How Appendicitis Is Diagnosed

Appendicitis is inflammation that happens in your appendix. If you have appendicitis, it is considered a medical emergency. You will want to receive a diagnosis as soon as possible.

If your healthcare provider believes you may have appendicitis, they will do a physical exam, collect your medical history, and order tests. This article will explain more about the diagnosis process for appendicitis.

Self-Checks/At-Home Testing

There are no at-home tests available to diagnose appendicitis. You have to see a healthcare provider to receive a proper diagnosis. However, you can perform a self-check for symptoms at home and share them with your healthcare provider. Keep in mind that a self-check cannot replace a medical visit or diagnosis.

Check for the following symptoms and discuss them with your healthcare provider:

• Stomach pain that starts in the belly button area and moves to the lower right area
• Stomach pain that becomes worse if you walk, sneeze, or cough
• Stomach pain that does not go away and becomes worse over time
• Stomach swelling
• Nausea
• Vomiting
• Constipation or diarrhea
• Fever
• Loss of appetite

Physical Examination

Your healthcare provider will want to determine what is causing your stomach pain. They will begin by collecting your medical history. They may ask about:  

• Your other medical conditions
• Details about your symptoms, including how and when they started 
• Current prescription medications and over-the-counter (OTC) drugs you are taking
• Past illnesses and surgeries you had
• Your recent travel history
• Your drug, alcohol, and tobacco use

After collecting your medical history, your healthcare provider will do a physical exam. It may include:

• Putting pressure on your stomach to check your reaction and pain levels
• Checking for guarding or muscle tension in response to their touch
• Checking for the psoas sign by moving your leg back to see if it causes pain when the hip flexes
• Checking for the obturator sign by internally rotating the hip
• Checking for Rovsing's sign by pressing on the left side of the stomach and seeing if you feel pain on the right side
• Doing a digital rectal exam by inserting a gloved and lubricated finger into the rectum
• Doing a pelvic exam in females by inserting gloved and lubricated fingers into the vagina

Labs and Tests

Sometimes the symptoms of appendicitis can be similar to other medical conditions. To rule them out, you may need tests. Your healthcare provider may order the following tests:

• Blood tests to check for signs of infection, dehydration, or electrolyte imbalance
• C-reactive protein (CRP) blood test to check for signs of inflammation
• Urine test to check for urinary tract infections or kidney stones
• Pregnancy test if you have a uterus

Imaging

Your doctor may also order imaging tests to view the inside of your stomach area. These tests may show:

• Obstruction or something blocking the area
• Perforation (hole)
• Enlarged or burst appendix
• Hardened stool stuck in the appendix
• Kidney stones

You may need the following imaging tests:

• Ultrasound scan that uses sound waves to check your stomach
• X-ray that uses electromagnetic radiation to create images
• Magnetic resonance imaging (MRI) that uses magnetic fields to create images
• Computed tomography (CT) scan that uses multiple X-rays and a computer to make 3D images

Differential Diagnoses

The symptoms of appendicitis can be similar to many other medical conditions. This is why your healthcare provider may order additional tests.

Other conditions that may have similar symptoms to appendicitis are:

• Kidney stones: Small, hard deposits that form in the kidneys
• Urinary tract infection (UTI): An infection that affects the urinary system
• Inflammatory bowel disease (IBD): A chronic inflammatory condition that affects the intestines
• Intestinal obstruction: Blockage in the intestines
• Abdominal adhesions: Bands of scar tissue that form between organs in the abdomen
• Pelvic inflammatory disease (PID): An infection in a female's reproductive organs
• Endometriosis: A condition that causes tissue to grow outside of the uterus
• Ectopic pregnancy: A fertilized egg is implanted outside the uterus

Summary

The diagnosis process for appendicitis may include a physical exam, collecting your medical history, and having tests and imaging. Your healthcare provider may order additional tests to rule out other medical conditions that may have similar symptoms to appendicitis.

The diagnosis process for appendicitis is a very important step. When you do not receive a diagnosis quickly, your appendix has a higher chance of bursting. Talk to your healthcare provider and seek medical attention right away if you think you may have appendicitis.