Appendicitis

Appendicitis is a medical emergency that happens when the appendix becomes inflamed and infected. It often causes sudden abdominal pain that gets worse over time. Without treatment, the appendix can burst, leading to serious infection. 

If you have severe stomach pain that is getting worse - especially in the lower right side of your abdomen - seek medical care right away. 

What is appendicitis?

Appendicitis occurs when the appendix becomes blocked, swollen and infected. 

The appendix is a small, finger-shaped pouch located in the lower right side of your abdomen, where the small intestine meets the large intestine. You do not need your appendix to live. 

Appendicitis most often develops quickly. Symptoms can worsen within 24 hours. 

Where is appendicitis pain located? 

Pain usually: 

• Starts near the belly button 
• Moves to the lower right side of the abdomen 
• Gets worse when you move, cough or walk 
• Becomes sharper and more constant over time 

Lower right abdominal pain that worsens steadily is one of the most common signs of appendicitis. 

What causes appendicitis? 

Appendicitis usually happens when the appendix becomes blocked. Causes may include: 

• Hardened stool (fecalith) 
• Swollen lymph tissue 
• Infection from a gastrointestinal illness 
• Rarely, a tumor 

When the appendix is blocked, bacteria multiply inside it. Pressure builds, blood flow decreases and infection develops. 

Without treatment, the appendix can rupture. 

Who is at risk? 

Appendicitis can happen at any age but is most common between ages 10 and 30. 

Risk factors include: 

• Family history 
• Low-fiber diet 
• Being male 
• Prior abdominal surgery 

Symptoms of appendicitis 

Common appendicitis symptoms include: 

• Abdominal pain that shifts to the lower right side 
• Loss of appetite 
• Nausea or vomiting 
• Low-grade fever 
• Bloating 
• Constipation or diarrhea 
• Feeling generally unwell 

Symptoms may look different in: 

• Young children 
• Older adults 
• Pregnant women 

In these groups, pain may be less specific or located elsewhere in the abdomen. 

Do not take pain medication before being evaluated unless instructed by a provider. Medication can mask important symptoms. 

How long before an appendix bursts? 

Appendicitis can worsen quickly. In many cases, rupture can occur within 24 to 72 hours after symptoms begin. 

Once the appendix bursts, bacteria spread into the abdomen. This can cause: 

• Peritonitis (infection of the abdominal lining) 
• Abscess formation 
• Sepsis (life-threatening infection) 

Signs of a ruptured appendix 

Seek emergency care immediately if you notice: 

• Pain that suddenly becomes severe 
• Pain that briefly improves then worsens 
• High fever 
• Widespread abdominal tenderness 
• Vomiting that does not stop 
• Swelling or rigidity of the abdomen 

A ruptured appendix is life-threatening and requires urgent treatment. 

How doctors diagnose appendicitis 

Providers diagnose appendicitis using: 

• Physical exam to check for rebound tenderness 
• Blood tests to check white blood cell count 
• Imaging tests such as CT scan or ultrasound 
• MRI for pregnant patients 
• Urine tests to rule out kidney or urinary causes 

Conditions that can mimic appendicitis 

Several conditions can cause similar symptoms, including: 

• Urinary tract infection 
• Kidney stones 
• Gallstones 
• Ovarian cysts 
• Pelvic inflammatory disease 
• Crohn’s disease 
• Diverticulitis 
• Gastroenteritis (stomach flu) 
• Pancreatitis 

Because symptoms overlap, medical evaluation is important. 

How is appendicitis treated? 

Appendectomy (appendix removal) 

Surgery to remove the appendix is the most common treatment. 

There are two approaches: 

Laparoscopic appendectomy 

• Small incisions 
• Faster recovery 
• Less pain 
• Often same-day discharge 

Open appendectomy 

• Larger incision 
• Used if rupture or complications occur 

Your surgeon will determine the safest option. 

Recovery after appendix surgery 

After laparoscopic surgery:

• Recovery usually takes about 2 weeks 

After open surgery: 

• Recovery may take 4 to 6 weeks 

During recovery: 

• Start with clear liquids 
• Avoid lifting heavy objects 
• Increase activity gradually 

Call your doctor if you develop: 

• Fever 
• Increasing pain 
• Redness or drainage at incision site 
• Ongoing nausea or vomiting 

Most people recover fully without long-term effects. 

Can antibiotics treat appendicitis? 

In some cases, antibiotics may be used first, especially if: 

• There is an abscess 
• Surgery carries higher risk 

However, antibiotics alone may not cure appendicitis permanently. Recurrence is possible. 

Your provider will discuss the safest option for your situation. 

When to seek care for appendicitis 

Seek immediate medical attention if you have: 

• Severe or worsening abdominal pain 
• Pain in the lower right abdomen 
• Fever with stomach pain 
• Vomiting with abdominal tenderness 

Early treatment greatly reduces the risk of rupture and complications. 

Emergency and surgical care at Banner Health 

At Banner Health, we provide: 

• Rapid emergency evaluation 
• Advanced imaging and lab testing 
• Minimally invasive surgery options 
• Experienced emergency and surgical teams 
• Compassionate care focused on safe recovery 

If you think you may have appendicitis, do not wait. Prompt treatment can prevent serious complications.