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Everything You Need to Know About Appendicitis

What is appendicitis?

Fast facts

  1. Appendicitis occurs most often between the ages of 10 and 30.
  2. Symptoms include pain around the bellybutton, loss of appetite, nausea, abdominal swelling, and low grade fever.
  3. One possible cause of appendicitis is an obstruction in the appendix. Obstruction can lead to bacteria multiplying inside the organ and the formation of pus.

Appendicitis is inflammation of the appendix. It may be acute or chronic.

In the United States, appendicitis is the most common cause of abdominal pain resulting in surgery. About 5 percent of Americans will experience appendicitis at some point in their lives.

Appendicitis can happen at any time, but it occurs most often between the ages of 10 and 30. It’s more common in males than in females.

If left untreated, appendicitis may cause your appendix to burst and cause infection. This can be serious and sometimes fatal.

Read on to learn more about symptoms, diagnosis, and treatment.

Is it appendicitis or gas?

Indigestion or other gas-related pain are common symptoms of appendicitis. In some cases, you may feel as though the gas is trapped and find that you’re unable to expel the gas.

If you’re only experiencing mild gas-related discomfort, you can take an over-the-counter (OTC) heartburn medication and see if your symptoms fade.

Popular OTC options include:

If your symptoms persist for more than a day or cause you unbearable pain or discomfort, see your doctor right away. You should also see your doctor if you’re experiencing any other unusual symptoms.

What are the other symptoms of appendicitis?

If you have appendicitis, you may experience one or more of the following symptoms:

  • pain around the bellybutton
  • lower right side abdominal pain
  • loss of appetite
  • nausea
  • vomiting
  • diarrhea
  • constipation
  • inability to pass gas
  • abdominal swelling
  • low-grade fever
  • a sense that you might feel better after passing stool

Appendicitis pain may start off as mild cramping. It often becomes more steady and severe over time. You may also feel a general pain become more targeted.

You likely won’t notice changes in your bowel habits. However, appendicitis can sometimes affect urination.

If you suspect you may have appendicitis, you should avoid taking laxatives or having an enema. These treatments may cause your appendix to burst if you’re experiencing appendicitis.

If you have tenderness on your right side along with any of these other symptoms, see your doctor. Appendicitis can quickly become a medical emergency.

Is back pain a symptom of appendicitis?

Appendicitis is primarily associated with stomach pain, but this pain can also be felt in your sides or back. Oftentimes, this pain will worsen if you move, walk, or even cough.

If you’re experiencing significant pain that doesn’t fade after 4 hours, you should see your doctor.

Are the symptoms of appendicitis the same in teens?

Although the symptoms of appendicitis are the same for adolescents as they are for adults, they may begin differently. In adolescents, appendicitis can begin as a vague stomachache near the navel. This pain may progress to the lower right side of the abdomen.

What about infants and toddlers?
In children under the age of 2, appendicitis often causes vomiting and a bloated or swollen abdomen first.

After this pain has appeared, you may:

  • develop a fever
  • lose their appetite
  • feel nauseous
  • vomit

If you’re experiencing these symptoms, see your doctor.

Learn more: How to recognize and react to signs of appendicitis in children »

What causes appendicitis?

In many cases, the cause for appendicitis is unknown. There can also be multiple causes for one case of appendicitis.

Doctors believe an obstruction in the appendix may cause appendicitis. Obstruction may be either partial or complete. Complete obstruction is a cause for emergency surgery.

Obstruction is often due to an accumulation of fecal matter. It can also be the result of:

  • enlarged lymphoid follicles
  • worms
  • trauma
  • tumors

When there’s an obstruction in your appendix, bacteria can multiply inside the organ. This leads to the formation of pus. The increased pressure can be painful. It can also compress local blood vessels. A lack of blood flow to the appendix may cause gangrene.

If the appendix ruptures, fecal matter can fill the abdomen. This is a medical emergency.

Peritonitis is another possible consequence of a ruptured appendix. It’s an inflammation of the tissue that lines the abdominal wall. Other organs can also become inflamed after a rupture. Affected organs may include the cecum, bladder, and sigmoid colon.

If the infected appendix leaks instead of ruptures, it can form an abscess. This confines the infection to a small walled off area. However, an abscess can still be dangerous.

How is appendicitis diagnosed?

