What Is Appendicitis?

Appendicitis is the inflammation of the appendix, a small, finger-shaped pouch located at the beginning of the large intestine. This condition can occur when the inside of the appendix becomes blocked. Causes of blockage include hardened stool, foreign bodies, tumors, and lymphoid hyperplasia. Lymphoid hyperplasia is the enlargement of immune system tissue.

When the appendix becomes blocked, bacteria and mucus begin to accumulate inside. This leads to swelling, inflammation, and infection in the walls of the appendix. In advanced stages, the appendix may rupture, allowing infection to spread into the abdominal cavity (peritonitis). Peritonitis is a serious, life-threatening condition that requires immediate medical attention.

Appendicitis can occur at any age, but it is most common among children and young adults aged 10 to 30.

Symptoms usually begin suddenly and worsen over time. The most common symptom is severe abdominal pain that starts around the navel and moves to the lower right side of the abdomen. However, symptoms may vary from person to person.

What Causes Appendicitis?

The exact cause is not fully understood. However, the condition occurs when the appendix becomes blocked and infected. Various factors that can lead to this blockage include:

Stool: Blockage of the appendix lumen (inner cavity) by stool is one of the most common causes.
Enlarged lymph tissue: Swelling of lymph tissue in the appendix wall due to infection or other reasons can cause obstruction.
Foreign bodies: Rarely, ingested foreign objects can block the appendix.
Tumors: Rare tumors in the appendix may also cause obstruction.
Infections: Certain viral or bacterial infections can lead to inflammation in the appendix, causing blockage.

As a result of the blockage, bacteria and other microorganisms accumulate inside the appendix and lead to infection. As the infection progresses, the appendix swells, becomes inflamed, and may eventually rupture.

When it ruptures, abdominal pain occurs. This can lead to peritonitis, a serious infection in the abdominal cavity, which can be life-threatening.

What Are the Symptoms of Appendicitis?

Appendicitis symptoms can vary from person to person, but there are some common signs.

Appendicitis Pain Symptoms:
The most typical symptom is abdominal pain. This pain usually:

Begins around the belly button.
Gradually shifts to the lower right side of the abdomen. At this point, tenderness increases, and pressing on the area can cause intense pain.
Is constant and sharp. It may ease occasionally but generally intensifies.
Worsens with coughing, sneezing, or movement.

Acute Appendicitis Symptoms:
Sudden and rapidly progressing appendicitis (acute appendicitis) causes abdominal pain. Other symptoms may also be present:

Nausea and vomiting: May appear after the onset of pain.
Loss of appetite.
Mild fever: Usually around 38–39°C.
Constipation or diarrhea.
Abdominal bloating.

Symptoms of a Ruptured Appendix:
If the inflamed appendix bursts (ruptures), symptoms can change suddenly and become severe:

Sudden and severe spread of abdominal pain: Pain can radiate throughout the abdomen and intensify.
High fever and chills.
Abdominal hardening and extreme tenderness.
Increased heart rate.
Rapid deterioration of overall condition.

Appendicitis Symptoms in Women:
In women, appendicitis symptoms may follow the typical course. The location and perception of abdominal pain are important. It can be confused with other pelvic conditions such as ovarian cysts, pelvic inflammatory disease (PID), or ectopic pregnancy. Therefore, women with lower right abdominal pain should be evaluated carefully.

Appendicitis Symptoms in Men:
Symptoms in men are usually typical, with lower right abdominal pain being prominent. Occasionally, testicular pain may also occur.

Appendicitis Symptoms in Children:
Diagnosing appendicitis in children can be more challenging because symptoms may be atypical and vague. Abdominal pain is usually the first sign, but children may have difficulty describing the location. Other symptoms may include:

Vomiting (often one of the first signs).
Loss of appetite.
Restlessness and irritability.
Abdominal bloating.
High fever.

Symptoms of Appendix Inflammation:
The general signs of appendiceal inflammation are listed above. As inflammation progresses, the pain intensifies and other systemic symptoms (fever, nausea, vomiting) become more pronounced.

Important Note: If you're experiencing abdominal pain along with any of the above symptoms, you should see a doctor immediately. This is especially critical if the pain is in the lower right abdomen. Early diagnosis and treatment significantly reduce the risk of appendix rupture.

How Is Appendicitis Diagnosed?

It is usually diagnosed through a combination of physical examinations and tests. First, the doctor takes the patient’s medical history and evaluates their symptoms. During an abdominal exam, the doctor checks for tenderness or pain in the lower right part of the abdomen. A change or increase in the location of pain—especially if it poses a life-threatening risk—is crucial for diagnosis.

The following methods may be used as part of the diagnostic process:

Blood Tests: A white blood cell count is performed to detect markers indicating infection.
Urine Test: Urinalysis may be done to rule out other possibilities such as urinary tract infections or kidney stones.
Imaging Tests: An ultrasound or a computed tomography (CT) scan is typically performed to confirm the diagnosis.
MRI: Magnetic resonance imaging (MRI) may be preferred for pregnant women, as it does not involve radiation.

Based on these tests and examinations, the doctor can make a diagnosis. Treatment usually involves surgical removal of the appendix. Early diagnosis and intervention play a key role in reducing the risk of complications.