What is Appendix pain?
Appendix pain
Appendix pain is typically described as pain or discomfort in the abdominal area (the belly), in the lower right side, where the appendix is located. Medically speaking, there is no such thing as “appendix pain”, even though the affected person may describe or experience it as such. The correct term is “abdominal pain”, which is a symptom of both serious and non-serious medical issues, such as gastroenteritis, gas, hepatitis, irritable bowel syndrome, gallstones, and indeed acute appendicitis.
The appendix vermiformis is a small, narrow tube found at the end of the caecum, which is a pouch-like structure at the intersection between the small and large intestine. The exact biological function of the appendix is unknown. Abdominal pain in the region of the appendix may be caused by acute appendicitis, an inflammation of the appendix that should be treated as a medical emergency. The characteristic pain that results from acute appendicitis will typically begin in the vicinity of the stomach or belly button and then, as the abdominal wall and other organs begin to be affected by inflammation, the pain will move towards the lower right side abdomen and become more severe. However, pain from inflammation originating in the appendix may also be felt elsewhere in the abdominal area, though it is very common for it to be felt in the lower right region.
Other symptoms, such as nausea, vomiting, and fever may also occur.[1]
Pain in the region of the abdomen is easily confused with pain from acute appendicitis, which specifically affects the appendix. A wide range of conditions can cause such abdominal pain, including non-serious buildups of gas or indigestion, as well as more serious conditions, such as ulcers, infection of the ovaries, diverticulitis, inflammatory bowel diseases, or kidney infection. People experiencing abdominal pain, whether or not localized to the lower right-hand side, that gradually gets worse, should seek medical attention urgently.[2][3]
What is the appendix?
The appendix vermiformis (colloquially known as “the appendix”) is a small, narrow tube found at the end of the pouch-like cecum, which is found at the junction between the small and large intestine. In most people, the appendix is located on the lower right-hand side of the abdomen. Although the exact function of the appendix is unknown – and for a time it was widely believed to have no function – some doctors believe that the appendix may serve as a storage unit for good bacteria and play a role in the development of the immune system.[4]
Causes of abdominal pain in the region of the appendix
As pain specific to acute appendicitis and abdominal pain from other causes are easily confused, it’s important to be aware of all of the common conditions that can cause this pain.
Appendix pain is located in the abdomen. The abdomen can be divided into four quadrants, by imagining a vertical line running through the navel (belly button) and another running line through it horizontally.[5] The human abdomen is a large region of the human body, and it is the location of a number of organs and organ systems.[6]
The left upper quadrant contains the stomach, spleen, left kidney, small intestine, descending colon, and transverse colon.[7]
The left lower quadrant contains the small intestine and the descending colon, sigmoid colon, and rectum.[6]
The lower right quadrant contains the small intestine, the cecum, and the appendix, as well as the ascending colon.
The upper right quadrant contains the pancreas, gallbladder, liver, right kidney, small intestine, ascending colon, and transverse colon.
The bladder lies roughly on the midline of the lower quadrants. The abdominal cavity is lined by the peritoneum, which is made up of connective tissue.[6] The peritoneum can become infected, a condition is known as peritonitis (see below). The organs are held in a web of tissue known as the mesentery.
In men, the abdomen also contains the prostate, which is situated just below the bladder. In women, the abdomen also contains the uterus, cervix, ovaries, and fallopian tubes. These differences between men and women mean that, in some cases, pain may be felt differently. This is partly because different organs and structures are involved. In acute appendicitis, men and women experience pain in the same regions.
Different disorders within the abdominal region may cause pain in different regions. For example, gastritis is usually felt in the left upper abdominal quadrant, while pain from an inflamed gallbladder or gallstones is felt in the right upper region. Pain that is experienced in the region of the appendix may be from acute appendicitis, but it may also result from other disorders and diseases of organs in the abdominal region.
Good to know: Pain from kidney problems is usually described as being in the back or side, rather than as pain in the abdomen.
Acute appendicitis
Acute appendicitis is a common condition that can affect people of all ages. It is an inflammation of the appendix, thought to be caused by a blockage of the appendix or by the appendix becoming infected. The main symptom of acute appendicitis is severe pain in the abdomen. This will usually begin as a dull pain located around the stomach area or belly-button region, before gradually moving to the lower right side and becoming sharper and more severe. At this stage, the portion of the abdomen where the appendix is located may be painful or tender to touch.
