Everything You Need to Know About Appendicitis

Medically reviewed by Aaron L Weigmann MD., MS Plastic Surgeon March 18, 2024| Written by Shahid Bashir

Everything You Need to Know About Appendicitis

The appendix is a finger-like structure at the lower right end of the large intestine. Any bacterial infection of this structure or its blockage may result in inflammation, also called appendicitis. 

The symptoms of appendicitis include mainly pain in the abdominal region. However, the intensity of pain depends on the severity of the inflammation. 

It usually begins with mild pain around the belly button and becomes severe in 48 to 72 hours. You may also feel more severe pain move into the right lower part of the abdomen. 

Medical management for appendicitis includes antibiotics and painkillers.

However, if the inflammation gets severe, appendectomy or the surgical removal of the appendix becomes crucial. It’s because an inflamed appendix can burst if left untreated, leading to the spread of infection in the abdomen and potentially septic shock.

Every age group is at risk of developing appendicitis, but the ratio is higher among people in their 20s and 30s. According to theNational Institute of Health, every 5 to 9 Americans out of 100 get appendicitis at some point in their lives. 

What Are the Early Warning Signs of Appendicitis?

Appendicitis is among those medical emergencies that require prompt action. After all, as soon as the warning signs appear, you may only have around 48 hours until the appendix can burst and cause several other complications. 

So, how do you know you have appendicitis so that you take the necessary steps?

Well, the early signs of appendicitis include pain in the middle of the abdomen.Abdominal painis indeed a symptom of several other medical conditions. But, it is the pattern of pain that indicates you may have appendicitis. 

The pain in appendicitis starts from the middle of the abdomen, just around the belly button. Usually, the pain at this point is vague and not continuous. You may feel it come and go in waves. But as time passes, you will feel an increase in the intensity of pain that persists for longer periods. 

At this point, the pain can become quite severe and move to the precise location of the origin of the pain -  at the lower right end of the abdomen which is the location of the appendix. 

A person experiencing appendicitis will feel intense pain if they palpate their lower right abdomen. The same will happen if they move or cough. 

The other signs that may also be present in appendicitis include:

  • Nausea
  • Vomiting
  • Fever and chills
  • Loss of appetite
  • Irregular bowel movements

How Painful is Appendicitis?

Odds are that you will only experience dull pain in the early stages of appendicitis. In fact, it’s common to miscalculate the dull pain in appendicitis as a normal stomachache.

That said, the severity of pain in appendicitis depends on several factors, especially the state of inflammation. As the inflammation in the appendix increases with time, the initial dull pain turns into sharp and intense pain. Typically, the pain is most intense at the location of the appendix — the right lower abdominal area.

When the pain becomes unbearable, it indicates the severity of the inflammation and a significant risk of rupturing of the appendix. If that happens, the infection may spread to the abdominal area, causing a life-threatening condition calledperitonitis.

What is Appendicitis Caused By?

Researchers are still studying the causes of appendicitis and there is not a “homerun” scientific explanation. It seems that the location of the appendix may make it prone to infection. 

However, in most cases, appendicitis is believed to be caused by the blockage of the appendix. 

Therefore, all factors that can block this opening of the large intestine can also carry a risk of appendicitis. These include:

  • Ahard stool passing through the large intestine can enter the appendix andblock its opening. This blockage facilitates bacterial growth inside the appendix, which leads to infection and results in symptoms of appendicitis. 

In astudy, a stool portion was found lodged inside the appendix during appendectomy, confirming how feces may block the tubular structure and cause appendicitis.

  • The presence ofpathogenic bacteria in the large intestine isn’t surprising. The bacteria can pass through the opening of the appendix and cause an infection inside. This infection can swell the appendix and block the opening. 
  • The appendix containslymphoid tissue that helps in fighting infection. The lymphoid tissues canenlarge due to some infection in the body. The resulting enlarged lymphoid tissues may obstruct the appendix and lead to symptoms of appendicitis. 
  • Tumors in the intestinal tract and the appendix can also result in the obstruction of the appendix opening, and rarely tumors may be incidentally encountered during appendectomy. 

How Can I Test For Appendicitis At Home?

Appendicitis doesn’t give you much time and requires immediate medical assistance. 

You must see a doctor if you experience any symptoms that resemble appendicitis. 

The doctor will ask you some questions about your pain and may also proceed with somelab and imaging tests to diagnose appendicitis.

But in case you need to determine if it’s time to see a doctor for appendicitis, then you can do the following tests at home. 

1. Analyzing Pain Patterns

The pain pattern for appendicitis is unique and distinguishable. It starts from mild pain in the middle of the abdomen. As time passes, the sharpness of the pain increases, and you feel most discomfort in the right lower region of the abdomen. 

This pain pattern indicates the presence of significant inflammation in the appendix.

2. Loss of Appetite

Let’s assume you’re unsure if the pain pattern you feel is the same as appendicitis. Then, the next thing that can help you test for appendicitis is your appetite. 

If the pain persists with aloss of appetite, youhave a high likelihood of appendicitis.

3. Blumberg’s Sign

In the Blumberg sign test, you press the right lower part of the abdomen and release. If you experience a wave of sharp pain after releasing your hand, you may have appendicitis. This technique is also calledrebound tenderness.

4. Rovsing’s Sign

The principle ofRovsing’s sign is that when you lie flat on your back and press the left lower part of your abdomen, you feel pain in the right lower part. It reflects inflammation in the abdominal wall lining — a hallmark sign of appendicitis.

5. Dunphy’s Sign

Appendicitis causes severe pain in the abdomen, and any abdominal movement makes the pain worse. This is Dunphy’s sign’s principle, where coughing worsens the pain.

