Abdominal Pain: Is It Appendicitis or Something Else?

Appendicitis develops when your appendix — a small pouch attached to your large intestine — becomes inflamed.

The most obvious sign of appendicitis is a sharp pain in your abdomen, but the symptom can have many other causes.

Here’s everything you need to know about appendicitis belly pain, how it differs from other conditions that cause a similar type of pain, and what to do if you think you have appendicitis.

Most often, the pain you feel when you have appendicitis begins as a dull ache around your belly button that shifts to your lower right abdomen, where your appendix is located.

• Pain that comes on suddenly
• Pain that becomes significantly worse over a few hours
• Pain that starts before other co-occurring symptoms, such as fever, nausea, and vomiting
• Loss of appetite
• Pain that worsens when you move around, breathe deeply, cough, sneeze, or experience other jarring motions

• Pain at “McBurney’s Point” — the area where your appendix is, in the lower right abdomen between your belly button and your hip bone
• Pain when someone applies and then quickly releases pressure in your lower right abdomen, a symptom called “rebound tenderness”
• Unconsciously guarding your lower right abdomen when someone tries to touch it
• Pain when someone applies resistance to your right knee as you try to lift that leg up while lying on your back
• Aching in your abdomen when you move your bent right knee to the left and right while lying on your back.

“Classic appendicitis pain, which is the migration from the mid-stomach to the McBurney’s point, is a unique feature of appendicitis pain,” says Austin Shuxiao, MD, a board-certified internal medicine doctor and the founder of the mobile IV therapy provider Peach IV in New York City.

“The nature of the pain also shifts, which is unique to appendicitis,” Dr. Shuxiao explains. “Early on, when the pain is mid-abdomen, it is dull. As it migrates to the right lower quadrant, it will become sharper and more intense, because the inflammation is progressing, and irritating more local structures.”

Despite these classic signs, sometimes appendicitis pain can look like other conditions.

Ovulation Pain

Constipation

Kidney Infection

Kidney Stones

Ovarian Cysts

Ovarian cysts often come with no noticeable symptoms, but for some women, pain can develop. Pain caused by ovarian cysts can be either dull or sharp, intermittent or constant, mild or severe. Sometimes it can be so bad that it causes nausea and vomiting, which are symptoms similar to appendicitis.

Ectopic Pregnancy

Ectopic pregnancy, in which a fertilized egg gets implanted outside the uterus, can result in right-sided abdominal pain.

Unlike appendicitis, ectopic pregnancy is often marked by cramp-like pain, and sometimes even shoulder and neck pain.

Other Common Causes of Abdominal Pain

Aside from appendicitis, some of the most common causes of abdominal pain include:

• Gallstones
• Irritable bowel syndrome (IBS)
• Urinary tract infection (UTI)
• Crohn’s disease
• Indigestion
• Gas
• Gastroenteritis
• Peptic ulcers
• Lactose intolerance and food allergies
• Hernia

The first step in diagnosis is a physical exam. A doctor will look for those classic appendicitis signs and symptoms, such as migrating pain that settles over McBurney’s Point, rebound pain, and guarding.

If you show these telltale signs, you will likely get a prompt diagnosis of appendicitis.

Treatment for appendicitis usually includes pain medication and antibiotics to clear the infection.

“In the case of appendicitis, early diagnosis can prevent complications like rupture, which can lead to peritonitis — a life-threatening infection requiring emergency treatment,” says Shuxiao. “Prompt attention can make all the difference.”

• Appendicitis pain starts at the belly button and moves down to the lower right side of the abdomen, where it usually becomes severe and is accompanied by nausea, vomiting, and fever.
• Appendicitis pain can look like other conditions that also cause abdominal pain, such as ovarian cysts, ectopic pregnancy, and even constipation.
• If you think you are experiencing appendicitis pain, go to the emergency room.
• Treatment for appendicitis almost always involves surgery to remove the infected appendix.