Other symptoms of acute appendicitis may include:[8]
- Nausea
- Vomiting
- Fever
- Constipation
- Frequent urination, because of irritation of and around the ureter, which can imitate the symptoms of a urinary tract infection
If the condition is left untreated, the appendix can burst. If this happens, an individual will typically experience severe pain across the entire abdominal region. This can cause peritonitis, a medically significant condition (see below).
If any symptoms of the condition occur and acute appendicitis is suspected, immediate medical attention should be sought. A person will be admitted to the hospital and usually undergo surgery to remove the appendix. This common procedure is called an appendectomy and is considered routine by doctors. It will usually be carried out using laparoscopic surgery.
Other causes of abdominal pain
Although acute appendicitis is a common cause of severe pain in the region of the appendix, there are a variety of other possible causes. The source of pain in this location is often difficult to pinpoint, meaning that pain, which feels like the result of acute appendicitis, may in fact stem from a different source, such as a problem related to other parts of the intestines or the kidneys.
Other possible causes of abdominal pain include:[9][10][11][12]
- Food poisoning
- Diarrhea
- Constipation
- Vomiting
- Stomach ulcers
- Crohn’s disease
- Irritable bowel syndrome
- Inflammatory bowel disease
- Diverticulitis
- Infectious enterocolitis
- Peritonitis
- Gallstones
- Inflamed gallbladder
- Kidney infections
- Kidney stones
- Pancreatitis
- Hepatitis
- Urinary tract infections
Women may additionally experience abdominal pain, usually in the lower abdomen, as a result of:
- Pelvic inflammatory disease
- Ovarian cysts, ovarian torsion or inflamed ovaries
- Ectopic pregnancy
- Endometriosis
- Dysmenorrhea
- Miscarriage
In rare cases, pain in the appendix area/abdomen can also be a symptom of a tumorous condition (benign or malignant). Nevertheless, if a tumorous condition is suspected, urgent medical attention may be required. Treatment options include surgery, chemotherapy, and radiation therapy.[13]
Appendix pain location
What does appendix pain feel like? If acute appendicitis is the cause of the abdominal pain, the pain will generally begin as dull and be located around the stomach and/or belly button region. This pain can develop quickly or slowly, but will in most cases become severe over time. As the pain intensifies, the lower right-hand side of the abdomen, where the appendix is typically located, will generally become particularly tender and may be painful to the touch. If the appendix has burst, the pain will typically spread across the whole abdominal region and will be correspondingly severe.
Acute appendix pain location in adults
In adults, appendix pain – or rather, pain in the region of the appendix – can be the result of appendicitis or another disorder. The location of the pain can sometimes indicate whether the pain is the result of appendicitis or another disorder.
Is the pain on the left side or the right side?
In most cases, if the cause of the pain is acute appendicitis, the pain will begin around the belly button and then be felt in the right region of the stomach. If the pain is also felt on the left, the peritoneum may also be infected. This can cause something called rebound tenderness (see FAQs).
If you are concerned that you may have acute appendicitis or another problem that is causing you abdominal pain, Please check with your doctor Find my Doctor to find out what the problem is.
A number of other disorders of the abdomen typically cause pain only on the left or only on the right. Disorders that can cause pain on the right in men and women include:[14]
- Cholecystitis/inflamed gallbladder
- Cholelithiasis/gallstones
- Hepatitis
- Duodenal ulcers
Disorders that can typically cause pain on the left in men and women include:[14]
Disorders that can typically cause pain on the left or the right or both in men and women to include:[14][15]
- Inflammatory bowel disease
- Pyelonephritis, a kidney infection
- Nephrolithiasis, or kidney stones, which can cause pain in a number of locations throughout the abdomen
- UTIs such as cystitis.
Disorders that can typically cause pain in the middle of the abdomen in men and women include:[14]
- Early appendicitis
- Stomach ulcers
- Gastroesophageal reflux disease
- Pancreatitis
- Urinary tract infections
- Inflammatory bowel disease
If you are concerned that you may have acute appendicitis, a UTI, or another problem that is causing you abdominal pain, Please check with your doctor Find my Doctor to find out what the cause is.
