCampb81615]

@DrJgps @StequaviousB @dp_oneill @TheEconomist

[Colin Campbell @ColinCampb81615]

@Urodoc46 @valhumphreys51 @dp_oneill @TheEconomist

[Colin Campbell @ColinCampb81615]

It’s pretty much settled. Recruiting for RCT’s to investigate the appendectomy/antibiotics question has relied on recruiters telling patients that there is a 15% chance of reoccurrence and not mentioning the missed tumour risk. I don’t think that nonsense will get past ethics committees any more - I hope not anyway - so think the RCT’s are pretty much a thing of the past..

https://t.co/1yW5lvYNvG

[Colin Campbell @ColinCampb81615]

@GuleidAmina @dp_oneill @TheEconomist You might find the following study interesting. Looks at about 1000 patients treated for appendicitis in 2020 during Covid special measures - they tried antibiotics for some patients (about 20%) but it back-fired big time…

https://t.co/ue3d4HCUMu

[Colin Campbell @ColinCampb81615]

@medic_southside @dp_oneill @TheEconomist 100% correct.

[Colin Campbell @ColinCampb81615]

@mindsmattersmd @dp_oneill @TheEconomist Antibiotics is pretty sketchy for appendicitis!

[Colin Campbell @ColinCampb81615]

Surgery is the ‘gold standard’ treatment for appendicitis for a good reason.. Scans don’t show what’s causing appendicitis - scans can’t tell you if you need your appendix out or not - a pathologist’s microscope is the only thing that can tell you if you need it out or not - so you need it out.

[Colin Campbell @ColinCampb81615]

..this is very poor reporting. Please look at the data - for those treated with antibiotics for appendicitis, 50% have reoccurrence within 4 years, somtimes involving rupture, and 1 in 30 adults will have a missed tumour in their appendix that if left in will go on to cause appendix cancer.. Be careful out there people..

[Colin Campbell @ColinCampb81615]

One of the reasons appendix cancer is thankfully so rare is because tumours in the appendix often cause appendicitis at an early stage and are removed. At this stage routine appendectomy +/- is often curative and no follow-up needed..

The recent trend of surgeons leaving the problematic appendix in and treating with antibiotics.. The implications for a future uptick in late stage appendix cancer diagnosis are serious..

I had appendicitis caused by a tumour (LAMN) in my appendix - it was probably contained and curable at that time.. I had the misfortune to run into a NHS surgeon in the UK who was an enthusiast for antibiotic treatment as an alternative to surgery. He refused surgery. Turned into a medical train wreck for me much later..

Let’s keep appendix cancer rare - and let’s keep surgeons informed..!

[Colin Campbell @ColinCampb81615]

Will the risk from the recent trend to treat uncomplicated appendicitis with antibiotics instead of surgery be discussed..?

In adults, about 1 in 30 cases CT diagnosed as uncomplicated are caused by a tumour in the appendix that can’t be seen in scans. These tumours will only be found in pathology IF the appendix is taken out.. As these radiologically occult tumours are small and often contained, early appendectomy is often curative IF they are taken out..

Problematic appendix being left in, particularly in older adults, has massive implications for future appendix cancer late diagnosis rates.. Is this being flagged up..?

[Colin Campbell @ColinCampb81615]

@kh505043 If you have uncomplicated appendicitis and your surgeon suggests antibiotics as an alternative to surgery - there are downsides to avoiding surgery that your surgeon may not share with you:

[Colin Campbell @ColinCampb81615]

Some NHS Scotland surgeons are refusing appendectomy to patients who are diagnosed with uncomplicated appendicitis and who are fit and keen for surgery. They are saying the following things to patients;

- “surgery to treat appendicitis is outdated and a mistake of the past, antibiotics is better and the future of treatment..”

- “after antibiotic treatment your appendix will shrivel up and be cured, and you’ll only have a 15% risk of reoccurrence..”

