Appendicitis can feel very similar to gas. However, unlike gas, appendicitis pain occurs specifically to the lower right of the belly button, is severe, and worsens over the next few hours.

Appendicitis occurs when the appendix becomes inflamed. Most people with appendicitis feel varying levels of sharp cramping or pain in the lower right abdomen, depending on how serious the inflammation is.

Excess gas, or flatulence, can build up in the digestive tract and cause discomfort, excessive gas, and pain anywhere in the abdomen.

This article will explore the symptoms of both appendicitis and gas and explore how to tell the difference between them.

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The most common symptom of appendicitis is abdominal pain. Other possible symptoms of appendicitis can include:

The early symptoms of appendicitis can be subtle, and they typically appear in the first 12–24 hours. Around 75% of people with appendicitis develop symptoms that require medical attention within 24 hours of the start of inflammation.

Warning signs of appendicitis

As there is a risk of the appendix bursting, which is a medical emergency, it is important that people recognize the warning signs of appendicitis. Warning signs typically progress in the following order:

  • sudden pain that begins near the belly button
  • pain that intensifies over time and moves to the lower right of the abdomen
  • lack of energy and loss of appetite
  • worsening symptoms, which can include nausea, constipation, inability to pass gas, and diarrhea
  • fever

In pregnant people

Acute appendicitis is the most common surgical disease of pregnancy that does not relate to childbirth.

Pregnant people may experience pain in a different part of the abdomen, as their body will reposition itself to accommodate the growing fetus. Pregnant people may also experience nausea or vomiting, and they may develop tenderness anywhere on the right side of the abdomen.

In children

Most cases of appendicitis occur in people aged 10–30 years old, so it is important to be aware of the different signs and symptoms that it can cause in children.

Some children, especially young children or infants, may not be able to fully describe or express their symptoms. This can make appendicitis harder to detect.

Children may also exhibit nonverbal signs of pain, such as:

  • walking bent over
  • lying on their side
  • acting withdrawn
  • being excessively fussy
  • being difficult to wake or keep awake

In older adults

Older adults with appendicitis may also experience confusion, and evidence notes they have a higher incidence of appendicitis complications.

The most common symptoms of excessive abdominal gas in the abdomen may include:

Initially, symptoms of appendicitis may be similar to gas. Some individuals with appendicitis may have an inability to pass gas, which is the source of discomfort when a person has gas. As such, this can lead to confusion when distinguishing between the two.

With gas, people may have the sensation that gas is moving through the intestines, they may feel mild-to-moderate pain anywhere in the abdomen, and discomfort will usually resolve quickly after passing gas.

However, with appendicitis, pain typically starts in the middle of the abdomen, then travels to the lower right-hand side of the abdomen, where it becomes severe and constant.

Due to the potential complications of appendicitis, it is advisable for anyone experiencing unexplained and chronic abdominal pain to seek medical help.

Appendicitis, especially when undiagnosed and untreated, can lead to serious complications. Potential complications may include:

Perforation and rupture

If the opening to the appendix becomes blocked, the surrounding tissues may die from a lack of oxygen and nutrient exchange.

The dead tissue can easily tear or develop a small opening (perforation), through which bacteria and other microbes can enter the organ.

If enough bacteria enter the organ, they can form an infected abscess. As it grows, the abscess may put pressure on the appendix, causing it to burst (rupture).

If this occurs, the appendix will spill and leak stool, pus, and other contents into the bloodstream.

Symptoms associated with appendix perforation and rupture include:

  • severe pain, which may make it difficult to stand upright or walk
  • extreme abdominal tenderness
  • high fever
  • facial flushing
  • sweats or chills
  • loss of consciousness
  • vomiting
  • lack of appetite

Although unlikely, a rupture can occur 36 hours from the onset of appendicitis. After 36 hours, the risk of rupture is around 2%. The risk then increases by around 5% every 12 hours after that.


Sometimes, a bacterial infection can cause an abscess to form around the appendix when it bursts. Complications from surgery can also cause this.


Once the appendix ruptures or leaks into the abdominal cavity, this can inflame the lining of the abdomen. This inflammation is known as peritonitis.

Peritonitis can also affect the organs that the abdominal lining covers, which lead to symptoms such as:

  • severe, continual abdominal pain
  • a high fever
  • nausea or vomiting
  • a rapid heartbeat
  • abdominal swelling
  • shortness of breath and rapid breathing


Severe, widespread, or untreated bacterial infections can enter the blood and spread through the body. This can cause fatal complications.

