Signs and Symptoms of Appendicitis

Abdominal pain is common and most often resolves on its own. But appendicitis can be a life-threatening condition requiring immediate medical attention. So how can you tell when the pain or loss of appetite you are experiencing is no big deal, and when it is inflammation of the appendix? Knowing the signs and symptoms of appendicitis can help get you the care you need, when you need it.

What Causes Appendicitis? 

Your appendix is a small pouch of tissue that extends from the large intestine. The pouch, or tube, is about four inches long and attaches on one end to the cecum, which is at the beginning of the colon or large intestine, on the lower right side of your abdomen. Scientists and doctors believe the appendix may be related to the immune system, but the exact purpose and function is still unknown. We do know that when the appendix gets inflamed and infected, it can cause serious health problems. And we also know that people who have their appendix removed through a surgery called an appendectomy can live a full and healthy life without their appendix.

Appendicitis occurs when there is blockage in the appendix, most often caused by stool that gets trapped. The blockage can also be due to swelling caused by an infection elsewhere in the body, or from another virus or illness such as cancer. But most often, it is simply a blockage of stool in the appendix that is the source of the problem. When the blockage occurs, the appendix becomes inflamed, and infection can grow. If it is not treated, infection spreads rapidly and the appendix will rupture. A rupture or perforation of the appendix causes the infection to spill out into the abdominal cavity causing a very serious and life-threatening condition called peritonitis.

What are the Symptoms of Appendicitis?

So how can you know whether the symptoms you are experiencing are a reason to take over-the-counter medicine and go to bed early, or rush to the nearest emergency room? Sometimes it can be tough to differentiate the symptoms of appendicitis at the outset. However, knowing and recognizing the following symptoms of appendicitis will help you make the right call. Anyone who experiences these symptoms should call their doctor or visit the closest hospital emergency department right away. Quick diagnosis and accurate treatment are important in making sure the infection does not spread. It’s always better to have a medical professional diagnose a lesser cause than to put your life at risk waiting to see if your condition will improve. Appendicitis does not get better on its own, and the longer you go without receiving medical attention, the higher the risk for serious complications.

So what should you look for? The most obvious symptom of acute appendicitis is sudden abdominal pain that starts in the upper abdomen or near the belly button and then moves down to the lower right side. Pain near the belly button may start as a dull pain, but typically becomes very sharp and quite severe as it shifts. The pain is often more intense with any movement including walking, running, sneezing, and coughing. Appendicitis is most common in the age range of 10-30 years old, but can occur at any age. It is also more common in people who have a family history of appendicitis, although there is no way to predict who will develop appendicitis.

Two groups of people in the target age range may have a particularly difficult time identifying pain on the lower right side of the abdomen. Children have a smaller abdomen so may feel the pain in a less specific area. Young children may also have a hard time identifying the precise location or source of pain. Children with appendicitis often experience difficulty having a bowel movement and passing gas. The appendix in pregnant women can be pushed higher in the abdomen by a growing fetus and uterus, so they may also feel the pain of appendicitis in a different or less specific location than the typical lower right side. 

Other symptoms of appendicitis can include a loss of appetite and nausea and/or vomiting. Vomiting typically begins after the pain, but in some cases can start before the telltale sharp abdominal pain on the lower right side. You may also experience fever, abdominal swelling, and an inability to pass gas. Sometimes there are other symptoms that appear as well. These can include pain anywhere in the abdomen, back, and/or rectum, severe cramps, painful urination, and constipation or diarrhea.

Again, these symptoms are similar to those seen with other medical conditions and digestive diseases such as urinary tract infection, gallbladder issues, and inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. It’s important that you seek medical attention early when experiencing any of the symptoms of appendicitis.

How is Appendicitis Diagnosed and Treated?

Your doctor will consider all of your symptoms when diagnosing appendicitis and will likely perform a physical exam to learn more about the abdominal pain you are experiencing. However, because the symptoms can be so similar to those of many different conditions, other techniques such as X-ray, CT scan, and ultrasound are often used in diagnosis as well. Blood tests cannot diagnose appendicitis but may be ordered to help detect infection anywhere in the body. And a urine test can rule out a urinary tract infection. A CT scan or ultrasound of the abdominal area, including the large intestine and appendix, will allow the doctor to observe the condition of the appendix and identify any other issues in the area. This imaging will also help a doctor see if an abscess has formed. If this is the case, it may be unsafe to perform an appendectomy until antibiotics are given and a procedure is done to remove the abscess.

Once the doctor has diagnosed appendicitis, treatment can begin. Antibiotics can sometimes resolve appendicitis. However, because of the quick-developing and life-threatening nature of the infection, most doctors will also recommend an appendectomy to remove the appendix. Appendectomy is a serious surgery but is performed often and considered relatively low risk, so it is the standard treatment option in almost all cases of appendicitis. Typically performed as laparoscopic surgery using small incisions, the risk and recovery time for laparoscopic appendectomy are much lower than for open surgery. Appendectomy is a common surgery, but you should still pay attention to signs of infection as you recover. Keep an eye on the area where the incision(s) were made, and see your doctor right away if there is increased redness, swelling, or pain. You should also call your doctor right away if you notice pus in the wound. 

In addition to an incision site infection, be on the lookout for possible complications in the days and weeks following an appendectomy. Your abdominal pain should be decreasing, so call your doctor if the pain increases or is not controlled my pain medication. You should also contact your doctor or go to the closest ER if you develop a fever, feel dizzy, vomit, or observe blood in your vomit or in your urine. If you are experiencing any of the symptoms of appendicitis, visit your nearest hospital emergency department or call 911. 

If you have other concerns about your gastrointestinal health, schedule a visit with Carolina Digestive Health Associates today. With multiple locations to serve you, we are committed to providing adults 16-senior with the most comprehensive, high-quality gastroenterology care.