A case of nonpharmacologic conservative management of suspected uncomplicated subacute appendicitis in an adult male.

BACKGROUND Appendicitis is an acute condition of the abdomen that is treated with surgical intervention. Conservative treatment of appendicitis currently involves intravenous antibiotics. While conservative care is a useful tool in apprehensive patients, in conditions such as appendicitis, delays in proper treatment can be life threatening. In spite of this, some patients will still refuse surgical and pharmacologic intervention, which can significantly limit the physician's therapeutic options. SUBJECT Sonographic evidence is presented of appendicitis in a patient who strongly desired to avoid pharmacologic or surgical intervention. RESULTS The patient underwent a medically supervised water-only fast followed by a plant-based, low-fat, low-sodium diet and achieved a significant reduction and eventual elimination of symptoms. CONCLUSIONS This case demonstrates the need for further research on the effects of medically supervised water-only fasting and careful refeeding in cases of uncomplicated appendicitis.