Your doctor will begin by performing a physical exam. They will look for tenderness in the lower right quadrant of your abdomen. If you’re pregnant, the pain may be higher. If perforation occurs, your stomach may become hard and swollen.

There isn’t any one test to diagnosis appendicitis. First, your doctor will order a complete blood count (CBC) test. A CBC can determine if there’s a bacterial infection. Bacterial infection is often correlated with appendicitis.

Your doctor will also perform several tests to rule out other similar conditions:

  • Urinalysis can rule out a urinary tract infection or kidney stone.
  • Pelvic exams can make certain that you aren’t experiencing any reproductive problems. They can also rule out other pelvic infections.
  • Pregnancy tests can rule out a suspected ectopic pregnancy.
  • Abdominal imaging can determine if you have an abscess or other complications. This may be done with an X-ray, ultrasound, or CT scan.
  • Chest X-ray can rule out right lower lobe pneumonia. This sometimes has symptoms similar to appendicitis.

If your doctor is unable to pinpoint another cause for your symptoms, you will be diagnosed with appendicitis.

What are the treatment options for appendicitis?

Treatment for appendicitis varies. In most cases, however, surgery will be necessary. The type of surgery will depend on the details of your case.

If you have an abscess that hasn’t ruptured, your doctor may first administer antibiotics. Your doctor will then drain the abscess using a tube placed through your skin. After you’ve received treatment for the infection, you’ll undergo surgery to remove your appendix.

If you have a ruptured abscess or appendix, surgery may be necessary right away. Surgery to remove the appendix is known as an appendectomy.

Your doctor can perform this procedure as open surgery or through a laparoscopy. Laparoscopy is less invasive, making the recovery time shorter. However, open surgery may be necessary if you have an abscess or peritonitis.

In rare cases, appendicitis may get better without surgery. This is only an option if your abdominal pain is minimal and your diagnostic tests are normal. In this scenario, your treatment plan might only involve antibiotics and a liquid diet until your symptoms resolve.

What’s the recovery time for appendicitis?

If you undergo a laparoscopy, you will likely leave the hospital a few days after the operation. This surgery is less invasive, so the recovery time tends to be shorter.

If you undergo open surgery or experience additional complications, such as peritonitis, you may have to remain at the hospital for up to a week, and a drain may be needed. If your abdominal muscles need to be cut during the procedure, your recovery time may be longer.

You may experience tenderness and bruising after your operation. This will improve over time and may be relieved by over-the-counter pain killers, such as acetaminophen (Tylenol) and ibuprofen (Advil).

You may also experience temporary constipation. Staying hydrated and eating fiber-rich foods may help regulate your bowel movements.

Foods high in fiber include:

  • split peas
  • lentils
  • black beans
  • lima beans
  • artichokes

You should be able to resume normal activities within a couple of weeks. Your doctor may advise you to avoid strenuous activity, such as sports and heavy lifting, for four to six weeks after your surgery.

What about appendicitis in pregnancy?

During pregnancy, acute appendicitis is the most common non-obstetric emergency requiring surgery. It occurs at the same rate in women who are and aren’t pregnant.

When it does occur in pregnant women, it’s usually during the second or third trimester. Its symptoms can often be mistaken for routine discomfort associated with pregnancy, making diagnosis difficult.

Delayed diagnosis can increase your risk of complications, including fetal loss. Women who are pregnant also have a higher risk of perforation or rupture.

Treatment for women who are pregnant and have appendicitis is the same as for women who aren’t pregnant.

During recovery, women who are pregnant will be monitored even more closely by their surgeon, primary doctor, and obstetrician.

If laparoscopic surgery is done, the recovery process generally is similar for women who are and aren’t pregnant.

If an open surgical procedure is needed, your recovery time may be longer. This is especially true if your abdominal muscles are cut during the procedure or if there’s peritonitis. In some cases, peritonitis may cause a fetal loss.

How can I prevent appendicitis?

You can’t prevent appendicitis, but there are steps you can take to lower your risk. It’s less common in people who have diets high in fiber.

thumbs up Add fiber by
  • sprinkling oat bran or wheat germ over breakfast cereals, yogurt, and salads
  • cooking or baking with whole-wheat flour whenever possible
  • swapping white rice for brown rice
  • adding kidney beans or other variations to salads
  • eating fresh fruit for dessert

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