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Appendicitis Symptoms: Causes & Treatment

Appendicitis symptoms include pain in the lower right abdomen, fever, and nausea. Learn about causes, diagnosis, and treatment of this common surgical emergency.

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Things worth knowing about "Appendicitis Symptoms"

Appendicitis symptoms include pain in the lower right abdomen, fever, and nausea. Learn about causes, diagnosis, and treatment of this common surgical emergency.

What is Appendicitis?

Appendicitis is an inflammation of the appendix (appendix vermiformis), a small finger-shaped pouch attached to the large intestine in the lower right abdomen. It is one of the most common surgical emergencies worldwide and can occur at any age, though it most frequently affects children, teenagers, and young adults.

Symptoms of Appendicitis

The symptoms of appendicitis typically develop over several hours and gradually worsen. Key symptoms include:

Abdominal pain: Often begins as a dull pain around the navel, then shifts and intensifies in the lower right abdomen over several hours.
Tenderness at the McBurney point: Localized tenderness between the navel and the right hip bone is a hallmark sign of appendicitis.
Rebound tenderness (Blumberg sign): Pain that worsens upon the sudden release of pressure on the abdomen may indicate involvement of the peritoneum.
Fever: A low-grade fever (37.5 to 38.5°C) is common; high fever may indicate perforation.
Nausea and vomiting: These frequently accompany the abdominal pain.
Loss of appetite: One of the earliest symptoms that can appear before the pain intensifies.
Changes in bowel habits: Diarrhea or constipation may occur.
Abdominal rigidity: The abdominal muscles may become tense as a protective reflex response to inflammation.

Special Considerations in Children, Older Adults, and Pregnant Women

In young children, symptoms are often atypical -- they may not be able to localize the pain and may present with general irritability, fever, and vomiting. In older adults, pain may be less pronounced, making diagnosis more challenging. In pregnant women, the appendix is displaced upward, so pain may be felt higher in the abdomen than usual.

Causes of Appendicitis

The most common cause is a blockage (obstruction) of the appendix, for example by:

Hardened stool (fecaliths)
Swollen lymph nodes (e.g., following an infection)
Foreign bodies or parasites (rare)

The blockage leads to increased pressure and bacterial overgrowth inside the appendix, triggering inflammation. If left untreated, the appendix may rupture (perforate), causing a life-threatening infection of the abdominal cavity known as peritonitis.

Diagnosis

Appendicitis is diagnosed through a combination of:

Physical examination: Checking for classic pain points and abdominal rigidity.
Blood tests: Elevated white blood cell count (leukocytes) and C-reactive protein (CRP) indicate inflammation.
Urine test: To rule out a urinary tract infection.
Ultrasound: Commonly used to visualize the appendix and exclude other causes.
CT scan: Used in unclear cases, especially in adults, for more detailed imaging.

Treatment

The standard treatment for appendicitis is an appendectomy -- surgical removal of the appendix. This is most commonly performed as a laparoscopic (keyhole) procedure, which is minimally invasive. In early, uncomplicated cases, antibiotic therapy may be considered in selected patients, but surgery remains the safest and most effective option. In cases of perforation, immediate surgery is essential.

When to Seek Medical Attention

If you experience persistent or worsening abdominal pain -- especially in the lower right abdomen -- accompanied by fever, nausea, or vomiting, seek immediate medical attention. Appendicitis is a medical emergency that requires prompt treatment to prevent life-threatening complications.

References

Wilms, I.M. et al. - Appendicitis. In: BMJ Best Practice, 2023. Available at: https://bestpractice.bmj.com
World Health Organization (WHO) - Essential Surgery, WHO, 2020.
Longo, D.L. et al. - Harrison's Principles of Internal Medicine, 20th edition, McGraw-Hill Education, 2018.

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