Appendicitis occurs when the appendix becomes inflamed. Early symptoms can vary between age groups, but severe and sudden abdominal pain is usually the first symptom.

The symptoms of appendicitis can be uncomfortable, painful, and potentially life threatening if left untreated. Because of this, it is important to be able to recognize them.

Appendicitis can occur at any age but may be more likely to occur in late teens and young adults.

This article explains the early symptoms of appendicitis. It also discusses diagnosis, treatment, and recovery from appendicitis.

Fast facts about appendicitis

  • Early symptoms include a pain near the belly button that may shift toward the lower right-hand side of the abdomen.
  • If treatment for gas does not solve the problem, prompt medical attention should be sought.
  • Many people with suspected appendicitis will go directly to the emergency department.
  • Early treatment is usually successful, but untreated appendicitis can lead to fatal complications.
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The appendix is situated on the right, lower side of the abdomen. It is a tube-shaped piece of tissue that is closed at one end. It is attached to the cecum, a pouch-like portion of the colon, or large intestine.

Sudden appendicitis is the most common cause of acute abdominal pain requiring surgery in the United States, with over 5% of the population developing appendicitis at some point.

Severe and sudden abdominal pain is usually the first symptom of appendicitis.

The pain often begins near the belly button. As it worsens, it will likely shift to the lower right side of the abdomen.

The feeling may become more intense within a few hours and be worsened by moving around, taking deep breaths, coughing, or sneezing.

Other symptoms of appendicitis include:

  • nausea
  • vomiting
  • loss of appetite
  • constipation or diarrhea
  • inability to pass gas
  • low grade fever (temperature between 99o and 102o Fahrenheit)
  • chills
  • stomach swelling
  • feeling the need to have a bowel movement to relieve discomfort

However, these symptoms appear in only around half of the cases of appendicitis.

Some people may experience symptoms such as stomach pain very slightly or not at all.

Learn more about appendicitis.

Symptoms in children and infants

Children and infants may not experience pain in one specific area. There may be tenderness throughout the body, or there may be no pain.

Children and infants may have less frequent or no bowel movements. If diarrhea occurs, this may be a symptom of another illness.

While children and infants may not experience precise pain as older people do, research suggests that abdominal pain is still the most common symptom of appendicitis symptom for this age group.

Symptoms in older adults and during pregnancy

Older adults and people who are pregnant may also experience different symptoms. The stomach pain may be less severe and less specific. Possible symptoms include nausea, vomiting, and fever.

During pregnancy, the pain may shift upward toward the upper right quadrant after the first trimester. There may also be some back or flank pain.

If there is stomach pain, this may result from another condition.

What can be mistaken for appendicitis pain?

Abdominal pain can be a symptom of other conditions that can be mistaken for appendicitis.

Examples include:

When to see a doctor

Appendicitis can be life threatening, and it requires immediate medical care. It is likely to worsen the longer it is left untreated. Initial symptoms may feel like gas.

If over-the-counter (OTC) medications do not relieve the gas, or if there is severe and worsening pain, the individual should contact a healthcare professional at once. It may be advisable to go straight to the emergency room.

Treating appendicitis as soon as symptoms appear will prevent it from worsening and causing further complications.

Read about the differences between appendicitis and gas.

A healthcare professional will normally diagnose appendicitis by reviewing symptoms and performing a physical exam. They may also order some laboratory tests in order to confirm diagnosis.

Physical exam

The healthcare professional will most likely perform a physical exam to find out more about the individual’s stomach pain. They will typically apply pressure to or touch certain areas of the abdomen.

They may also recommend pelvic and rectal exams.

Laboratory tests

Blood and urine tests can help confirm an appendicitis diagnosis or detect signs of other health issues. A healthcare professional may also ask for blood or urine samples to check for pregnancy.

If necessary, they may also order imaging tests, such as an abdominal ultrasound, MRI scan, or CT scan.

These imaging tests can show:

  • an enlarged or burst appendix
  • inflammation
  • a blockage inside the appendix
  • an abscess

Treatment normally begins with antibiotics and IV fluids. Some mild cases of appendicitis can be treated completely with antibiotics.

The most common next step is surgery, known as an appendectomy. Removing the appendix decreases the risk of it rupturing. Early treatment is important to reduce the risk of complications, which can be fatal.

There are two types of appendectomy surgery doctors may use. It is important for a person to follow all postoperative instructions from their surgical team.

Laparoscopic surgery

Surgeons make several small incisions and use special tools to remove the appendix through them.

Benefits of laparoscopic surgery include:

  • a lower risk of complications, such as hospital-related infections
  • shorter recovery time

Individuals should limit their physical exercise for the first 3-5 days after surgery.

Laparotomy surgery

Surgeons remove the appendix through a single incision made in the lower right area of the abdomen. This may be necessary for a burst appendix.

It allows the surgeon to clean the inside of the abdomen to prevent infection.

Individuals should limit their physical activity for the first 10 to 14 days after a laparotomy surgery.

Delaying treatment can seriously increase the risk of complications.

Inflammation can cause the appendix to rupture, sometimes as soon as 48 to 72 hours after the symptoms begin.

A rupture can cause bacteria, stool, and air to leak into the abdomen, causing infection and further complications, which can be fatal.

Infections that can result from a burst appendix include peritonitis, an inflammation of the lining of the abdomen, or an abscess.

Taking pain medications can potentially mask symptoms and delay treatment.

With prompt treatment, appendicitis is treatable, and recovery is normally fast and complete. With early surgery, the mortality rate is under 1%.

Without surgery or antibiotics, for example, in remote areas, the mortality rate can be 50% or higher.

If the appendix bursts, this can lead to complications, such as an abscess or peritonitis. Recovery may be lengthy in these cases. Older people may also take longer to recover.

The appendix is often considered a nonfunctioning organ, unnecessary for survival, but some scientists suggest that it may play a role in maintaining a healthy immune system.

The following are questions people frequently ask about appendicitis.

Can appendicitis resolve on its own?

Appendicitis is typically considered a medical emergency. This is because it can cause the appendix to burst, which can lead to serious complications. Some mild cases of appendicitis may be treatable with antibiotics alone. However, surgery is generally the standard treatment for the condition.

How do you rule out appendicitis?

Healthcare professionals will typically diagnose or rule out appendicitis using a person’s medical history, a physical exam, and laboratory tests.

How long can you have appendicitis before knowing?

Symptoms of appendicitis generally present within 24 hours of the onset of the condition.

The earliest symptom of appendicitis is usually abdominal pain. This often begins near the belly button and then spreads to the lower right part of the abdomen. The pain may be sudden and worsen over time.

Pressing on the area, moving around, coughing, and sneezing may all make the pain worse. Other symptoms may include fever, nausea, constipation or diarrhea, and swelling of the stomach.

Appendicitis is considered a medical emergency. If a person experiences sudden pain in their abdomen, they should contact a healthcare professional right away.

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