DIGESTIVE HEALTH MORE DIGESTIVE DISEASES
The Stages of Appendicitis
Natural Progression of an Inflamed Appendix
By Colleen Doherty, MD Published on February 14, 2023
Medically reviewed by Brian H. Wetchler, DO
Abdominal pain is the most common symptom of appendicitis. It's typically felt near the belly button before migrating (moving) to the lower right side of the abdomen.
Other possible symptoms follow the pain of appendicitis and include
Loss of appetite
Nausea/vomiting
Change in bowel habits
Malaise (feeling generally unwell)
Low-grade fever
Appendicitis signs include tenderness in the lower right side of the belly when pressed on by a healthcare provider. Guarding and stiffness (rigidity) of the stomach muscles may also be present.
An appendiceal phlegmon can be felt on physical examination as a bulging structure in the right lower side of the abdomen. It develops in up to 10% of appendicitis cases and is more common in young children than in others
Early appendicitis pain tends to be mild, vague, and achy. It's usually located near the belly button and may come and go.
As the inflamed appendix comes into contact with the tissue that lines the abdominal wall, the pain shifts to the lower right side of the belly, becoming sharp, continuous, and severe.
The timeline of pain migration and increase in intensity generally occurs over 12 to 24 hours, although this is not a hard-and-fast rule.
Antibiotics are an alternative treatment option if the appendix has not ruptured and there are no complications, like abscess formation or peritonitis
Appendicitis naturally progresses from uncomplicated to complicated appendicitis if not treated. Uncomplicated (also called early or simple) appendicitis is when the appendix is swollen and infected. Complicated appendicitis occurs when the appendix tissue dies and/or bursts open (ruptures).
Abdominal pain that moves from the navel (belly button) to the lower right side of the abdomen is a classic and nearly universal symptom of appendicitis. Pain generally becomes severe and continuous within 12 to 24 hours of starting. Rarely, as with chronic appendicitis, the pain remains mild, coming and going for days to weeks.