One potentially fatal complication is sepsis, which is when the body has an extreme immune response to the infection.

Symptoms of sepsis include:

  • blue, blotchy, or pale skin, lips, or tongue
  • the stomach sucking up under the rib cage
  • a rash that does not fade when a person applies pressure to it
  • confusion
  • slurred speech or not making sense
  • a weak, high pitched cry that is not normal (in young children or infants)
  • being sleepier than usual or harder to wake
  • not responding normally to regular activities, such as feeding (in young children or infants)
  • difficulty breathing

A person should speak to a doctor about unexplained abdominal pain, digestive symptoms, or excessive or chronic gas.

Anyone who thinks that they or someone else may have appendicitis or associated complications should seek emergency medical care immediately.

To diagnose appendicitis, a doctor will perform a physical exam. They may also ask questions about the person’s symptoms and medical history.

They may also use various diagnostic tools, including:

  • Blood tests: These tests can check for dehydration, fluid or electrolyte imbalances, or signs of infection, such as high white blood cell counts.
  • Ultrasounds, X-rays, or MRI scans: These tests allow the doctor to see the person’s abdominal organs and structures.
  • Urinalysis: This test can help rule out kidney stones and urinary tract infections.
  • Pregnancy tests: This test can rule out pregnancy as a cause of a person’s symptoms.

Most people with appendicitis require surgery, or appendectomy, to remove the appendix and repair any surrounding tissue or organ damage. Prompt surgery can reduce the risk of appendix rupture and other complications.

A surgeon will usually perform appendectomy using one of two procedures: open surgery or laparoscopic surgery. The sections below will discuss these, plus some other options, in more detail.

Open surgery

In open surgery, the surgeon will remove the appendix through an incision in the abdomen, either above or beside the appendix.

Laparoscopic surgery

In laparoscopic surgery, the surgeon will create several smaller incisions and insert specialized surgical tools and a tiny tube with a camera and light.

Laparoscopic surgery typically has a quicker recovery time, less pain, and less scarring than traditional open surgery.

Other treatments

To address complications, healthcare professionals may also use other treatments, such as:

  • antibiotics
  • removing infected abdominal tissue
  • draining pus from the abscess or infection site
  • blood transfusions
  • intravenous electrolyte or fluid therapy

There is usually no way to prevent appendicitis. Some people even have a higher risk of developing it.

Risk factors for appendicitis include:

  • Age: Most people get appendicitis at 10–20 years of age.
  • Sex: Evidence notes that those assigned male at birth (AMAB) are slightly more likely to develop appendicitis than those assigned female at birth (AFAB).
  • Low fiber diet: A low fiber diet can potentially cause fats, undigested fiber, and inorganic salts to build up in the appendix and cause inflammation or obstruction.
  • Genes: Some studies suggest that genetics can play a role in appendicitis. A 2018 population study notes that individuals with a family history of appendicitis have a higher risk of appendicitis.

Some FAQs about appendicitis may include:

How does the start of appendicitis feel?

Typically, appendicitis will start with pain that may come and go in the middle of the tummy. Within hours, the pain will travel to the lower right side of the abdomen and become constant and severe.

How do I check myself for appendicitis?

If a person has severe pain in the lower right of their abdomen, pain that worsens when moving or touching the abdomen, as well as other symptoms such as fever and nausea, it could indicate appendicitis. In such circumstances, it is advisable to contact a doctor.

How do you know if it’s not appendicitis?

Appendicitis often results in severe pain in the lower right of the abdomen. If the pain is mild to moderate, improves over time, and feels as if it is moving through the intestines, it could instead be signs of gas.

How long can you have appendicitis before it bursts?

After the onset of symptoms, a rupture can occur after 36 hours. However, the risk of rupture is relatively rare after 36 hours. The risk of the appendix bursting increases as more time elapses.

Several home remedies can help relieve excessive gas, including:

  • massaging the abdomen
  • , if possible

Read on to learn more about tips and home remedies for relieving gas.

Many conditions can cause stomach pain, especially if they affect the digestive tract or abdominal organs.

These include:

Most people with temporary mild-to-moderate abdominal pain have gas or symptoms of indigestion.

However, appendicitis is the most common cause of severe abdominal pain requiring surgery, and at least 5% of people in the United States develop it at some point in their lives.

A person should talk to a doctor about any minor symptoms they have. If any moderate-to-severe symptoms of appendicitis occur, a person should seek emergency medical care to prevent the risk of serious complications.

Most people recover well if they receive a diagnosis and treatment early enough.