- “there is a mortality associated with surgery, don’t you know..?”

- “going along with antibiotic treatment is like money in the bank for your business”

- “after treatment - you have no more chance of coming back in here with appendicitis than the average man on the street”

There are problems with this approach and these statements on many levels.. The accepted real-world reoccurrence rate after antibiotic treatment is 50% by year 4. For adult cases, 1 in 30 patients have a tumour in their appendix causing their appendicitis. These tumours cannot be seen in scans and will only be found in pathology IF the appendix is taken out. Left in - they are often deadly.

A 2026 study following up about 1000 uncomplicated appendicitis patients treated in Glasgow in 2020 concluded the following:

“Conclusions
Antibiotic treatment of appendicitis is associated with high recurrence and risk of missed neoplasms. Appendicectomy is safe, with low rates of significant complication. When offering nonoperative management for appendicitis, patients should be informed about the risk of recurrence and missing sinister pathologies.”

https://t.co/1yW5lvYfG8

It seems that some NHS Scotland surgeons are not following the evidence, withholding surgery, misleading patients, treating without informed consent, discharging after antibiotic treatment with no follow-up, all resulting in unnecessary harm.

I’m very interested to know what people know about this - please like and share as widely as possible.

[Colin Campbell @ColinCampb81615]

@IrishEcocritic It is - in older patients the risk that the appendicitis is caused by a neoplasm in the appendix is elevated - make sure you talk to your surgeon about this risk as part of deciding how to treat appendicitis..

[Colin Campbell @ColinCampb81615]

In the UK I had classic appendicitis symptoms the National Health Service (NHS) diagnosed me with ‘CT confirmed uncomplicated appendicitis’ - I was fit for surgery and expected surgery. They refused me surgery and treated me with IV antibiotics for 5 days telling me it would cure me.. Afterwards my NHS GP tried to get me a second opinion and get my appendix out.. That was refused.

Eventually, 4 months later I had to borrow money and pay a private surgeon in Glasgow to take my appendix out for me - that’s when the tumour causing my inital appendicitis was found - but because the appendix had been left in me it had ruptured allowing the tumour to go on to develop into a stage 4 tumour no longer curable by appendectomy..

For many social healthcare just gets in the way of correct treatment - and causes immense patient harm.. Be careful out there people..

[Colin Campbell @ColinCampb81615]

Not necessarily free in the UK - I had CT confirmed appendicitis and in a NHS Scotland hospital and was fit for surgery but was refused appendectomy (it was a bank holiday weekend) and was treated with IV antibiotics as an alternative to surgery by a clown surgeon.

The NHS then refused me a second opinion. Eventually, 4 months later I had to borrow money and pay a private surgeon in Glasgow to take my appendix out for me. That’s when the tumour causing my appendicitis was found - but by that stage it had ruptured because it was left in and had developed into a stage 4 tumour. If an early appendectomy had been carried out as it should have been the probability it would have been curative - but it’s too late for that now.

So, the private appendectomy cost me about £17k including scans and colonoscopy and consultations that went along with the process - but obviously the cost to my health and that costs to my business are far greater than the private appendectomy costs..

Be careful out there people..!

[Colin Campbell @ColinCampb81615]

..you forget - appendicitis can be caused by a tumour in the appendix. 1 in 30 cases of adult appendicitis is caused by a radiologically occult tumour in the appendix - it will only be found in pathology after appendectomy.. ..but leave the inflamed appendix in and ‘treat’ with antibiotics and an oppertunity to surgically cure appendix cancer by early appendectomy is lost..

[Colin Campbell @ColinCampb81615]

..if fit for surgery, surgery is a safe and definitive cure.. ..leaving problematic appendix in and just ‘treating’ with antibiotics is just kicking the can (or grenade) down the road and is very risky.. You can only find out what is causing your appendicitis once it’s out and under a pathologists microscope.. Be careful out there folks..