A sharp pain in the abdomen can often be triggered by a buildup of gas, but it can also be a symptom of a problem with your appendix.
Knowing how to tell the difference between the two is important, as an inflamed appendix can be a life threatening medical emergency.
If the appendix becomes obstructed, it can cause inflammation and infection. This is what’s known as appendicitis. Treatment most often involves surgical removal of the appendix.
Pain that’s caused by gas tends to be short-lived and usually doesn’t require treatment.
Gas pain may be caused by swallowing air while you’re eating or drinking. Gas can also build up in your digestive tract due to bacteria in your gut that breaks down food, releasing gas in the process. Passing gas can often help the pain go away.
This small, oblong pouch descends from your colon in your lower right abdomen. It doesn’t serve any vital function.
The telltale symptom of appendicitis is a sudden, sharp pain that starts on the right side of your lower abdomen.
It may also start near your belly button and then move lower to your right. The pain may feel like a cramp at first, and it may get worse when you cough, sneeze, or move.
The pain usually doesn’t go away until the inflamed appendix is surgically removed.
Other symptoms of appendicitis often include:
- nausea and vomiting
- a low grade fever, which is generally below 100.4°F (38°C)
- diarrhea or constipation
- abdominal bloating
- little or no appetite
Symptoms of a ruptured appendix
The risk with appendicitis is that, if left untreated, your appendix could rupture (burst).
How long does this typically take? From the time you first notice any symptoms, it can take between 48 and 72 hours before your appendix ruptures.
In some instances, that timeframe can be even shorter. That’s why it’s so important to take those early symptoms seriously.
Signs that your appendix has ruptured may be delayed for a few hours. Because the pressure — and source of the pain — inside your appendix is relieved when it bursts, you might initially feel better.
However, once your appendix bursts, the bacteria that was inside your appendix can spill into your abdominal cavity, causing inflammation and infection. This condition is called peritonitis.
Symptoms of peritonitis
Peritonitis is a serious condition that needs immediate medical attention.
Symptoms of peritonitis may include:
- pain and tenderness throughout your abdomen
- pain that worsens with movement or touch
- nausea and vomiting
- diarrhea or constipation
- an urge to pass gas
- fever and chills
These symptoms can last until treatment begins and may worsen with each passing hour.
Appendicitis symptoms in children
Appendicitis can occur at any age, but it most often occurs between the ages of 10 and 20 years old.
Most children will likely complain of a sharp stomach pain. There are other symptoms, too, such as:
- walking bent over at the waist
- lying on their side with their knees drawn upward
- nausea and vomiting
- abdominal tenderness to the touch
Keep in mind that children may not be able to describe their symptoms or pain very well or in much detail.
Learn how to recognize the signs of appendicitis in children.
Appendicitis symptoms during pregnancy
Although rare, appendicitis can also occur during pregnancy.
Signs of appendicitis during pregnancy are similar to the signs of appendicitis in people who aren’t pregnant. However, the appendix sits higher in the abdomen during pregnancy because the growing baby shifts the position of the intestines.
As a result, the sharp pain associated with an inflamed appendix may be felt higher up on the right side of your abdomen.
A ruptured appendix can be risky for both the parent and baby.
Pain from gas can feel like knots in your stomach. You may even have the sensation that gas is moving through your intestines.
Unlike appendicitis, which tends to cause pain localized on the lower right side of the abdomen, gas pain can be felt anywhere in your abdomen. You may even feel the pain up in your chest.
Gas pain tends to last a few minutes to a few hours, and it usually goes away without any treatment. If you feel relief from your abdominal symptoms after burping or passing gas, then you likely had typical gas pain.
If you have gas pain that lasts for more than a few hours, it may be a sign of something more serious. Possible underlying causes include obstipation and decreased motility of the colon.
In obstipation, you can’t eliminate gas and stools, usually because of a bowel obstruction downstream. Decreased motility of the colon means that your digestive muscles don’t contract as often as they should. This can occur in some gastrointestinal conditions.
If the pain comes on suddenly and is isolated in your lower right abdomen, pay close attention to other symptoms, such as fever, nausea, and gastrointestinal issues.
If you have some of these symptoms and the pain doesn’t go away or gets worse, go to the emergency room. If you have appendicitis, you’ll want to get immediate medical care.
