Appendicitis signs: is it my appendix, and what should I do tonight?

The typical pattern

• Pain that starts as a dull ache around the belly button
• Over a few hours, the pain moves to the lower right side and becomes sharp and constant
• Pain worse with walking, coughing, or going over bumps in a car
• Loss of appetite, nausea or vomiting
• A mild fever, and sometimes constipation or loose stool

It does not always look typical

Children, pregnant women and older people often have unusual symptoms. In pregnancy the pain can be higher up. Older people may have less pain and little fever. Children may just be unusually quiet, off their food and not want to jump or walk. When in doubt, get examined.

In Nigeria tummy pain and fever are often put down to malaria, typhoid or 'ulcer' and treated at home or at a chemist. Appendicitis is easily missed this way. Antibiotics from a chemist can hide the signs for a while without curing the problem.

What to do tonight

• Go to the nearest hospital with an emergency department and a surgeon on call. Do not wait for morning if the pain is severe or getting worse
• Have someone take you. Do not drive yourself
• Do not eat or drink much in case you need an operation; small sips of water are usually fine
• Do not take laxatives, enemas or herbal purgatives
• Do not put a hot water bottle on your tummy
• Take any medicines you use, and a list of what you have already taken

Signs it may have burst

Pain that suddenly spreads across the whole tummy, a hard, rigid tummy, high fever, fast heartbeat or feeling faint can mean the appendix has burst. This is a serious emergency. Go straight to hospital.

What happens at the hospital

A doctor examines you and usually orders blood tests, a urine test, a pregnancy test for women, and often an ultrasound or CT scan. If it is appendicitis, the usual treatment is an operation to remove the appendix (appendicectomy), most often by keyhole surgery. In some uncomplicated cases antibiotics alone are an option, though the appendicitis can come back; your surgeon will explain.

Appendicitis is an emergency, so the first operation is usually done wherever you are seen. Mezo's appendicectomy booking is for planned surgery, for example when a surgeon has advised removing the appendix after an earlier attack treated with antibiotics.

Common questions