These tests are not perfectly accurate, and it is recommended that you be examined by a doctor when the severity of symptoms starts increasing.

How to Treat Appendicitis?

Appendicitis requires immediate medical assistance. This is because, in most cases, the appendix can burst within 48 hours of the initial symptoms. Once the infected appendix ruptures inside the body, it can lead to several life-threatening complications. 

The treatment for appendicitis in the hospital setup comprises two steps.

1. Medication

In the early stage of appendicitis, medication can help to manage the condition and relieve the pain. The medicines include strong IVantibiotics to control bacterial infection in the appendix and painkillers to manage the pain.

However, medicines are often not a permanent solution once you are diagnosed with appendicitis. 

Yes, they can help you temporarily relieve the symptoms and save you from complications—and there has been a recent increase in evidence supporting the treatment of appendicitis with antibiotics alone. However, if you don’t opt for the removal of the appendix, you are always at risk of developing severe infection again.

2. Surgery

Removal of the infected appendix is the ultimate treatment option for appendicitis. 

The doctor performs this surgery within 24 hours of appendicitis diagnosis. This is because time is crucial in appendicitis, and a slight delay can lead to another spectrum of complications.

The surgical procedure for the removal of the appendix is appendectomy. 

Surgeons perform anopen surgery, cutting the abdomen and removing the appendix from the inside. The most common complication with appendectomy is the infection at the surgical site. To prevent this, surgeons wash the incision site with antiseptics thoroughly and take care not to make a hole in the diseased appendix.

The current standard approach islaparoscopic surgery for appendectomy. It involves small incisions through which laparoscopic tools and a camera reach the appendix. These tools cut the appendix from the origin and remove it from the body. 

The recovery time for the laparoscopic appendectomy is short in comparison to open surgery. 

Is Appendix Surgery Painful?

Appendicitis is a painful condition, but the appendix removal surgery is often the opposite. Asmentioned earlier, there are two methods for an appendectomy — one is open surgery, and the other is laparoscopy. 

A patient undergoing open surgery or laparoscopy for appendectomy doesn’t feel pain during the surgical procedure. It is because the patient is under general anesthesia during the procedure. Furthermore, patients often report significantly improved pain immediately after the inflamed appendix is removed.

However, post-surgical complications can cause pain and discomfort in the abdomen. Open surgery may bemore prone to complications and usually takes longer to heal. 

In case of pain after surgery, your doctor may prescribe you painkillers.

How Can Diet Prevent Appendicitis?

There is not much research on the correlation between diet and appendicitis. Most of the research fails to find any direct influence of diet and appendicitis. 

But here are some diet tips that can be beneficial in preventing appendicitis:

1. Get a Fiber-Rich Diet

Acase-control study conducted in hospitals shows a higher risk of developing appendicitis among people consuming a low-fiber diet. Fiber improves the digestive system and lowers the chances of infection. 

It also softens the stool, thereby reducing the risk of hard stool blocking appendix opening.

2. Choose Probiotic Foods

Probiotic foods facilitate the growth of healthy gut bacteria. It has a positive influence on our digestive and immune system. A study on theeffects of probiotics emphasizes its role in inflammation and regulation of innate and adaptive immune systems. 

An optimal-acting immune system lowers the risk of developing microbial infections, such as appendicitis. 

3. Go for Healthy Fats

Healthy fats derived from avocados, fatty fish, seeds, and nuts help reduce inflammation. In contrast,research shows an increased risk of developing appendicitis among people who consume high amounts of animal fat. 

A fatty diet can also result in the formation ofgallstones, which can block the appendix and lead to appendicitis.

4. Cut down on Processed Sugar

Research shows that increasedprocessed sugar consumption is directly related to increased intracellular pro-oxidants. It also adversely affects the composition and functioning of gut microbiota. 

Both these changes translate to a bad metabolic system prone to infection, thus increasing the possibility of appendicitis.

5. Reduce Spicy Foods

Consuming spicy food is a bad choice when experiencing symptoms of appendicitis. This is because spicy food contains a compound calledcapsaicin, which has the potential to cause irritation and inflammation in the digestive tract.

A2021 study on the effects of capsaicin shows its negative impact on digestion, metabolism, and gastrointestinal mucosa. One should consider limiting the consumption of spicy foods to reduce the risk of gastrointestinal issues. 

It is essential to keep in mind that none of the diet changes guarantee that you will not get appendicitis. But yes, positive changes in diet can improve overall health and quality of life. 

How Can Lifestyle Changes Prevent Appendicitis?

When studying disease prevention, you will always find lifestyle changes on the list. This is because lifestyle isdirectly related to how your body functions and how much your body is protected from risk factors. 

A positive lifestyle comprises good habits that boost the body's functional capacity.

A major lifestyle change in preventing appendicitis is a shift towards consuming a balanced diet. 

A diet rich in fiber has significant potential to prevent appendicitis. Hydration is another contributing factor to optimal health that people neglect unintentionally. Adequate liquid consumption prevents several digestive problems, such as avoiding irritation and constipation. 

There is not much evidence on the link between exercise and appendicitis. However, it is evident from thedata that a healthy amount of physical activity improves digestive health. It promotes a healthy bowel movement andlowers the chance of inflammation


The Appendix is a finger-like projection at the end of the large intestine that doesn’t serve any vital purposes in the body to our knowledge. When the appendix develops a bacterial infection, it results in inflammation, a condition called appendicitis. 

Appendicitis can cause extreme discomfort and serious complications if not managed properly. Though medications are available to manage pain and lower infection, appendicitis requires antibiotics and usually surgical removal of the infected appendix i.e., appendectomy.  

You can lower your risk of developing gastrointestinal diseases and appendicitis by improving your diet and choosing a healthy lifestyle.