saudigastro.com/patients/appendicitis
Category
Serious
Red flags
4
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
What is it?
The appendix is a small finger-shaped pouch attached to the beginning of the large bowel, in the lower right of the belly. Appendicitis means it has become inflamed and swollen, usually because it is blocked. If it is not treated, it can burst (perforate), spreading infection through the belly, which is dangerous. Appendicitis can happen at any age, including in children, although it is most often seen in older children and young adults. Because young children and older adults may not describe the pain clearly, the signs can be easy to miss, which is a reason to seek care early.
How common is it?
Appendicitis is one of the most common causes of sudden belly pain needing emergency surgery, and many people will meet it in childhood or young adulthood. It is less common in infants and young children, but tends to be more serious when it occurs because it is often diagnosed later.
Why does it happen?
The usual cause is a blockage of the opening of the appendix by hardened stool, swollen lymph tissue (often after an infection) or, rarely, a growth. Bacteria then multiply inside, pressure rises, and the wall becomes inflamed and may lose its blood supply. In many people no clear cause is found. It is not caused by seeds, a particular food or something the person did.
Symptoms
- Pain that often starts around the belly button and moves to the lower right side over hours, becoming sharper and constant
- Loss of appetite
- Nausea and vomiting
- Low-grade fever
- Pain that is worse with movement, coughing, walking or bumps in the road
- Constipation or, sometimes, diarrhoea
- In young children: being unusually quiet, refusing food, drawing up the legs, crying with belly pain, or vomiting
Red flags — seek urgent medical care
Belly pain that is getting worse, especially in the lower right belly, with fever or vomiting
This is the typical picture of appendicitis. Go to the emergency department now. Do not eat or drink while you go, in case surgery is needed.
Sudden relief of pain followed by worse pain, a hard belly, a high fever or a fast heartbeat
The appendix may have burst, which is dangerous. Call emergency services immediately.
A baby or child with severe belly pain, repeated vomiting, a swollen tender belly, unusual sleepiness or refusal to move
A child needing urgent care should be seen immediately. Take them to the emergency department now; do not wait to see if it settles and do not give laxatives, home remedies or pain medicine first.
Pregnancy, older age, diabetes or a weak immune system with belly pain
Appendicitis can look different and progress faster in these groups. Seek emergency assessment early.
How is it diagnosed?
The doctor examines your belly, looks for tenderness in the lower right, and takes your history. Blood tests show signs of inflammation, and a urine test helps rule out a urinary infection. Imaging is used to confirm the diagnosis: ultrasound is often used first, especially in children and pregnant women because it avoids radiation, and a CT scan is commonly used in adults. Sometimes the diagnosis is made mainly from the exam and the course of the illness. The surgical team decides which tests you need.
What the latest science says
Surgical removal of the appendix, most often by keyhole surgery, remains the standard treatment. For selected people with uncomplicated appendicitis, treatment with antibiotics alone has been studied as an alternative; some recover without surgery, but a number later need the operation. This choice should be discussed with the surgeon and is not suitable for everyone.
Outlook — what to expect
With prompt treatment most people recover fully and quickly, usually within days to a couple of weeks after keyhole surgery. Delay increases the chance of rupture, abscess and a longer stay in hospital. You can live normally without your appendix.
Treatment
Habits & Lifestyle
This is an emergency condition, so there is no home treatment. What you do early matters.
- Go to the emergency department promptly if appendicitis is suspected
- Do not take laxatives, enemas, heat packs or pain medicines to try to settle the pain first
- Do not eat or drink while waiting to be assessed, because you may need an operation
- After surgery, follow your surgeon's advice on activity, lifting and wound care
- Contact your surgical team if fever, wound redness or worsening pain develops after surgery
Diet
Food is mostly a matter of recovery. Before surgery you will be asked not to eat or drink.
- Follow the fasting instructions given by the hospital team
- After surgery, start with fluids and light foods and return to normal eating as you feel able
- Drink enough fluids and include fibre to prevent constipation, especially if you are taking pain medicine
- For children, follow the paediatric team's advice on feeding after the operation
Medications
Medicines support the surgery and recovery. The medical team decides what is suitable, including for children and pregnant women.
- Intravenous antibiotics to treat or prevent infection, usually started once appendicitis is suspected or confirmed
- Intravenous fluids and pain relief chosen by the team
- After uncomplicated surgery, you may need little or no further antibiotic; with rupture or abscess, a longer course is often needed
- Take any prescribed medicines as directed and finish antibiotic courses
Procedures & Surgery
The usual treatment is an operation.
- Laparoscopic (keyhole) appendectomy is the most common operation
- Open surgery is sometimes needed, for example with a ruptured appendix or complicated disease
- If an abscess forms, a drain may be placed first, and surgery done later
- Antibiotics alone may be considered in selected cases of uncomplicated appendicitis after discussion with the surgeon
Living with the condition
- Most people return to normal activity within a few weeks. Your surgeon will tell you when you can go back to school, work, sport and driving.
- Contact your doctor if pain, fever or wound problems appear after you go home.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- Is surgery needed now, and what type?
- Could antibiotics alone be an option in my case?
- How long will my child or I need to stay in hospital?
- When can I return to school, work, exercise or driving?
- Which symptoms after discharge should bring me back?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide