Appendicitis
This article is general health information for the selected condition. It is not a diagnosis and does not replace clinical judgement. If you have questions or need treatment advice, please consult a qualified healthcare professional.
What is appendicitis?
Appendicitis is inflammation of the appendix, a small pouch attached to the large bowel. Pain classically begins around the navel and moves to the lower right abdomen over some hours, becoming steadily worse. Untreated it can burst, spilling infection into the abdomen, so it is one of the most common reasons for emergency abdominal surgery.
Causes
- Blockage of the appendix opening by hardened stool
- Swollen lymphoid tissue after infection
- Rarely a tumour
- Bacterial overgrowth behind the blockage
Symptoms
- Pain starting near the navel then moving to the lower right
- Pain worse on moving, coughing or pressing
- Loss of appetite
- Nausea and vomiting
- Low grade fever
- Constipation or diarrhoea
- Abdominal swelling
- Pain relieved briefly then returning worse if it bursts
Risk factors
- Age between 10 and 30, though it occurs at any age
- Male sex slightly more common
- Family history
- Low fibre diet in some studies
Diagnosis
- Clinical examination for right lower abdominal tenderness
- Blood tests showing raised white cells and inflammatory markers
- Urine test and pregnancy test to exclude other causes
- Ultrasound, preferred in children and pregnancy
- CT scan in adults where the diagnosis is unclear
- Scoring systems such as Alvarado to support the decision
Treatment
- Appendicectomy, usually keyhole surgery
- Intravenous antibiotics before and sometimes instead of surgery
- Pain relief and intravenous fluids
- Drainage of an abscess if one has formed
- Open surgery if the appendix has burst with widespread infection
Self care
- Appendicitis cannot be treated at home and needs assessment
- Do not eat or drink if surgery is likely, in case of anaesthetic
- Avoid strong painkillers before assessment, they can mask signs
- Do not use laxatives or heat pads, which may worsen it
- After surgery, walk early and build activity back gradually
- Keep wounds clean and dry and watch for redness
When to see a doctor
Book an appointment if:
- Abdominal pain that is steadily worsening over hours
- Pain settling in the lower right abdomen
- Abdominal pain with fever and vomiting
- Pain worse on movement or coughing
- After surgery, if wounds become red, painful or discharge
- Persistent abdominal pain of any unclear cause
Some symptoms need emergency care rather than an appointment. See the warning signs listed above.
Prevention
- There is no reliable way to prevent appendicitis
- A high fibre diet may modestly reduce risk
- Early assessment prevents the complication of rupture
Outlook
Recovery after uncomplicated appendix removal is excellent, with most people back to normal activity within two to four weeks after keyhole surgery. If the appendix has burst, recovery is longer and antibiotic treatment is extended. Selected uncomplicated cases can be treated with antibiotics alone, though a proportion of those go on to need surgery later.
Common questions
Why does the pain move?
Early inflammation irritates nerves shared with the mid abdomen, so pain is felt centrally and vaguely. As the inflamed appendix touches the abdominal wall lining, the pain becomes sharp and localised to the lower right. That migration is a useful diagnostic clue.
What happens if the appendix bursts?
Infection spreads into the abdominal cavity causing peritonitis, or forms a walled off abscess. Both need urgent treatment, usually surgery and a longer antibiotic course, and recovery takes considerably longer.
Can antibiotics avoid surgery?
For selected uncomplicated appendicitis, antibiotics alone succeed for many people. However a meaningful proportion have recurrence and eventually need surgery, so the choice depends on individual circumstances and imaging findings.
References
Important: Dard AI is not a medical device and does not diagnose, treat, or replace clinician judgement. This article is general information only. Always consult a qualified healthcare professional about diagnosis and treatment, and seek emergency care for severe or rapidly worsening symptoms.