Appendicitis: Symptoms, Pain Location and When to Go to Hospital

A dull pain around the belly button that slowly moves to the lower right side of the abdomen, with loss of appetite and low fever. This is the classic story of appendicitis, and it is one of the most common causes of emergency surgery. The important message is simple: if you suspect it, do not wait at home and do not take painkillers to “see if it passes”.

What is appendicitis?

The appendix is a small finger-shaped pouch attached to the large intestine, in the lower right abdomen. Appendicitis means it is inflamed and infected, usually because it becomes blocked by stool, a swollen gland or, rarely, a worm. If untreated, the appendix can burst within 24 to 72 hours, spreading infection through the abdomen (peritonitis), which is life-threatening.

Symptoms

• Pain starting near the navel, then shifting to the lower right abdomen and becoming sharper
• Pain worsening with walking, coughing, or movement
• Loss of appetite
• Nausea and vomiting
• Low-grade fever
• Constipation or sometimes diarrhoea
• Abdominal swelling or tenderness when pressed

In children, older adults and pregnant women, symptoms may be unusual. Young children may only be unwell, cranky and refuse food. In pregnancy, the pain may be higher in the abdomen.

Appendicitis or something else?

Many conditions can cause right-sided abdominal pain: gastroenteritis, constipation, kidney stones, urinary infection, period pain (see period pain), ovarian cysts, and in women an ectopic pregnancy. A doctor examines the abdomen and orders blood tests and an ultrasound or CT scan. Diagnosis can sometimes be difficult, so doctors may observe you for several hours.

What to do if you suspect it

• Go to a hospital emergency room straight away.
• Do not eat or drink anything, in case you need an operation.
• Do not take painkillers, antibiotics, laxatives or antacids on your own. They can hide the signs and delay the diagnosis.
• Do not apply heat packs to the abdomen. Heat may increase the risk of rupture.
• Do not wait overnight to see if the pain settles.

Treatment

• Surgery to remove the appendix (appendectomy), usually by keyhole surgery, is the standard treatment. Recovery is quick: most people go home in a day or two and return to normal in 1 to 3 weeks.
• Antibiotics are given before and after surgery. In selected mild cases, doctors may try antibiotics alone, but the infection can return in a significant number of people.
• If the appendix has burst, surgery is more complex and hospital stay longer, with an abscess or abdominal wash-out needed.

You can live a perfectly normal life without your appendix.

Recovery tips

• Follow your surgeon’s advice on diet. Light food first, then normal meals as tolerated.
• Walk gently from the first day to prevent clots and constipation.
• Avoid heavy lifting for a few weeks.
• Keep the wound clean and dry.
• Take medicines as prescribed and see the doctor for a follow-up.

Go to hospital at once if

• Abdominal pain lasts more than four to six hours, and is worsening or moving to the right lower side
• You have a fever, repeated vomiting, or a swollen, hard abdomen
• Pain suddenly becomes severe, then briefly improves. This can mean rupture.
• A child has severe tummy pain with fever and refuses to walk or move
• After surgery: increasing pain, fever, redness or pus from the wound, or persistent vomiting

Key takeaways

• Appendicitis pain starts around the navel and moves to the lower right abdomen.
• It is an emergency. Go to hospital early, and avoid food, drink and home painkillers.
• Keyhole surgery is the usual treatment, with a fast recovery.
• A delay raises the risk of the appendix bursting.

Related products on Medimart

There is no home treatment or over-the-counter medicine for appendicitis, and delay can be dangerous. After surgery, your surgeon will tell you which medicines to use. For recovery you may find these useful:

• Paracetamol: for pain after surgery, only if your surgeon advises it
• Lactulose: a laxative doctors may prescribe to ease constipation after surgery

Browse first aid and bandages on Medimart, delivered across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from a doctor. Severe abdominal pain is an emergency. Please go to a hospital.