Appendicitis symptoms: Most of us have heard of “appendix surgery”; it’s one of the most common emergency operations worldwide. But when stomach pain strikes, it’s not always easy to know if it’s just gas, food poisoning… or something serious like appendicitis.
As a surgeon, I see this often:
- Patients arrive late, after 2–3 days of pain, thinking it was acidity or “bad food”.
- By then, the appendix has burst or infection has spread inside the abdomen.
- Treatment becomes more complex, recovery is longer, and risks are higher.
This article will help you understand:
- What the appendix is and what appendicitis means
- The typical symptoms, and how they can sometimes be confusing
- Red flag signs you should never ignore
- When surgery is urgent and what to expect
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What is the appendix?
The appendix is a small, finger-like pouch attached to the beginning of the large intestine, in the lower right side of your abdomen. We don’t need it for digestion, and people live perfectly normal lives after it is removed. However, when it gets blocked and infected, it can cause appendicitis, a painful and potentially dangerous condition.
What is appendicitis?
Appendicitis means inflammation (swelling and infection) of the appendix. It usually happens because:
- Something blocks the opening of the appendix (hard stool, swelling of lymph tissue, rarely a growth)
- Bacteria multiply inside
- The appendix wall becomes swollen, painful and filled with pus
- If not treated in time, the appendix can burst (perforate), spilling infected material into the abdomen and causing peritonitis (infection of the abdominal cavity) or an abscess.
This is why appendicitis is considered a surgical emergency.
Classic symptoms of appendicitis:
Not every patient reads the textbook, but there is a “typical” pattern we look for.
Pain that shifts to the lower right side:
A common story is:
Pain starts near the belly button or in the upper abdomen; dull, vague discomfort. Within a few hours, it moves to the lower right side of the abdomen. The pain gradually becomes sharper and more constant. Pain usually worsens with:
- Walking
- Coughing or sneezing
- Sudden movements
- Pressing and releasing the area
Loss of appetite:
Many patients suddenly don’t feel like eating, even their favourite food. This loss of appetite, combined with pain, is a classic early sign.
Nausea and vomiting:
Nausea is common, often with one or two episodes of vomiting, especially in the early hours. Persistent, repeated vomiting may suggest a more advanced or complicated case.
Low-grade fever:
A mild fever (around 99–100°F / 37.5–38°C) may appear as the inflammation progresses. A higher fever can indicate a more severe or advanced infection.
Changes in bowel habits:
Some people notice:
- Mild diarrhoea
- Constipation
- A feeling of not being able to pass gas comfortably
These alone are not specific, but in combination with right-sided pain, they matter.
Symptoms can be confusing, especially in children and women. Appendicitis doesn’t always follow the “typical script”. Children, elderly people and pregnant women may have unusual symptoms or pain location. Pain may be more central, higher, or not very clear. Some patients only feel vague stomach pain, mild fever and “unwellness”.
This is why self-diagnosing as “just gas” can be risky. If pain is persistent, severe, or worsening, it’s safer to be evaluated by a doctor.
Red-flag signs: When you should seek urgent medical help
You should go to a hospital or emergency department immediately if you notice:
- Sudden pain that starts around the belly button and moves to the lower right side
- Abdominal pain that becomes steadily worse over a few hours
- Pain that worsens when you walk, cough or move
- Loss of appetite, nausea, and vomiting, along with pain
- Fever with right lower abdominal pain
- Pain so bad that you cannot stand straight, walk properly or sleep
You should be especially alert if:
- Pain suddenly feels better after being very severe, and then you feel weaker and unwell. Sometimes, this can mean the appendix bursts and the pain temporarily decreases before infection spreads.
- The abdomen becomes very hard, swollen, or extremely tender to touch.
- You have severe abdominal pain along with dizziness, sweating, or fainting.
In any of these situations, do not try to manage at home with painkillers alone. Painkillers can mask symptoms and delay diagnosis.
