What is appendicitis?
The appendix is a small tube attached to the first part of the large bowel. When it becomes blocked and inflamed, pain often starts near the navel and later moves to the lower right abdomen. Nausea, loss of appetite, vomiting, fever, diarrhoea or constipation may occur.
The pattern can differ in children, older adults and pregnancy. Without treatment, the appendix may burst and cause an abscess or widespread infection in the abdomen.
What are the symptoms of appendicitis?
Appendicitis usually starts suddenly and gets worse over hours. Common symptoms are:
- Pain that starts around the navel and moves to the lower right abdomen
- Pain that gets sharper on coughing, walking or moving
- Loss of appetite, nausea or vomiting
- A low-grade fever
- Diarrhoea or constipation
The pattern can differ in children, older adults and pregnancy, so abdominal pain that keeps getting worse needs prompt assessment.
How is appendicitis diagnosed?
The team combines your symptoms, abdominal examination, temperature, pulse, blood tests and urine test. Ultrasound is often used in children, younger adults and pregnancy. CT is usually more accurate in adults when the diagnosis remains uncertain. Other bowel, urinary and gynaecological conditions can cause similar pain.
When is an appendix operation needed?
Appendicectomy is the standard treatment for most patients who are fit for an operation. Surgery is more urgent when there is a suspected burst appendix, widespread infection or worsening illness.
A localised abscess sometimes requires antibiotics and image-guided drainage first. Once the infection settles, removing the appendix later is not always needed; it is advised if symptoms return and is discussed with you. Because an abscess or mass can occasionally hide another condition, a follow-up scan or colonoscopy is often advised for adults over 40.
How is the appendix removed, and what are the risks?
Most appendicectomies are performed laparoscopically through small incisions under general anaesthesia. The surgeon inspects the abdomen, seals the appendix at its base and removes it in a protective bag. Open surgery may be safer when infection is extensive, anatomy is difficult or another problem is found.
Risks include bleeding, wound infection, an abscess inside the abdomen, injury to bowel or urinary structures, blood clots and conversion to open surgery. Risk and hospital stay are usually greater after a burst appendix or delayed presentation.
Recovery after appendix surgery
Many patients with uncomplicated appendicitis go home within one or two days. Complicated infection may require a longer stay and further antibiotics. Walking, fluids and a gradual return to normal food begin early.
Follow advice about dressings, bathing, driving, lifting and work. Contact the team for increasing pain, persistent vomiting, fever, wound redness or pus, abdominal swelling, or inability to pass stool or gas. The laboratory report on the removed appendix should be reviewed.
When to seek urgent care
Seek emergency care for severe or steadily worsening abdominal pain, especially if it moves to the lower right side or occurs with fever, repeated vomiting, faintness or a swollen, rigid abdomen. Do not take laxatives or wait for the pain to settle.