Acute appendix pain location in men
The location of appendix pain in men and women is the same. However, there are a number of conditions that may cause appendix pain, or abdominal pain, only in males. These include:[14][15]
If you are concerned that you may have acute appendicitis, prostatitis, or another problem that is causing you abdominal pain, Please check with your doctor Find my Doctor to find out what the cause is.
Acute appendix pain location in women
As stated above, men and women experience pain from acute appendicitis in the same locations.
However, there are a number of conditions that may cause abdominal pain only in females. These include:[14][15]
- Ovarian torsion
- Ectopic pregnancy
- Ovarian cysts or ruptured ovarian cysts
- Pregnancy
- Dysmenorrhea
- Pelvic inflammatory disease
- Endometriosis
All of the above can cause pain in the region of the appendix, mostly in the right lower abdomen and the left lower abdomen.[14]
Good to know: Pain in the region of the appendix can also be a sign of pregnancy. During early pregnancy, mild stomach pain results from the expansion of tissue and the womb, as well as from hormones. The implantation of the fertilized egg in the lining of the uterus also commonly causes pain. Moderate period-like pain can also occur at the beginning of a pregnancy.[16] If severe pain and/or cramping occurs, medical advice should be sought as soon as possible (see below).
If you are concerned that you may have acute appendicitis, endometriosis, or another problem that is causing you abdominal pain, You can search for the nearest doctor Find my doctor.
Appendix pain location during pregnancy
The changes the body undergoes during pregnancy mean abdominal pain can be relatively normal, and it may be mistaken for pain from acute appendicitis. This pain can be a result of non-serious factors such as:[17][18]
- The expanding uterus: As the uterus grows during pregnancy, the bowel is displaced, potentially leading to pain in the abdominal area.
- Round ligament pain: The round ligaments, located at the front of the uterus, can cause sharp and sometimes severe pain as the uterus expands. Typically, this pain is in the lower half of the abdomen. While the person experiencing the pain may confuse this with appendicitis, a physician will be able to tell the difference.
- Constipation and gas: Common during pregnancy, due to changes in the location of the gastrointestinal tract, which is pushed out of the way and compressed by the expanding uterus. Constipation and gas can cause mild to moderate pain in the whole abdominal region.
At times, abdominal pain during pregnancy can be a result of more serious conditions.
Urinary tract infection: A treatable condition with symptoms including a sudden and/or frequent urge to urinate, pain when urinating, and general abdominal pain.
Ectopic pregnancy: A condition that occurs when a fertilized egg implants itself somewhere other than the uterus, often causing severe abdominal pain. Pain from an ectopic pregnancy is usually felt in the lower abdomen.
Miscarriage: Miscarriage is the sudden loss of a pregnancy in the first 20 weeks. Symptoms can include pain and cramps on the right and left of the lower abdominal region. It is often accompanied by vaginal bleeding, as well as the loss of fluid or tissue from the vagina.
Abdominal pain during pregnancy may also be the result of acute appendicitis. Appendicitis during pregnancy can be difficult to diagnose due to the movement of the appendix from its usual position to a higher position near the liver or belly button. In pregnant women, pain from acute appendicitis may be felt in the right upper quadrant of the abdomen.[15] These symptoms should be reported to doctors as soon as they occur. To prevent complications, emergency surgical intervention is typically required.[17]
If you are concerned that you may have acute appendicitis or are experiencing an ectopic pregnancy, or another problem that is causing you abdominal pain, Please check with your doctor Find my Doctor to find out what the cause is.
Appendix pain location in children
Pain in the region of the appendix in children may be a result of a variety of conditions. These include relatively non-serious conditions such as:[18]
- A buildup of gas
- Constipation
- Gastroenteritis
- Mild food poisoning
- A mild food allergy
If abdominal pain lasts for longer than a day or is particularly severe, it could be a sign of a range of conditions including:
- Urinary tract infection
- Hernia
- Inflammatory bowel disease
- Intussusception of the bowel, where a section of the intestine slides into the next, like a telescope folding up. This is rare and tends to affect the small intestine. However, it is a medical emergency.