How doctors diagnose appendicitis
There is no single blood test that “proves” appendicitis, so doctors put together a full picture:
- History and physical examination
- Where the pain started, how it moved, how long it has lasted
- Whether it hurts more on the right side
- Gentle pressure over specific points in the abdomen
- Blood tests to look for signs of infection (raised white blood cell count, high CRP, etc.)
- Ultrasound or CT scan to look at the appendix and surrounding structures and to rule out other conditions that can mimic appendicitis (ovarian problems, kidney stones, gastroenteritis, etc.)
Sometimes, even with tests, the picture is not 100% clear. In those cases, doctors may observe you in the hospital for a few hours, repeat the examination, or proceed to surgery if the overall risk of appendicitis is high.
Why is surgery often urgent?
If appendicitis is confirmed or strongly suspected, most patients are advised to undergo appendectomy, the removal of the appendix.
This is usually done by:
- Laparoscopic (keyhole) surgery: 2–3 small cuts, a camera and instruments used to remove the appendix.
- Open surgery: A single cut in the lower right abdomen (used in certain situations: very severe infection, limited facilities, or previous multiple surgeries)
Time matters because:
The longer an inflamed appendix is left inside, the higher the risk it will perforate (burst). A burst appendix leads to pus and infection spreading inside the abdomen, which can cause:
- Peritonitis (infection of the inner abdominal lining)
- Abscess (pocket of pus)
- Longer hospital stay
- More complicated surgery and recovery
Early surgery, before rupture, is usually simpler, with quicker recovery and fewer complications.
Is non-surgical treatment ever possible?
In selected, mild or early cases (usually under close medical supervision and good facilities), some centres may attempt antibiotic-only treatment. However, there is a higher chance of recurrence of appendicitis later.
Not all patients are good candidates for this approach. It is not suitable for children, pregnant women, or complicated appendicitis (abscess, perforation, severe infection).
For most patients, especially in India and resource-limited settings, standard treatment for confirmed appendicitis remains surgical removal of the appendix.
What to expect after an appendicectomy:
Recovery generally depends on:
- Whether it was laparoscopic or open
- Whether the appendix had burst or not
- Your overall health and age
In straightforward laparoscopic cases, many patients go home within 1–3 days. Light activity is allowed early; heavy lifting and strenuous exercise are avoided for a few weeks. They may experience some discomfort and bloating for a short time.
Your surgeon will guide you on:
- Wound care
- Pain control
- Diet progression
- When you can return to work, travel, or exercise
Most people live completely normal lives after an appendicectomy. The body does not miss the appendix.
Also Read | Our Expert Article: Dr Dhaval Mangukiya On Preparation & Recovery Tips For Laproscopy
When abdominal pain is not appendicitis:
Not every right-sided belly pain is appendicitis. Common conditions that can mimic it include:
- Stomach infection (gastroenteritis)
- Urinary tract infection
- Kidney stones
- Ovarian cysts or torsion in women
- Mesenteric lymphadenitis (inflamed lymph nodes, often in children)
This is why it is important to let a doctor examine you, rather than guessing based on Google or advice from friends.
Appendicitis is common, treatable and usually straightforward when caught early. The danger comes from delay. Sudden pain that moves to the lower right side of the abdomen, with loss of appetite, nausea and low fever, is not “just gas” until a doctor rules out appendicitis. Do not ignore worsening or persistent pain, or pain that makes it difficult to walk or stand straight. Timely medical evaluation can prevent serious complications and save you from bigger problems.
If in doubt, it is always safer to get checked. With abdominal pain and suspected appendicitis, “better safe than sorry” is not just a saying, it is good medical sense.
Medical disclaimer: This article is for general information only. It does not replace a consultation with a qualified doctor. If you or someone in your family has sudden or severe abdominal pain, especially in the lower right side, please seek medical attention immediately for proper diagnosis and treatment.