Health insights
Appendicitis: Symptoms, Pain Location and When You Need Surgery
Appendicitis pain often starts near the belly button and moves to the lower right. Know the warning signs and why waiting is risky.
Most belly pain is harmless and passes in a few hours. Appendicitis doesn't. It can turn serious within a day or two, so it helps to know the pattern and act early.
What is appendicitis?
The appendix is a thin pouch, about the size of a finger, attached to the large bowel on the lower right side of the belly. If its opening gets blocked, germs multiply inside and the appendix swells and becomes infected. Left alone, it can burst and spread infection through the belly. It can happen at any age, but it is most common between 10 and 30 years.
Symptoms
The usual pattern goes like this:
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A dull pain near the belly button or upper belly. It may feel like gas.
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Over some hours, often 12 to 24, the pain moves to the lower right side and becomes sharper.
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The pain gets worse when you walk, cough, sneeze, take a deep breath or press on the spot.
Other signs include loss of appetite, nausea and vomiting after the pain begins, a low fever, a bloated belly, and trouble passing gas or stool.
Not everyone follows this pattern. Small children may only seem unwell, cry and refuse food. Older adults may have milder pain. In pregnancy the pain can sit higher on the right side.
Which side is appendix pain?
The lower right side, roughly halfway between the belly button and the point of the right hip bone. Pain on the left is usually from something else, but any severe belly pain needs a doctor.
What to do if you suspect it
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See a doctor or go to a hospital the same day. Don't wait to see if it settles.
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Keep your stomach mostly empty, since you may need surgery. Small sips of water are fine.
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Don't take laxatives. They can make an inflamed appendix worse.
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Don't use painkillers to wait and see. They can hide the problem while the appendix gets worse.
Get help now: Go to the emergency room now if the pain is severe, suddenly gets worse, or suddenly stops (this can mean the appendix has burst). The same goes for a hard, tender belly, high fever, repeated vomiting or a fast heartbeat.
How it is diagnosed
There is no single test. The doctor will examine your belly and usually order blood and urine tests. An ultrasound is often the first scan, especially for children and pregnant women. A CT scan is sometimes needed when the picture is still unclear. Gas pain, a urine infection, a kidney stone or an ovarian cyst can feel similar, which is why a proper check matters.
Treatment
Surgery (appendectomy)
Removing the appendix is the standard treatment, and it is usually done by keyhole (laparoscopic) surgery. You're asleep under general anaesthesia. The surgeon makes three small cuts, passes in a camera and fine instruments, and takes out the appendix. It usually takes 30 to 60 minutes. If the appendix has burst or the infection is severe, an open cut may be needed and the operation can take longer.
Compared with open surgery, keyhole surgery usually means smaller scars, less pain and a quicker recovery.
Antibiotics only
In some selected patients with mild appendicitis, doctors may try antibiotics without surgery. It doesn't suit everyone. In a large trial, about 3 in 10 patients treated this way still needed surgery within 3 months. Your surgeon will tell you whether it is a safe option for you.
Recovery after surgery
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Hospital stay is often 1 to 2 days, and longer if the appendix had burst.
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Mild pain at the cuts and some shoulder pain from the gas used in surgery settle within a few days.
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Most people eat light food within hours and normal food in a day or two.
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Walk a little from day one. It helps recovery.
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Desk work is usually possible after 1 to 2 weeks. Avoid heavy lifting and hard exercise for 2 to 4 weeks, or as your surgeon advises.
Call your doctor if you have fever, redness or pus at a cut, worsening belly pain or repeated vomiting.
Risks
Appendix surgery is common and generally safe, but every operation carries some risk. These include wound infection, a pocket of pus inside the belly, bleeding and, rarely, injury to nearby organs. Problems are more likely when the appendix has already burst, which is one more reason not to wait.
Common questions
Can appendicitis go away on its own? Pain can ease for a short while, but the problem usually doesn't go away. Don't assume it has. Get checked.
Can food cause appendicitis? No. Seeds, spicy food and junk food are not proven causes. The usual cause is a blockage inside the appendix.
Can I live without an appendix? Yes. You can live a normal life without it, with no change in diet.
Can it be prevented? There is no sure way to prevent it. Getting help early is what protects you.
Have questions or want to see a specialist? For appointment and queries, call 8156929292. AXTEN HOSPITALS - HONEST SURGERY, HONEST CARE.