Stephen Colbert undergoes surgery for ruptured appendix

“Late Show” host Stephen Colbert has canceled this week’s show as he is recovering from an appendectomy. About threads.

“From now on, all emails to my appendix will be handled by my pancreas,” the comedian wrote in the post.

As for their take on Colbert’s condition — which organizers described as a “ruptured appendix” — today’s med page We spoke with David Fram, MD, MPH, a surgeon at the University of Washington in Seattle who is leading recent research efforts on treating appendicitis.

The appendix is ​​only about the size of a pinky finger, but when it becomes inflamed, it can start rubbing against the lining of the stomach on the right side, and that’s where most people start feeling pain, Flamm says. Symptoms of appendicitis may begin as generalized pain around the belly button and then worsen toward the right side. Some people lose their appetite.

Flum pointed out that the common expression “ruptured appendix” technically refers to a punctured or ruptured appendix. However, appendicitis does not necessarily involve rupture; it can also be just inflammation.

“If the inflammation is particularly severe, or if there are certain types of bacteria present in the appendix, the wall of the appendix may crack and pus and bacteria may begin to leak into the surrounding area,” Hulme says. . He explained. “It’s what we call the ‘burst’ appendix.”

Colbert underwent surgery for a ruptured appendix, but in recent years more research has focused on whether appendicitis (even when accompanied by perforation) can be managed with antibiotics.

In fact, Dr. Hulme led the Comparison of Outcomes Between Antibiotics and Appendectomy (CODA) trial, which found that antibiotics were noninferior to appendectomy on standard 30-day quality of life scores. People who took antibiotics also returned to work twice as quickly as those who had surgery, Flamm said.

However, the study’s long-term follow-up revealed that nearly half of the patients had to have their appendix surgically removed by the second year.

Both treatment strategies have advantages and disadvantages, and “one treatment is not better than the other,” Flamm said.

The advantage of antibiotics is that they avoid surgery, which many patients prefer, especially if they need to return to work or caregiving quickly. But the trade-off, Fram says, is the risk of developing appendicitis again in the future. With an appendectomy, Flam says, it’s a “one-and-done procedure.” “You can be there, get sick, take your appendix out, and never have to worry about your appendix again.”

He said the majority of appendicitis patients who come to the hospital end up undergoing appendectomies, in part because appendectomies have been the go-to treatment for many years.

Still, a perforated appendix can often be treated with antibiotics, Fram says.

“I think there’s a misconception that antibiotics are only effective in people with early appendicitis, or what’s called simple appendicitis. Part of the reason for that is that early studies didn’t include people with a perforated or ruptured appendix. Because we were carefully selecting patients to make sure they weren’t,” Hulme added that the CODA trial did include these patients.

But in rare cases of severe appendicitis, where an abscess develops and drains pus, no doctor would consider giving antibiotics, he said. In these cases, surgery is the best option.

Ultimately, Fram said, the decision between appendectomy and antibiotics “should be an informed decision for the patient. It’s not for us to make that decision for the patient.”

Hulme reminded health workers: decision making tools It was developed by the University of Washington’s Treatment-Individualized Appendicitis Decision-Making (TRIAD) program to determine whether a particular patient needs an appendectomy or can be treated with antibiotics instead.

According to the study, 5% to 9% of people will develop appendicitis during their lifetime. National Institute of Diabetes and Digestive and Kidney Diseases. Appendicitis is most likely to occur in your 20s and teens, but it can occur at any age.

This isn’t the first time Colbert has canceled a show this year. last monthhe had to cancel several episodes because he contracted the coronavirus.