What You Need to Know About Early Appendicitis

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The appendix is a small tubelike pouch attached to the large intestine in your lower-right abdomen. Appendicitis occurs when the appendix becomes inflamed. Without medical care, the appendix can burst, leading to complications like sepsis (body-wide infection) and even death, so it's vital to catch the early signs.

Symptoms of early appendicitis vary and are often confused with other conditions. Most commonly, people experience pain low in their abdomen. This pain typically starts near the belly button, then moves to the lower-right area. In addition, it is common to experience nausea and other gastrointestinal symptoms.

This article explains early appendicitis symptoms, how healthcare providers diagnose it, and how it's treated.

Man with stomach pain at home

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Early Signs of Appendicitis

Since the appendix can rupture without prompt treatment, it's crucial to recognize appendicitis symptoms early. These early signs often include appendix pain, gastrointestinal symptoms, and fever.

It's not always clear what causes appendicitis. Healthcare providers think it may be caused by a blockage in the appendix from hardened stool, growths, infection, or inflammatory bowel disease (IBD).

When to Seek Medical Attention

Not everyone experiences every early appendicitis symptom, so don't wait to see if you develop more serious symptoms. If you have severe abdominal pain or suspect another symptom could be appendicitis, seek medical attention.

Severe and Sudden Pain

The most common early appendicitis symptom is severe and sudden pain in the abdomen. Abdominal pain caused by appendicitis is sometimes mistaken for other abdominal problems, like gas. However, appendicitis pain has several unique traits, including:

  • Pain starts at the belly button and then moves to the lower right (migratory pain).
  • Pain comes on suddenly.
  • It may be intense enough to wake you from sleep.
  • It worsens when you move, take deep breaths, cough, or sneeze.
  • It feels unlike other pain you've experienced.
  • It usually happens before other symptoms.
  • It worsens quickly.

Lower right abdominal pain is a classic symptom of appendicitis during pregnancy. However, if your pregnancy is advanced, you may experience pain as high as the upper-right quadrant.

Nausea and Vomiting

Nausea and vomiting are also early appendicitis signs. If your stomach upset is accompanied by severe abdominal pain, you could have appendicitis.

Stomach Bloating

Bloating is another early appendicitis symptom. Bloating is when the abdomen distends or expands, making your stomach look larger. A feeling of fullness or discomfort often accompanies it.

Bloating is common during menstruation or episodes of gas, so people often dismiss this symptom. However, if bloating is accompanied by other symptoms, especially severe abdominal pain, you may have appendicitis.

Constipation or Diarrhea

Constipation and diarrhea are both appendicitis symptoms. Unfortunately, they also accompany many other illnesses and infections, making it difficult to know if these symptoms arise from appendicitis or something else.

If constipation or diarrhea are accompanied by other symptoms, especially abdominal pain, you should contact a healthcare provider.

Low Fever

An early appendicitis symptom is a low fever, but a higher fever may indicate your appendix has burst.

Low vs. High Fever

The difference between a low fever and a high fever is:

Since a ruptured appendix is a medical emergency, don't wait until your fever is high to seek medical care.

Loss of Appetite

Losing your appetite is another symptom of early appendicitis. Sometimes appetite loss comes before other abdominal symptoms like nausea and vomiting.

Difficulty Passing Gas

If you have appendicitis, you may have trouble passing gas or feel like having a bowel movement would relieve your pain. However, using the bathroom does not ease appendicitis pain.

Appendicitis in Children

It can be challenging to determine appendicitis in children. While they can experience the same symptoms as adults, oftentimes children do not experience typical symptoms, or they may have difficulty describing their pain. Therefore, seek medical advice if you notice your child holding their stomach, walking hunched over, or otherwise exhibiting discomfort.

How Is Appendicitis Diagnosed?

A healthcare provider will take your medical history, including your symptoms, do a physical exam, and run some tests to diagnose appendicitis. Standard tests and exams for appendicitis diagnosis include:

Tests may confirm appendicitis or determine that something else is causing your pain, like intestinal obstruction or kidney stones.

How Is Appendicitis Treated?

Surgeons treat appendicitis by surgically removing the appendix in a procedure called an appendectomy. During an appendectomy, a surgeon removes your appendix while you are under general anesthesia, which means you are asleep during the procedure.

An appendectomy may be open, in which a surgeon makes an incision in the lower-right abdomen in order to remove the appendix, or laparoscopic, a procedure in which a surgeon cuts smaller incisions and works with the help of cameras. Laparoscopic surgery is less invasive and usually results in fewer complications.

Some mild cases of appendicitis may resolve with antibiotics instead of an appendectomy. A study comparing antibiotics and appendectomies found that antibiotic use helped prevent the need for surgery and offered better recovery outcomes.

In the trial, half of the participants received antibiotics, and half underwent appendectomies. The study found that while 29% of people in the antibiotic group required an appendectomy, most avoided surgery, were treated on an outpatient basis, and missed less work than those in the appendectomy group.

However, it’s important to remember that antibiotics would likely only be used in mild cases of appendicitis.

Can You Prevent Appendicitis?

There is no known way to prevent appendicitis. However, noticing and seeking care for early appendicitis symptoms can reduce the likelihood that your appendix will rupture.

Summary

The most prominent early sign of appendicitis is abdominal pain that begins at the belly button, then migrates to the lower-right side. In addition, you may experience nausea, vomiting, constipation, diarrhea, bloating, fever, loss of appetite, and trouble passing gas. Seeking care early may help you catch the problem before your appendix bursts.

A Word From Verywell

Appendicitis symptoms mimic lots of other illnesses and infections. Fortunately, an appendectomy is a common procedure that saves lives. If you're feeling this kind of pain in your lower-right abdomen, it's important to reach out to your healthcare provider.

Frequently Asked Questions

  • Can appendicitis come on slowly?

    Not typically. A classic indicator of appendicitis pain is that it comes on quickly.

  • How do you rule out appendicitis?

    To diagnose or rule out appendicitis, a healthcare provider will do a physical exam and run some tests. Typical tests include blood work, urinalysis, an abdominal ultrasound, MRI, and CT scan.

  • Can appendicitis symptoms come and go?

    In the early stages, appendicitis pain may come and go. However, as time goes on, the pain becomes constant and severe. In addition, pain that eases, then gets worse can indicate a ruptured appendix.

10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Aptilon Duque G, Mohney S. Appendicitis in pregnancy. In: StatPearls [Internet]. StatPearls Publishing.

  3. Nemours Children's Health. Appendicitis.

  4. Cedars Sinai. Fever.

  5. National Institute of Diabetes and Digestive and Kidney Diseases. Definition and facts for appendicitis.

  6. National Institute of Diabetes and Digestive and Kidney Diseases. Diagnosis of appendicitis.

  7. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for appendicitis.

  8. Flum, D, et al. A randomized trial comparing antibiotics with appendectomy for appendicitisNEJM. Oct. 5, 2020. doi:10.1056/NEJMoa2014320

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By Kathi Valeii
As a freelance writer, Kathi has experience writing both reported features and essays for national publications on the topics of healthcare, advocacy, and education. The bulk of her work centers on parenting, education, health, and social justice.