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Irritable Bowel a Risk for Negative Appendectomy

A prior diagnosis of irritable bowel syndrome, higher anxiety scores associated with unnecessary surgery

THURSDAY, May 10 (HealthDay News) -- Patients who are anxious, present with atypical symptoms or have irritable bowel syndrome are more likely to undergo misdiagnosed, or negative, appendectomy. The low usage of computed tomography scans in such patients also contributes to unnecessary surgery, according to study findings published in the May issue of Gut.

Ching-Liang Lu, M.D., of Taipei Veterans General Hospital in Taipei, Taiwan, and colleagues conducted a study of 430 patients who underwent surgery to treat suspected appendicitis, of whom 68 (15.8 percent) had negative appendectomy.

Younger age, female sex, lower levels of health-related quality of life, a prior diagnosis of irritable bowel syndrome and higher anxiety scores were all associated with negative appendectomy compared to patients in the positive appendectomy group. They were also more likely to have a lower white cell count, atypical presentations, such as absence of migration pain, and were less likely to have undergone a computed tomography scan.

"Physicians should be cautious before operating on or referring patients with irritable bowel syndrome for appendectomy. Computed tomography scan should be considered in patients with suspected appendicitis, particularly in those with irritable bowel syndrome and atypical clinical presentations," the authors conclude.

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