Appendicitis

What is appendicitis?
Appendicitis is one of the causes of serious belly pain. It happens when the appendix becomes infected and inflamed. The appendix is a 3 ½-inch-long, finger-shaped pouch that extends from the large intestine.

Experts do not know what the appendix does in the body, but most of the time it does not cause problems. About 8 out of 100 people will get appendicitis sometime during their lives. It is most common in people ages 10 to 30, but it can happen at any age.

Acute appendicitis is considered a medical emergency requiring prompt surgical removal of the appendix (appendectomy). An appendectomy is usually performed by a general surgeon.

What causes appendicitis?
It is not clear why people get appendicitis. In many cases, a small object (such as a hard piece of stool) blocks the opening to the appendix. Blockage may also occur from infection elsewhere in the body since the appendix swells in response to any infection.

A blocked appendix allows bacteria to grow rapidly, causing the appendix to swell and become inflamed. If not treated, the appendix may burst, spilling infectious materials into the abdominal cavity. Peritonitis, an inflammation of the thin tissue that lines the abdominal cavity, could develop as a result. It is a potentially life-threatening condition if not treated quickly and aggressively with strong antibiotics.

What are the symptoms?
The most common symptom of appendicitis is belly pain that worsens over a period of 12 to 18 hours, eventually becoming very severe.

  • Many people first feel pain near their belly button (navel). But, the location of the pain may vary depending on your age, the position of your appendix or if you are female and pregnant. The pain may be in different parts of your belly or even on your side or back.
  • The pain often shifts to the lower right side of the belly and becomes more severe.
  • The pain may get worse if you move, walk, or cough.

Other symptoms may include:

  • Fever
  • Nausea and/or vomiting just before or soon after belly pain begins
  • Constipation or inability to pass gas
  • Loss of appetite
  • Severe cramps

Sometimes the only symptom is a general feeling of not being well and a pain that is hard to describe. The pain in your belly may be severe or it may not seem like a very strong pain but feels different than any pain you have had before. 

You should check with your doctor if you are unsure of your symptoms. Call your doctor immediately if you have severe belly pain  or if you have moderate belly pain that does not go away after 4 hours.

How is appendicitis diagnosed?
Abdominal pain may be caused by a number of different problems so diagnosis can be difficult. Diagnosis may include:

  • Questions asked by your doctor to determine your symptoms and when they started
  • Abdominal exam:  Your doctor will press on your belly to try and locate the pain
  • Looking for signs of infection by taking your temperature and performing blood tests
  • Additional tests such as a CT scan and/or an ultrasound of your belly

How is it treated?
If you think you may have appendicitis, do not try to treat it at home. Do not use pain remedies, antacids, laxatives, or heating pads, which can cause an inflamed appendix to rupture.

Seek medical treatment immediately. If you have appendicitis, it is very important to be treated right away. Do not eat or drink, unless your doctor says it is okay. If you need surgery, it is best if you have not had anything to eat or drink.

Standard treatment for appendicitis is surgery to remove your appendix (appendectomy). Sometimes tests can't show for certain that you have appendicitis. But if it is even suspected your doctor will probably err on the safe side and recommend surgery to remove the appendix. If left untreated, your appendix can burst and cause serious, even life threatening, problems.

Your surgeon may remove your appendix through an incision (cut) in your belly (known as traditional or open surgery). Minimally invasive techniques utilizing a laparoscope and smaller incisions may also be used.

There are advantages and disadvantages to each type of surgery and not everyone is a candidate for minimally invasive procedures.

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