In some cases, appendicitis may be the cause of abdominal pain. Children with appendicitis often present with similar pain or symptoms as adults with the condition. Other symptoms of appendicitis in children include:
- Fever
- Vomiting
- Nausea
- Lack of appetite
It is important to ensure children receive medical attention as soon as possible if appendicitis is suspected. Treatment will usually involve an appendectomy. This is considered a routine procedure but will involve a hospital stay.
If you are concerned that your child may have acute appendicitis or another stomach problem, you can search for the nearest doctor near you.
Complications of untreated appendix pain
Acute appendicitis is a common disorder and is easily treated if it is diagnosed early. If it is not treated, the appendix may burst and this may lead to peritonitis.**
Peritonitis
Peritonitis is uncommon, but when it does occur, it is a medical emergency. Peritonitis is an infection of the peritoneum, the lining of the abdominal cavity. If it occurs without an underlying cause, it is known as primary peritonitis. However, peritonitis is usually caused by disorders including:[19]
- Acute appendicitis, if the appendix bursts
- Pancreatitis
- Diverticulitis
- Acute cholecystitis
- Pelvic inflammatory disease
- Penetrating injury of the abdomen, such as a stab wound or gunshot wound
This list is not exhaustive. Many other abdominal disorders that involve inflammation can result in peritonitis if they are not treated.[15]
Peritonitis is the result of an infection spreading from an organ to the peritoneal tissue. The regions in which pain is felt and how severe the pain is, change as the infection spreads.[19]
Abdominal pain from peritonitis may be felt in several ways. Generally, an infection affecting an organ in the abdomen will be painful, and as the infection spreads to the peritoneum nearest the organ, the pain will also spread. If the infection then spreads to the entire peritoneum, the pain will then be felt as general belly pain and tenderness.
Pain from peritonitis feels worse when the affected person flexes their hips or coughs; it is also painful if pressure is applied.[20] It will usually be most intense over the site of the organ that originally began the infection.
Other symptoms of peritonitis may include:
- Fever, with a body temperature of 38 C/ 100.4 F
- Low blood pressure
- Fast heartbeat
- Low output of urine
- Septic shock in severe cases
If you are concerned that you may have peritonitis, a burst appendix or another problem that is causing you abdominal pain and distress, share your symptoms with Adoctor conditions and symptoms.
Appendix pain relief
Relief from abdominal pain will generally depend on its underlying cause. When caused by acute appendicitis, the standard treatment option is surgery, which will usually take the form of an appendectomy. If a person experiencing moderate or severe abdominal pain is concerned and shows no improvement within a reasonable amount of time, they should seek medical help.
An appendectomy involves the complete removal of the appendix, sometimes following a course of antibiotics to reduce inflammation and make surgery easier. Keyhole surgery is generally used during this procedure, allowing for a shorter recovery time and less scarring. Generally, there are no long-term complications following an appendectomy.
It is more likely that abdominal pain is the result of gastroenteritis, gas, or food poisoning than acute appendicitis. It may be best to treat for these first, before seeking emergency medical help. About 179 million cases of acute gastroenteritis are reported every year in the USA, but only 7% of the population will have appendicitis in their lifetime, making gastroenteritis more common than appendicitis.[21][22] Gastroenteritis generally includes diarrhea and vomiting, nausea and abdominal pain, and sometimes fever.
Treatment of gastroenteritis and food poisoning includes bed rest, oral rehydration, and medication to manage nausea, vomiting, and diarrhea.[23] However, If there is no improvement in symptoms within a reasonable time with this treatment, then a physician should be consulted urgently.
If you are concerned that you may have acute appendicitis, gastroenteritis, or another problem that is causing you abdominal pain, use Adoctor conditions and symptoms to check your symptoms.
Appendix pain FAQs
u003cstrongu003eIn what location do you experience appendix pain?u003c/strongu003e
In most cases of appendicitis, the pain will typically begin around the stomach or belly button area and move to the lower right side of the abdomen, while also becoming sharper and more severe.
u003cstrongu003eWhy is appendix pain sometimes felt on the left?u003c/strongu003e
In most cases, pain from acute appendicitis is felt on the right. However, some people experience it on the left. This occurs when the inflammation affecting the appendix spreads to the peritoneum, the lining of the abdominal cavity.
