Appendicitis

  • Symptoms

    The symptoms of appendicitis vary. It can be hard to diagnose appendicitis in young children, the elderly, and women of childbearing age.

    Typically, the first symptom is pain around your belly button. (See: Abdominal pain) The pain may be vague at first, but becomes increasingly sharp and severe. You may have reduced appetite, nausea, vomiting, and a low-grade fever.

    As the inflammation in the appendix increases, the pain tends to move into your right lower abdomen and focuses directly above the appendix at a place called McBurney's point.

    If your appendix ruptures, the pain may lessen briefly and you may feel better. However, once the lining of your abdominal cavity becomes inflamed and infected (a condition called peritonitis), the pain gets worse and you become sicker.

    Your abdominal pain may be worse when walking or coughing. You may prefer to lie still because sudden movement causes pain.

    Later symptoms include:

    • Chills
    • Constipation
    • Diarrhea
    • Fever
    • Loss of appetite
    • Nausea
    • Shaking
    • Vomiting

    Signs and tests

    If you have appendicitis, your pain will increase when the doctor suddenly releases the pressure after gently pressing on your lower right belly area. If you have peritonitis, touching the belly area may cause a spasm of the muscles.

    A rectal examination may reveal tenderness on the right side of your rectum.

    Doctors can usually diagnose appendicitis by your description of the symptoms, the physical exam, and laboratory tests. In some cases, additional tests may be needed. These may include:

    • Abdominal CT scan
    • Abdominal ultrasound
    • Diagnostic laparoscopy

    Note: The U.S. Food and Drug Administration recalled a drug used during some appendicitis-related imaging tests after reports of life-threatening side effects and deaths. The drug, called NeutroSpec, was used to help diagnose appendicitis in patients ages 5 and older who may have had the condition but did not show the usual signs and symptoms.