Appendicitis is inflammation of the appendix, a small finger-shaped pouch attached to the large intestine in the lower right side of the abdomen. It is one of the most common reasons for emergency abdominal surgery, most often between the ages of 10 and 30, but it can happen at any age. If it is not treated, the appendix can burst and spread infection through the abdomen, so early recognition matters.
Quick answer: The classic pattern is pain that starts around the belly button, then moves over several hours to the lower right abdomen and becomes sharper, worse with walking, coughing or bumps in the road. Loss of appetite, nausea or vomiting and a mild fever are common. Diagnosis uses examination, blood tests and an ultrasound or CT scan. Treatment is usually removal of the appendix (appendectomy), often by keyhole surgery; some mild cases can be treated with antibiotics alone under hospital supervision.
Key takeaways
- ✅ Abdominal pain that keeps getting worse over 6 to 24 hours needs same-day medical assessment.
- ✅ Do not take laxatives or apply heat to the abdomen if appendicitis is possible.
- ✅ Symptoms are often less typical in young children, older adults and pregnant women.
- ✅ Most people go home within 1 to 3 days after uncomplicated keyhole surgery.
What causes appendicitis?
Appendicitis usually starts when the opening of the appendix gets blocked, by hardened stool (a faecolith), swollen lymph tissue after an infection, or less often a worm or tumour. Bacteria multiply inside the blocked appendix, it swells and becomes inflamed, and its blood supply can be cut off, leading to gangrene and rupture, often within 48 to 72 hours of symptoms starting.
Symptoms of appendicitis
- Dull pain around the navel that moves to the lower right abdomen (right iliac fossa) and becomes constant and sharp
- Pain worse on moving, coughing, sneezing or walking; people often lie still with knees bent
- Loss of appetite, which is very common
- Nausea and vomiting, usually after the pain begins
- Low-grade fever
- Constipation or, sometimes, loose stools; burning urine if the appendix lies near the bladder
Go to emergency immediately if there is:
- Severe pain spreading across the whole abdomen, or a rigid, board-like belly
- High fever with chills, or a fast heartbeat
- Sudden relief of pain followed by worsening illness, which can mean the appendix has burst
- Persistent vomiting, or a child who is drowsy and refusing to eat or drink
Appendicitis in children, older adults and pregnancy
- Young children may not describe the pain clearly. Watch for fever, vomiting, refusal to eat, a swollen tummy, and pain when walking or jumping. Rupture happens faster in young children.
- Older adults may have milder pain and little fever, so diagnosis is often delayed.
- In pregnancy, the growing womb pushes the appendix upward, so pain may be higher on the right side. It is the most common non-obstetric surgical emergency in pregnancy, and prompt treatment protects both mother and baby.
Other conditions that can look like appendicitis
| Condition | Clues |
|---|
| Gastroenteritis | Diarrhoea and vomiting come first; pain is crampy and widespread |
| Mesenteric lymphadenitis (children) | Often after a cold or sore throat; ultrasound shows swollen glands |
| Kidney stone or urine infection | Colicky flank pain, blood or pus cells in urine |
| Ectopic pregnancy, ovarian cyst problems, pelvic infection | Women of reproductive age; a pregnancy test and pelvic ultrasound help |
| Typhoid, intestinal TB, Crohn's disease | Longer illness, fever pattern, weight loss |
How appendicitis is diagnosed
- Examination: tenderness at McBurney's point (one-third of the way from the right hip bone to the navel), pain on releasing pressure (rebound tenderness), and other signs.
- Blood tests: a raised white blood cell count and CRP support the diagnosis.
- Urine test and pregnancy test to rule out other causes.
- Imaging: ultrasound first in children and pregnant women; CT scan in adults when the diagnosis is unclear. MRI can be used in pregnancy.
Doctors often use scoring systems such as the Alvarado score, which adds up symptoms, examination findings and blood count results, to judge how likely appendicitis is.
Treatment of appendicitis
- Appendectomy: the standard treatment. Laparoscopic (keyhole) surgery uses small cuts and usually means less pain and faster recovery; open surgery through a small cut in the lower right abdomen is also safe and effective.
- Antibiotics first: for selected adults with uncomplicated appendicitis confirmed on CT, antibiotics alone can settle the infection. However, about 1 in 4 to 1 in 3 people later need surgery, so this is a shared decision with the surgeon.
- Burst appendix or abscess: needs antibiotics, surgery to clean the abdomen, and sometimes a drain placed through the skin. Hospital stay is longer.
Recovery: after keyhole surgery for simple appendicitis, most people walk the same day, go home in 1 to 3 days, and return to desk work or school in about 1 to 2 weeks. Avoid heavy lifting for 2 to 4 weeks, or as advised. Seek care for fever, increasing pain, wound redness or discharge.
Frequently asked questions
Can appendicitis go away on its own?
Rarely, mild inflammation settles, but there is no way to know in advance, and waiting risks rupture. Any suspected appendicitis needs medical assessment.
Can you live normally without an appendix?
Yes. The appendix has a minor role in the immune system, and removing it causes no long-term problems.
Can eating seeds cause appendicitis?
This is a common myth. Seeds very rarely block the appendix; hardened stool and swollen lymph tissue are the usual causes.
Related reading: CBC blood test and WBC count and ectopic pregnancy symptoms.
Last updated: September 2026. General health information only, not a diagnosis or a treatment plan. Severe or worsening abdominal pain needs urgent medical care.
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