A common test that can distinguish possible appendicitis from other abdominal pain uses rebound tenderness to determine whether it is the appendix that is inflamed or another structure. In this test, the doctor slowly presses their fingers on a part of the abdomen that does not hurt – in the case of suspected acute appendicitis, this would be the left-hand side – and then quickly let’s go. The affected person feels pain in the lower right abdominal area. This sort of pain is known as “contralateral rebound tenderness”, as pain occurs on the side opposite to where the pressure is applied.
In very few cases, the reason for appendix pain being felt on the left maybe because of a hereditary condition known as situs inversus, in which the organs of the chest and abdomen are in mirror-image positions – that is, they are on the opposite side to where they are in most people.[24] In people with situs inversus, for example, the liver and appendix are on the left of the abdomen. However, situs inversus only affects about one in 8000 people, and it is far more likely that, if you feel appendix pain on the left, it is because of rebound tenderness.[25]
-
Patient. “Appendicitis.” August 1, 2017. Accessed September 28, 2017. ↩
-
Cancer. “Appendix Cancer: Introduction.” April, 2016. Accessed September 28, 2017. ↩
-
Healthline. “Appendix.” August 21, 2017. Accessed September 28, 2017. ↩
-
Patient. “Appendicitis.” August 1, 2017. Accessed September 28, 2017. ↩
-
Medscape. “Regions and Planes of the Abdomen”. 23 October 2013. Accessed 11 June 2018. ↩
-
WebMD. “Picture of the Abdomen”. 11 June 2018. ↩ ↩ ↩
-
Austin Peay State University Biology. “Exam 3 Review: Chapter 23: Large Intestine Anatomy”. Accessed 11 June 2018. ↩
-
Patient. “Appendicitis.” August 1, 2017. Accessed September 28, 2017. ↩
-
RSNA. “Beyond Appendicitis: Common and Uncommon Gastrointestinal Causes of Right Lower Quadrant Abdominal Pain at Multidetector CT.” March 17, 2010. Accessed September 29, 2017. ↩
-
University of Maryland Medical Centre. “Conditions with Similar Symptoms as: Appendicitis.” August 11, 2015. Accessed September 29, 2017. ↩
-
NHS Inform. “Stomach ache and abdominal pain”. 6 March 2018. Accessed 28 March 2018. ↩
-
Netdoctor. “Lower abdominal pain in women”. 8 June 2016. Accessed 28 March 2018. ↩
-
Cancer.Net. “Appendix Cancer.” April, 2016. Accessed September 29, 2017. ↩
-
Amboss. “Abdominal examination”. Accessed 11 June 2018. ↩ ↩ ↩ ↩ ↩ ↩ ↩
-
MSD Manuals Professional Version. “Acute Abdominal Pain”. January 2017. Accessed 11 June 2018. ↩ ↩ ↩ ↩ ↩
-
Tommy’s. “Stomach pain in pregnancy”. ↩
-
ELSEVIER. “Appendicitis during pregnancy.” July, 2003. Accessed September 29, 2017. ↩
-
Everyday Health. “Appendicitis in Children.” February 6, 2017. Accessed September 29, 2017. ↩
-
Nursing. “Understanding peritonitis: Find out how to respond appropriately to this potentially fatal disorder.”. July 2006. Accessed 13 December 2018. ↩ ↩
-
Medscape. “Peritonitis and Abdominal Sepsis Clinical Presentation”. 11 January 2017. Accessed 10 June 2018. ↩
-
Centers for Disease Control and Prevention Journal of Emerging Infectious Diseases. “Incidence of Acute Gastroenteritis and Role of Norovirus, Georgia, USA, 2004–2005”. August 2011. Accessed 30 March 2018. ↩
-
American Family Physician. “Acute Appendicitis: Review and Update”. November 1999. Accessed 30 March 2018. ↩
-
AdaHealth. “Gastroenteritis”. Accessed 30 March 2018. ↩
-
National Center for Advancing Translational Sciences Genetic and Rare Diseases Information Center. “Situs inversus”. Accessed 10 June 2018. ↩
-
Medscape. “Situs Inversus Imaging “. 31 May 2018. Accessed 11 June 2018. ↩
**Question: What is Appendix Pain?**
**Answer:**
Appendix pain refers to discomfort in the right lower quadrant of the abdomen, which is where the appendix, a small finger-shaped organ protruding from the large intestine, is located. It’s a common symptom of appendicitis, an inflammation of the appendix that can lead to serious complications if left untreated.
