Appendicitis

Pain is the most common symptom of appendicitis. It often starts near your belly button and might come and go. The pain then usually moves down to the lower right side of your tummy and becomes more severe and more constant. It may hurt more when you move or cough.

Other common symptoms of appendicitis include:

• fever
• nausea or vomiting
• loss of appetite
• diarrhoea or constipation

The symptoms of appendicitis may be more subtle in young children, especially if they cannot tell you exactly where the pain is. Unlike gastroenteritis ('gastro'), vomiting or diarrhoea are usually mild with appendicitis.

Appendicitis can be caused by an infection or a blockage in the appendix. The exact reason for this is not known. It is thought to happen when food or faeces (poo) gets stuck in the appendix. This blockage can cause the appendix to become swollen, inflamed and infected.

If you think that you or someone you know may have appendicitis, see a doctor as soon as possible.

If you have severe pain that gets worse when you move or touch your abdomen, go straight to your local emergency department.

Your doctor will diagnose appendicitis by asking about your symptoms and examining you.

Appendicitis can be hard to diagnose, especially in young children. Even in adults, it can be difficult to tell apart from other medical problems that affect your tummy. Your doctor may observe how your symptoms change over time before making a diagnosis.

Sometimes, tests can help diagnose appendicitis. These may include:

• ultrasound
• CT scan
• blood test

Because appendicitis may be life-threatening if left untreated, your doctor may recommend surgery to check your appendix. They might suggest this even if they are not certain it's inflamed but they believe appendicitis is the most likely diagnosis.

The main treatment for appendicitis is surgery to remove the inflamed appendix. This is called an appendectomy or appendicectomy. The appendix is not needed by the body and your body can function normally without one.

While you wait for your surgery, you may receive intravenous (IV) antibiotics to treat the infection.

There are 2 main types of surgery to remove the appendix:

• laparoscopic (keyhole surgery) — your surgeon will make 3 small cuts (about 1 to 2 cm each) in different parts of your tummy to insert a camera and surgical instruments
• open surgery — your surgeon makes a larger cut in the bottom right side of your tummy to remove your appendix

Your recovery depends on:

• your overall health
• the type of surgery you had
• whether your appendix had burst
• any surgical or anaesthetic complications

Most people recover without any complications. Sometimes, the wound may get infected. If this happens, you will need antibiotics and you should follow up with your doctor.

Sometimes, the appendix is removed and found to be normal (not inflamed). This usually means there is another reason for your symptoms. If you still have symptoms after surgery, your doctor may suggest other tests to find the cause of your symptoms.

After surgery, your doctor may suggest that you take it easy for a few weeks until your wound heals. You will also need a follow-up appointment with your surgeon for your pathology results. Your appendix is sent to a lab to make sure there are no dangerous growths or cancer in the appendix.

Complications of appendicitis are rare but can be life-threatening if left untreated.

A swollen and infected appendix can sometimes burst. If this happens, the infection may spread throughout your abdomen. This can lead to serious problems, such as:

• peritonitis (inflammation of the abdomen's lining)
• an abscess (a collection of pus) around your appendix
• a blockage of your bowel

There is no known way to prevent appendicitis.

For more information about the causes, symptoms, diagnosis, and treatment of appendicitis see the following websites:

• NSW Government offers a fact sheet about appendicitis for people who have presented to the emergency department.
• Sydney Children's Hospital Network fact sheet offers advice relating to children as well as what happens to your child before going into the operating theatre.
• The Royal Children's Hospital offers information on appendicitis as well as how to tell if your child is likely to have appendicitis or gastroenteritis.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.

Other languages

• NSW Government offers a fact sheet on appendicitis in Arabic, Chinese, Greek, Korean and Vietnamese.