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Overview

What Is Appendicitis?

Appendicitis is inflammation of the appendix, a small, finger-shaped pouch attached to the large intestine. It can affect people of any age, although it is more common in children, teenagers, and young adults. Appendicitis often worsens over time rather than resolving safely on its own. Without prompt treatment, the appendix can rupture and cause a serious infection in the abdomen.

Emergency Warning Signs

Emergency Warning Signs of Appendicitis

Seek urgent care

Urgent abdominal pain

Severe or worsening abdominal pain, especially pain that moves to the lower right side, needs urgent medical evaluation. Do not wait for every typical symptom to appear, because appendicitis can look different from person to person.

  • Worsening abdominal pain, especially pain that shifts toward the lower right side.
  • Fever, chills, nausea, vomiting, or a strong loss of appetite.
  • A swollen, rigid, or very tender abdomen.
  • Confusion, faintness, severe weakness, or rapidly worsening illness.
  • Atypical or less localized pain in young children, older adults, or pregnant people.

A ruptured appendix can cause sudden worsening illness, widespread abdominal pain, or signs of infection. Call emergency services for collapse, severe weakness, breathing difficulty, or an inability to stay awake.

Symptoms

Appendicitis Symptoms

Appendicitis may feel like vague pain near the belly button at first. The pain may move to the lower right abdomen and become sharper or more severe, especially with movement, coughing, or touch. These symptoms of appendicitis can develop over hours, but the pattern is not identical for everyone.

  • Abdominal pain that becomes more severe or focused over time.
  • Nausea or vomiting after the pain begins.
  • Reduced appetite or an inability to tolerate food.
  • Fever or chills.
  • Constipation, diarrhea, or difficulty passing gas.
  • Bloating or increased abdominal tenderness.

Symptoms in Different Age Groups and Pregnancy

Young children may not be able to describe their pain clearly, while older adults may have less fever or abdominal tenderness than expected. During pregnancy, the appendix and pain may be positioned higher as the uterus grows, so pain may not stay in the usual lower right area. New or worsening abdominal pain should be assessed promptly, particularly when other symptoms of appendicitis are present.

Causes

What Causes Appendicitis?

Appendicitis often begins when the appendix becomes blocked. The blockage can allow pressure, inflammation, and bacterial overgrowth to develop inside the appendix. Hardened stool, swollen tissue, or another obstruction may contribute, although the exact trigger is not always identified.

Risk Factors

Appendicitis Risk Factors

  • Appendicitis is most common in children, teenagers, and young adults, but it can occur at any age.
  • A family history of appendicitis may be associated with higher risk.
  • Some gastrointestinal infections or inflammatory conditions may contribute to appendix blockage or inflammation.
  • Risk factors do not predict appendicitis reliably, and many people have no identifiable risk factor.

Complications

Appendicitis Complications

Appendicitis generally worsens rather than reliably resolving on its own. Its progression is sometimes described as stages, moving from inflammation to tissue damage, rupture, and recovery, but clinicians do not use one universal four-stage system. Prompt evaluation can help prevent serious complications.

  • A perforated or ruptured appendix can release infected material into the abdomen.
  • An abscess may form around the appendix and require drainage or additional treatment.
  • Peritonitis can cause a serious infection of the abdominal lining.
  • Sepsis can occur when infection triggers a dangerous whole-body response.
  • Bowel obstruction or extensive inflammation can delay recovery.

Diagnosis

How Appendicitis Is Diagnosed

Clinicians ask when the pain started, where it began or moved, and what other symptoms are present. They examine the abdomen for tenderness, guarding, swelling, or pain with movement. This information helps guide testing and treatment decisions.

Initial evaluation

History, abdominal examination, blood testing, urine testing, and pregnancy testing when relevant can look for inflammation, infection, or another cause of pain.

Imaging tests

Ultrasound, CT, or MRI may help visualize the appendix and look for complications or another cause of abdominal pain.

No single test is perfect. Appendicitis can resemble gastroenteritis, kidney stones, ovarian conditions, or other causes of abdominal pain, so clinicians interpret test results together with the examination and symptoms.

Treatment & Management

Appendicitis Treatment and Management

Do not delay care

Appendicitis needs medical evaluation

Suspected appendicitis needs prompt medical assessment. Do not use laxatives, enemas, or heating pads to try to treat severe unexplained abdominal pain.

Appendectomy and Hospital Treatment

An appendectomy, often performed with minimally invasive laparoscopic surgery, is the usual definitive treatment. Hospital care may include intravenous fluids, pain control, and antibiotics when infection is suspected. An abscess or rupture may require drainage, additional antibiotics, or further surgery.

Antibiotics alone may be considered for selected people with uncomplicated appendicitis under close clinician supervision. The appendix can become inflamed again, and later surgery may still be needed. After treatment, follow the care team’s instructions about medicines, activity, wound care, and follow-up.

Outlook and Prognosis

Outlook and Prognosis for Appendicitis

Most people recover well after timely treatment and can live normally without an appendix. A rupture, abscess, widespread infection, delayed diagnosis, or other health conditions may lengthen recovery. Early treatment generally supports a smoother recovery.

  • Recovery is often faster after uncomplicated laparoscopic surgery than after rupture or an abscess.
  • Activity, lifting, driving, and work or school can usually resume gradually according to the surgical team’s instructions.
  • Follow-up may be needed to check wounds, symptoms, bowel function, and recovery.
  • New fever, worsening pain, repeated vomiting, spreading redness, or drainage from an incision should prompt medical contact.

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Symptoms

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