Appendicitis

Appendicitis is a condition that happens when your appendix gets inflamed. Acute appendicitis develops suddenly and can cause severe pain. If left untreated, it can lead to serious health problems. In many cases, appendicitis worsens quickly and can result in a ruptured appendix within 24 hours, making it a medical emergency. A ruptured appendix can cut off blood flow to nearby tissues and lead to life-threatening infections.

It’s important to recognize the symptoms of appendicitis and get immediate medical care. Surgery to remove the appendix is the most common and effective treatment. 

Understanding the appendix

The appendix is a small, tube-like organ located where your small intestine meets your large intestine, in the lower right part of your belly (abdomen). It’s not clear what its function is, but it may play a role in the immune system, especially in younger people. You don’t need your appendix to survive, so it’s important to get care right away and have it removed if you have appendicitis.

What causes appendicitis?

Your appendix can become inflamed due to hardened stool (fecaliths), enlarged tissues or lymph nodes or, rarely, tumors that can block the appendix. Bacteria from gastrointestinal illnesses can also infect the appendix. In some cases, viral infections and parasites can spread to the appendix, though they are less common than bacterial infections. 

When bacteria are not able to flow freely from the appendix to the large intestine, they can multiply and cause an infection. Sometimes, this infection can cause appendicitis. 

Who is at risk for appendicitis?

These factors can increase your risk of developing appendicitis:

• Age: Appendicitis can occur at any age but is most common between the ages of 10 and 30.
• Family history: You’re more likely to develop appendicitis if others in your family have had it.
• Diet: A low-fiber diet can make appendicitis more likely.
• Gender: Males have a slightly higher risk than females.
• Prior abdominal surgery: Surgery can cause scar tissue that can raise your risk of appendicitis.

Signs and symptoms of appendicitis

Symptoms of appendicitis include:

• Abdominal pain: The pain usually starts around the belly button and moves to the lower right abdomen. It may get worse over time or when you move, walk or cough. This type of pain is the most common symptom of appendicitis.
• Loss of appetite: A noticeable decrease in appetite is common.
• Fever: You may have a low-grade fever as your body responds to the infection.
• Change in bowel function: You may have diarrhea, constipation, bloating or gas.
• Feeling unwell: You may feel sick or tired.

Signs can be different in children, seniors and pregnant women, so contact your health care provider with any concerns about abdominal symptoms.

If you have symptoms of appendicitis, it’s important to get medical care right away. Don’t take pain medication unless your provider recommends it. Medicine could block symptoms that help with your diagnosis.

Appendicitis is easier to treat when it’s spotted early. And treating appendicitis sooner means your appendix is less likely to rupture and lead to a more serious infection.

Ruptured (burst) appendix

A ruptured appendix is a serious complication. It can occur if your appendix gets holes in its walls and bursts. That can spread bacteria, mucus and stool outside of your digestive tract. Symptoms include:

• Pain that eases up and then gets worse.
• A fever that spikes.
• Pain that may spread across your abdomen.
• Nausea and vomiting, sometimes with bile or blood as the condition gets worse. You may not be able to keep liquids down.
• Abdominal tenderness or swelling.

A ruptured appendix can cause an infection that spreads through the belly (peritonitis) or the body (sepsis) and can be life-threatening. It’s very important to get medical care right away.

How doctors diagnose appendicitis

A health care provider will typically diagnose appendicitis with:

• Physical exam: Feeling for tenderness and pain, especially pain that gets worse when you press on the abdomen and release the pressure. They will also check for signs of infection like fever and rapid heart rate.
• Imaging tests: Ultrasound and/or CT scans can show the appendix and the surrounding area. Your provider may recommend an MRI if you’re pregnant.
• Blood tests: A high white blood cell count and other markers can be signs of inflammation or infection.
• Urine tests: Urine tests can check for urinary or kidney issues that could be causing symptoms.

Conditions that can mimic appendicitis

Your provider will check to make sure you have appendicitis and not another condition with similar symptoms, such as:

• Urinary tract infection (UTI)
• Gallstones
• Kidney infections or kidney stones
• Digestive issues like Crohn's disease, inflammatory bowel disease, diverticulitis, gastroenteritis or intestinal obstruction
• Female reproductive issues like ovarian cysts, endometriosis or pelvic inflammatory disease
• Stomach flu
• Pancreatitis

If you’re not sure about what’s causing abdominal pain, get medical care right away. Early diagnosis and treatment may reduce your risk of dangerous complications.

How is appendicitis treated?

Appendectomy and recovery steps

The most common treatment for appendicitis is surgery to remove the appendix. This procedure is called an appendectomy. Removing the appendix helps prevent serious complications like rupture or infection. There are two main types of appendectomy, depending on your condition and health history.

Laparoscopic vs. open appendectomy

• Laparoscopic appendectomy is a minimally invasive procedure. Surgeons use small surgical tools and a thin camera (called a laparoscope) to remove the appendix through several tiny cuts. This method usually means:
  • Faster recovery
  • Less pain after surgery
  • A shorter hospital stay (you may go home the same day or within a day or two)
• Open appendectomy is done through one larger cut in the lower right side of your belly. This approach may be needed if:
  • Your appendix has ruptured
  • You have scar tissue or other complications

Your surgeon will choose the best method based on your situation.

Recovery after appendix surgery

After surgery:

• You’ll start with a clear liquid diet, then slowly add solid foods.
• You shouldn’t lift anything heavier than 10 pounds until your incision has healed.
  • Healing takes about 2 weeks after laparoscopic surgery.
  • It may take 4 to 6 weeks after open surgery.
• Light activity is encouraged. You can slowly return to your usual routine over several weeks.

Your provider will schedule follow-up appointments to check your healing. They’ll remove any stitches or staples if needed. Most people recover fully from an appendectomy and don’t have long-term diet or activity restrictions.

Call your doctor if you have:

• A fever
• Increased pain or swelling
• Redness or fluid around the incision
• Nausea, vomiting or trouble eating

What if your appendix has burst?

If your appendix bursts, it can cause a serious infection. In some cases, a pocket of pus (abscess) may form. Your provider may:

• Drain the abscess first using a needle guided by imaging
• Recommend delayed surgery (a few weeks later), once the infection is under control

This staged approach helps lower your risk of complications.

In rare cases, appendicitis is caused by a cancerous tumor blocking the appendix. Your appendix will be tested after surgery, and if cancer is found, your doctor will discuss further treatment options.

Can antibiotics treat appendicitis?

Antibiotics may be an option for treating appendicitis in some situations, such as:

• If a CT scan shows a perforation or abscess, antibiotics and drainage might be used first
• If you have other medical conditions that make surgery risky

However, people treated with antibiotics alone may still need surgery later. There’s also a higher chance that appendicitis could return.

Talk with your provider to see if antibiotics might be right for you. They can explain the risks and benefits based on your individual case.

When to seek care for appendicitis

Appendicitis happens when the appendix becomes inflamed, often causing sudden, severe abdominal pain, nausea and other symptoms. It’s usually diagnosed through a physical exam, imaging tests, and blood work, and is most often treated with surgery.

Why fast treatment matters and how Banner Health can help

If you think you might have appendicitis, don’t wait. Getting medical care quickly can help prevent serious complications, like a ruptured appendix or infection.

At Banner Health, we offer expert care for appendicitis, including:

• Experienced providers trained in emergency and surgical care
• Advanced diagnostic tools, including imaging and lab testing
• Minimally invasive treatment options for faster recovery
• Whole-person care focused on your comfort, safety and healing