Making a diagnosis
A doctor will need to perform a physical examination to make a proper diagnosis. This will involve the doctor gently pressing on the painful area.
If the pain get worse when the doctor presses down and then releases, it could indicate that the tissue around the appendix is inflamed.
A response known as “guarding” may also suggest that your body is trying to protect an inflamed appendix. This means that, when anticipating pressure on the painful area, you tighten your abdominal muscles rather than relaxing them.
A review of your recent symptoms and medical history is also crucial to making a diagnosis.
Questions the doctor may ask
The doctor or healthcare professional will need to know details about your medical history and symptoms.
Be prepared to answer the following questions:
- When did the symptoms begin?
- How would you describe the pain (sharp, achey, crampy, etc.)?
- Have you had similar symptoms before?
- Has the pain come and gone, or has it been constant since it started?
- What have you eaten in the past 24 hours?
- Have you done any exercise recently that might have caused you to pull a muscle or develop a cramp?
Tests you can expect
There’s no blood test that can specifically identify appendicitis or gas. There is a test, though, that can show whether there’s an increase in your white blood cells (WBCs).
If your WBC count is high, it could suggest that you’re fighting some kind of infection.
The doctor may also recommend a urine test. This could help indicate whether a urinary tract infection (UTI) or kidney stones are causing your symptoms.
A doctor can use an imaging test to determine whether your appendix is inflamed. An ultrasound and a CT scan are both highly accurate imaging devices.
An imaging test may not always uncover compelling evidence of appendicitis, but it may reveal other potential causes of your symptoms.
One example is ileus, which occurs when materials such as food stop moving through the intestines as they should. If you have ileus, imaging test results may show a dilated (or expanded) colon that’s filled with gas.
Treatment of appendicitis usually involves an appendectomy, the surgical removal of the appendix. This procedure can often be performed as an outpatient operation.
There are two types of appendectomies. With both types of surgeries, antibiotics are often prescribed to treat any remaining infection.
Open surgery involves one incision in the lower right abdomen. This is especially helpful if your appendix has burst and the area around the appendix needs to be treated for infection.
Laparoscopic surgery involves a few small incisions.
A tube called a cannula is inserted into one of the incisions. This tube fills the abdomen with gas which expands the abdomen and helps the surgeon get a better look at the appendix.
Another thin, flexible tool called a laparoscope is then inserted through that incision. It contains a tiny camera that displays images on a nearby monitor. The camera helps guide the surgeon to remove the appendix. They’ll use instruments that are inserted through another small incision.
Laparoscopic surgery has fewer risks than open surgery and has a shorter recovery time.
Treatment during pregnancy
A traditional appendectomy can be more challenging during pregnancy.
However, according to a 2016 study, a laparoscopic appendectomy seems to be a safe procedure during pregnancy with a low risk of complications. A laparoscopic appendectomy is minimally invasive.
Most gas pain is triggered by diet, so making some changes to what you eat and drink may help you avoid or limit this type of pain.
It may be useful to keep a food diary of everything you eat and drink, and to note when you experience gas pain. That can help you identify connections between foods or beverages and your symptoms.
Common triggers of gas include:
- dairy products
- carbonated beverages
- high fiber foods
- fatty foods
To help ease your gas pain, you may want to try these home remedies:
- peppermint tea
- chamomile tea
- apple cider vinegar mixed with water
Over-the-counter (OTC) remedies, such as simethicone, may help clump gas bubbles together so they can be passed more easily. Simethicone is the main ingredient in Gas-X and is found in smaller amounts in different forms of Mylanta.
Lactase supplements may be helpful if you’re lactose-intolerant and have pain and other symptoms after eating dairy products.
Walking and other physical activity may also help you release trapped gas. If your gas pain persists or it’s an ongoing issue, be sure to see a doctor to find out why.
Gas and appendicitis are just two of many conditions that can cause abdominal pain.
Other causes of pain can include:
Abdominal pain from appendicitis and gas can feel similar at first. The easiest way to tell the difference between the two is to pay careful attention to any other symptoms.
If you start having abdominal pain, especially in your lower right side, be on the lookout for fever, nausea, and loss of appetite. These symptoms, along with abdominal pain, could signal appendicitis.
Similar pain that goes away on its own without other symptoms is likely a buildup of gas.
If you suspect appendicitis, err on the side of caution and get medical attention quickly. A ruptured appendix can be a serious health emergency.