Early Signs of Appendicitis

Early appendicitis can seem like food poisoning or gas, but it typically starts with sudden, often sharp abdominal pain near the belly button. That pain will move to the lower-right side of your belly. Other early signs of appendicitis can include nausea, vomiting, and a low fever.

If you have severe abdominal pain or other symptoms you think are coming from your appendix, go to the emergency room. Don't second-guess or wait to see if you start to feel worse.

An inflamed appendix requires immediate treatment. It's better to be seen and be wrong about the cause of your symptoms than to ignore the early signs of appendicitis and risk a potentially life-threatening appendix rupture.

This article covers the early signs and symptoms of appendicitis, as well as how is diagnosed and treated.

Belly Pain: Most Common Early Sign of Appendicitis

A sharp, sudden pain in the abdomen near your navel is the most common early sign of appendicitis. Even though your appendix is lower down in your abdomen, pain starts near the center of your belly because the membrane that covers your intestines (peritoneum) is also inflamed.

The pain usually starts before other appendicitis symptoms, though you may have felt a little sick or “off” before you noticed it.

As the condition worsens, that pain moves closer to where your appendix is—toward the lower-right side of your abdomen, near your hip bone. This is known as McBurney's point.

Appendicitis pain will generally persist and quickly get worse, rather than slowly improve with things like having a bowel movement or taking an over-the-counter (OTC) medication.

While the pain may be confused for other issues early on, it usually takes on some unique traits that can help you differentiate it.

Appendicitis pain is:

• In one area, rather than felt throughout the belly
• Intense and hard to ignore (even potentially bad enough to wake you from sleep)
• Constant, lasting for several hours to a few days (either until it is treated or the appendix bursts, which can make the pain suddenly get better only to get worse again)
  
• Worse when you move, take deep breaths, cough, sneeze, or get jostled (e.g., when you go over a bump in the road while riding in a car)
• Unlike other pain you've had
  

Other Appendicitis Pain Locations

While most cases of appendicitis involve pain in that lower-right quadrant of the abdomen, there are exceptions to this:

• If your pregnancy is advanced, you may have appendix pain in your upper-right quadrant.
• If your appendix is located more toward the back (retroperitoneal), you might feel pain more in the lower-right back/flank.
• Appendicitis pain can be on the left side if, for example, you have a larger-than-normal appendix or an extra-long intestine. This presentation is extremely rare.

Don't avoid medical care if you have symptoms that are not in the "right place."

Gastrointestinal Symptoms

Gastrointestinal (GI) symptoms can be among the early signs of appendicitis. These include:

• Loss of appetite: When your body knows something is wrong, it may prompt you to avoid eating so there is less stress put on your GI tract.
• Nausea and vomiting: As your body starts fighting inflammation and infection from appendicitis, you may get queasy and throw up. Unlike with a viral illness, you won't feel better after vomiting if you have appendicitis. In fact, you may start to feel worse. 
• Trouble passing gas: You may feel or look bloated, but find that you cannot fart and get relief. 
• Constipation and diarrhea: An infection or inflammation in your GI tract can make things speed up and cause loose stools or slow down and make stools hard to pass. In some cases, it can even lead to a complete digestive shutdown.
  

Fever

With early appendicitis, you may have a low fever (99 to 100.3 degrees F) as your body tries to fight inflammation and infection. A higher fever (over 100.4 degrees F) can be a sign that your appendix has burst.

Since a ruptured appendix is a medical emergency, don’t wait until your fever gets higher to seek medical care. 

Danger of Ignoring Early Appendicitis Signs

You can’t diagnose yourself with appendicitis, but you can compare your symptoms to some of the key features of an inflamed appendix and see if they align.

If they do, or if you even think they might, go to the emergency room. It is extremely unlikely that appendicitis will get better on its own without treatment.

Research has shown that waiting more than 48 hours to get a diagnosis and start treatment leads to complication rates greater than 60%.

Your provider will move quickly to either confirm that you have appendicitis or rule it out. They will ask about your symptoms and medical history, do a physical exam, and run some tests to reach a diagnosis.

If your appendix has not ruptured yet, the clock is ticking in terms of the window of opportunity for preventing complications.

Appendix Rupture

How long it takes for appendicitis to lead to a burst appendix varies, but it can happen within hours to a day or two.

In general, data suggest that the risk of your appendix bursting if you get treatment within the first 24 to 36 hours is low. The risk goes up about 5% for every hour past 36 hours that you wait.

An inflamed appendix can burst or leak and lead to serious infection that can keep moving throughout your body and potentially be fatal. This is why it is usually treated with an appendectomy—surgery to remove the appendix.

You may need to have antibiotics (in an IV or taken as a pill by mouth) for a while after you have your appendix out as well.

Summary

The most common early sign of appendicitis is abdominal pain that begins at the belly button, then moves to the lower-right side of your belly. You may also have nausea, vomiting, constipation, diarrhea, bloating, fever, loss of appetite, and trouble passing gas.

Recognizing the early signs of appendicitis and getting medical care as soon as possible is key. If the appendix bursts, it can lead to life-threatening complications and even death.