**Symptoms of Appendix Pain:**
* Sharp, stabbing pain in the lower right abdomen, initially around the belly button
* Gradual migration of pain to the lower right quadrant
* Nausea and vomiting
* Loss of appetite
* Low-grade fever
* Diarrhea or constipation
**Causes of Appendix Pain:**
Appendicitis occurs when the appendix becomes obstructed, usually by stool, a foreign body, or a tumor. This obstruction leads to inflammation, which can cause the appendix to rupture if not treated promptly.
**Differential Diagnosis:**
Other conditions with similar symptoms to appendix pain include:
* Gastroenteritis (stomach infection)
* Urinary tract infection (UTI)
* Ovarian cysts (in women)
* Hernia
**Diagnosis:**
Diagnosis of appendicitis involves a physical exam, medical history review, blood tests, and imaging studies such as ultrasound or computed tomography (CT) scan.
**Treatment:**
The standard treatment for appendicitis is surgical removal of the appendix (appendectomy), which is a relatively straightforward procedure. Antibiotics may also be administered to treat any infection.
**Complications of Untreated Appendix Pain:**
Ignoring appendix pain can lead to serious complications, including:
* Rupture of the appendix, causing peritonitis (infection of the abdominal cavity)
* Sepsis (overwhelming infection)
* Abscess formation
* Death
**When to Seek Medical Attention:**
If you experience sudden onset of severe lower right abdominal pain accompanied by other symptoms of appendicitis, seek immediate medical attention. Early diagnosis and treatment are crucial to prevent complications.
Appendix pain is a common problem, especially in young adults. It can be caused by a variety of factors, including infection, inflammation, or blockage. Symptoms of appendix pain can include:
* Sudden, sharp pain in the lower right abdomen
* Nausea and vomiting
* Fever
* Chills
* Constipation or diarrhea
If you are experiencing any of these symptoms, it is important to see a doctor right away. Appendix pain can be a sign of a serious medical condition, and early treatment is essential.
### What are the risk factors for appendix pain?
There are a number of risk factors for appendix pain, including:
* Being young (between the ages of 10 and 30)
* Being male
* Having a family history of appendix pain
* Having a history of abdominal surgery
* Having a weakened immune system
### How is appendix pain diagnosed?
Appendix pain is diagnosed based on a physical examination and a medical history. Your doctor will ask about your symptoms, including when they started, how severe they are, and where they are located. Your doctor will also perform a physical examination, which may include pressing on your abdomen to feel for pain or swelling.
In some cases, your doctor may order additional tests to confirm the diagnosis of appendix pain. These tests may include:
* Blood tests
* Urine tests
* Imaging tests, such as an ultrasound or a CT scan
### How is appendix pain treated?
Appendix pain is typically treated with surgery to remove the appendix. This is a relatively simple procedure that is usually performed laparoscopically, which means that it is done through small incisions in the abdomen.
In some cases, your doctor may recommend antibiotics instead of surgery. Antibiotics can be used to treat an infection of the appendix, but they are not always effective.
### What is the prognosis for appendix pain?
The prognosis for appendix pain is generally good. If the appendix is removed promptly, the condition can be cured. However, if the appendix ruptures, it can lead to a serious infection, which can be life-threatening.
### How can I prevent appendix pain?
There is no sure way to prevent appendix pain, but there are some things you can do to reduce your risk of developing the condition. These include:
* Eating a healthy diet
* Exercising regularly
* Maintaining a healthy weight
* Getting enough sleep
* Avoiding smoking
* Limiting alcohol intake
If you have any of the risk factors for appendix pain, it is important to be aware of the symptoms and to see a doctor right away if you experience any of them. Early diagnosis and treatment can help to prevent serious complications.