Appendicitis: the pain that moves to the right
Hours matter more than tests
Dr. Marc Delaunay
Gastroenterologist
In simple terms
How the pain typically migrates, why children and older adults are harder to diagnose, and what surgery involves.
What it is, in plain words
The appendix is a small blind-ended tube attached to the start of the large bowel. When its opening becomes blocked, pressure and bacteria build up inside, the wall becomes inflamed and, untreated, can burst and spill infection into the abdomen. That progression usually takes 24 to 72 hours.
Signs to look out for
- Pain that starts vaguely around the navel and settles in the lower right abdomen over several hours
- Pain worse on movement, coughing or going over a speed bump
- Loss of appetite, which is almost always present
- Nausea, one or two vomits, low-grade fever
- Sudden relief followed by worsening generalised pain, suggesting perforation
Why it happens
It can happen at any age but peaks between 10 and 30. Blockage may come from a hardened lump of stool, lymphoid swelling after an infection, or rarely a tumour in older adults.
How doctors confirm it
Diagnosis is mainly clinical, supported by blood tests showing raised white cells and inflammatory markers. Ultrasound is used first in children and pregnant women; CT is more accurate in adults. A pregnancy test and urine test exclude common mimics.
Treatments and solutions
- Surgical removal, usually laparoscopically through three small incisions, with discharge often within 24 to 48 hours
- Antibiotics before surgery, and for several days after if the appendix had perforated
- Antibiotic-only treatment as an option in selected uncomplicated cases, accepting a recurrence risk of roughly one in three within five years
- Drainage first, then delayed surgery, when an abscess or inflammatory mass has formed
- Prompt fluid resuscitation and pain relief while awaiting theatre
Living with it day to day
Do not take strong painkillers and wait at home hoping it passes, and do not use a hot water bottle on the abdomen. Eating and drinking should stop once surgery is suspected.
When to seek medical help
Go to hospital the same day for abdominal pain that localises to the lower right side, especially with fever, vomiting or loss of appetite.
This article explains general health information in simple language. It does not replace advice from your own doctor.
The words explained
Medical terms used above, in everyday language.
- Inflammation
- The body's reaction to injury or irritation: redness, swelling, heat or pain.
- Diagnosis
- The moment a doctor identifies which illness is causing your symptoms.
- Antibiotic
- A medicine that kills bacteria. It does not work against viruses like colds or flu.
When should you see a doctor?
- Your symptoms last more than a few weeks or keep coming back.
- They get worse quickly, or stop you doing everyday things.
- You notice sudden pain, breathing trouble, fainting or bleeding — seek urgent care.
- You already take medication and want to change anything about it.
This article explains general health information. It does not replace advice from your own doctor.
Frequently asked questions
- What is Appendicitis: the pain that moves to the right?
- How the pain typically migrates, why children and older adults are harder to diagnose, and what surgery involves.
- What are the main symptoms or signs of Appendicitis: the pain that moves to the right?
- Common signs vary from person to person. The article above lists the symptoms to watch for, how they progress, and when they need medical attention.
- When should you see a doctor for Appendicitis: the pain that moves to the right?
- See a doctor if symptoms last more than a few weeks, get worse quickly, stop you doing everyday things, or if you notice sudden pain, breathing trouble, fainting or bleeding.
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