Abdominal pain is a common complaint, and in many cases, it is caused by something minor such as indigestion or a stomach upset. However, when abdominal pain becomes persistent, worsens over time, or follows a specific pattern, it may indicate a more serious condition such as appendicitis.
Appendicitis is one of the most common causes of sudden abdominal pain requiring emergency medical treatment. Recognising its key features can help you understand when it is important to seek urgent medical attention.
What Is Appendicitis?
Appendicitis refers to inflammation of the appendix — a small, finger-shaped pouch attached to the large intestine, located in the lower right side of the abdomen.
When the appendix becomes inflamed, pressure builds up within it. If left untreated, the appendix may rupture, releasing bacteria into the abdominal cavity and leading to serious infection. For this reason, acute appendicitis is considered a medical emergency that usually requires prompt surgical treatment.
What Causes Appendicitis?
Appendicitis most commonly develops when the opening of the appendix becomes blocked. This blockage may be caused by:
- Hardened stool
- Swollen lymph tissue following an infection
- Inflammation or narrowing of the appendix
Once blocked, bacteria can multiply rapidly inside the appendix, causing swelling, reduced blood flow, and inflammation. Appendicitis can affect people of all ages, but it is most commonly seen in adolescents and young adults between the ages of 10 and 30.
How Can I Tell If My Abdominal Pain Is Appendicitis?
Appendicitis pain often follows a characteristic progression. Understanding this pattern helps distinguish it from other causes of stomach pain.
The Starting Point: Pain Around the Belly Button
Early appendicitis pain often begins as a dull, poorly localised ache around the centre of the abdomen or near the belly button. At this stage, it may feel similar to gas pain or indigestion and can be easy to dismiss.
The Key Sign: Pain That Moves to the Lower Right
Over the next 12 to 24 hours, the pain typically shifts to the lower right side of the abdomen. This is a key feature of appendicitis.
As inflammation worsens, the pain becomes:
- More localised
- Constant rather than intermittent
- Sharper and more intense
- Movement, coughing, or pressing on the area often makes the pain worse.
In addition to abdominal pain, appendicitis symptoms may include:
- Nausea or vomiting shortly after pain begins
- Loss of appetite
- Fever or chills
- Abdominal tenderness or bloating
Not everyone experiences all symptoms, which is why medical evaluation is essential.
Acute vs Chronic Appendicitis: What’s the Difference?
Appendicitis is most commonly acute, but in rare cases, symptoms may present in a more prolonged or intermittent form.
Acute Appendicitis
Acute appendicitis is the most well-recognised and common form. Symptoms usually develop suddenly and worsen over a short period, often within 24 to 48 hours.
Key features of acute appendicitis include:
- Rapid onset of abdominal pain
- Pain that typically shifts to the lower right abdomen
- Increasing severity over time
- Associated symptoms such as fever, nausea, or vomiting
Because acute appendicitis can progress quickly and may lead to rupture if untreated, it is considered a medical emergency and usually requires prompt surgical treatment.
Chronic Appendicitis (Less Common)
Chronic appendicitis is far less common and may present differently. Symptoms tend to be milder, intermittent, or longer-lasting, sometimes occurring over weeks or months.
- Recurrent or persistent lower right abdominal pain
- Discomfort that comes and goes rather than worsening rapidly
- Fewer systemic symptoms, such as fever
Due to its subtle presentation, chronic appendicitis can be more difficult to diagnose and may be mistaken for other gastrointestinal conditions. Medical evaluation and imaging are important to rule out other causes of abdominal pain.
Can I Rule Out Appendicitis at Home?
The short and most important answer is no.
Many conditions such as gastroenteritis, kidney stones, gallstones, or intestinal infections, can cause abdominal pain that resembles appendicitis. A doctor must perform a proper examination to assess specific clinical signs, such as rebound tenderness, and determine the underlying cause.
Delaying medical assessment can increase the risk of complications, including a ruptured appendix and widespread infection within the abdomen.
When Should You See a Doctor?
You should seek medical attention promptly if you experience:
- Persistent or worsening abdominal pain, especially on the lower right side
- Fever, vomiting, or sudden loss of appetite
- Pain severe enough to limit walking, standing upright, or daily activities
What to Expect: Diagnosis and Treatment
Understanding what happens in the emergency setting can help reduce anxiety and uncertainty.
Diagnosis: How Doctors Confirm Appendicitis
Doctors diagnose appendicitis using a combination of:
- A physical examination
- Blood tests to check for signs of infection
- Imaging studies such as ultrasound or CT scan to confirm inflammation of the appendix
These steps help ensure an accurate diagnosis before treatment begins.
Treatment: The Role of Appendicitis Surgery
Once acute appendicitis is diagnosed, the standard treatment is an appendectomy — surgical removal of the appendix.
In Singapore, appendicitis surgery is commonly performed using minimally invasive laparoscopic techniques. This approach typically involves smaller incisions and supports a smoother postoperative recovery, depending on the individual case.
Consult a Specialist in Appendicitis Surgery in Singapore
Not all abdominal pain is appendicitis, but only a trained specialist can determine this safely through proper assessment.
If you are experiencing symptoms suggestive of appendicitis or ongoing stomach pains that do not improve, a timely consultation is important. Dr Thng YongXian, a hepatopancreatobiliary and general surgeon, provides surgical consultation and care for appendicitis, including minimally invasive appendectomy where appropriate.
Early evaluation allows for accurate diagnosis, appropriate treatment planning, and safer outcomes.