Appendicitis or gas: Differences and when to see a doctor (2023)

Appendicitis occurs when the appendix becomes inflamed. It can feel very similar to gas. However, unlike gas, appendicitis pain occurs specifically to the lower right of the belly button, is severe, and worsens over the next few hours.

Most people with appendicitis feel varying levels of sharp cramping or pain in the lower right abdomen, depending on how serious the inflammation is.

Excess gas, or flatulence, can build up in the digestive tract and cause discomfort, excessive gas, and pain anywhere in the abdomen.

This article will explore the symptoms of both appendicitis and gas and explore how to tell the difference between them.

The most common symptom of appendicitis is abdominal pain that tends to:

  • begin near the belly button before moving lower and to the right
  • worsen when moving, inhaling deeply, sneezing, or coughing
  • develop very suddenly
  • worsen in a matter of hours
  • be severe and feel unlike other pain the person has felt before
  • occur before additional symptoms

Aside from abdominal pain, appendicitis symptoms also include:

The early symptoms of appendicitis can be subtle, and they typically appear in the first 12–24 hours.

Around 75% of people with appendicitis develop symptoms that require medical attention within 24 hours of the start of inflammation.

In pregnant people

Pregnant people may experience pain in a different part of the abdomen, as their body will reposition itself to accommodate the growing fetus.

Pregnant people may also experience nausea or vomiting, and they may develop tenderness anywhere on the right side of the abdomen.

In children

Most cases of appendicitis occur in people aged 10–20 years old, so it is important to be aware of the different signs and symptoms that it can cause in children.

Some children, especially young children or infants, may not be able to fully describe or express their symptoms. This can make appendicitis harder to detect.

(Video) Stomach ache or appendicitis?

Children may also exhibit nonverbal signs of pain, such as:

  • walking bent over
  • lying on their side
  • acting withdrawn
  • being excessively fussy
  • being difficult to wake or keep awake

In older adults

Older adults with appendicitis may also become confused.

Appendicitis, especially when undiagnosed and untreated, can lead to serious complications.

The following sections will look at these potential complications in more detail.

Perforation and rupture

If the opening to the appendix becomes blocked, the surrounding tissues may die from a lack of oxygen and nutrient exchange.

The dead tissue can easily tear or develop a small opening (perforation), through which bacteria and other microbes can enter the organ.

If enough bacteria enter the organ, they can form an infected abscess. As it grows, the abscess may put pressure on the appendix, causing it to burst (rupture).

If this occurs, the appendix will spill and leak stool, pus, and other contents into the bloodstream.

Symptoms associated with appendix perforation and rupture include:

  • severe pain, which may make it difficult to stand upright or walk
  • extreme abdominal tenderness
  • high fever
  • facial flushing
  • sweats or chills
  • loss of consciousness
  • vomiting
  • lack of appetite

When a rupture does occur, it is at least 48 hours from the onset of appendicitis. After 36 hours, the risk of rupture is around 2%. The risk then increases by around 5% every 12 hours after that.


Sometimes, a bacterial infection can cause an abscess to form around the appendix when it bursts. Complications from surgery can also cause this.


Once the appendix ruptures or leaks into the abdominal cavity, the lining of the abdomen will become inflamed. This inflammation is known as peritonitis.

Peritonitis can also affect the organs that the abdominal lining covers, which lead to symptoms such as:

(Video) Appendicitis Signs & Symptoms | & Why They Occur

  • severe, continual abdominal pain
  • a high fever
  • nausea or vomiting
  • a rapid heartbeat
  • abdominal swelling
  • shortness of breath and rapid breathing

Learn more about peritonitis here.


Severe, widespread, or untreated bacterial infections can enter the blood and spread through the body. This can cause fatal complications.

One potentially fatal complication is sepsis, which is when the body has an extreme immune response to the infection.

Symptoms of sepsis include:

  • blue, blotchy, or pale skin, lips, or tongue
  • the stomach sucking up under the rib cage
  • a rash that does not fade when a person applies pressure to it
  • confusion
  • slurred speech or not making sense
  • a weak, high pitched cry that is not normal (in young children or infants)
  • being sleepier than usual or harder to wake
  • not responding normally to regular activities, such as feeding (in young children or infants)
  • difficulty breathing

The most common symptoms of excessive abdominal gas include:

  • passing a lot of gas (more than 13–21 times per day) and burping a lot
  • abdominal bloating
  • abdominal pain

A person should speak to a doctor about unexplained abdominal pain, digestive symptoms, or excessive or chronic gas.

Anyone who thinks that they or someone else may have appendicitis or associated complications should seek emergency medical care immediately.


(Video) Appendicitis - How Do I Know If I Have Appendicitis?

To diagnose appendicitis, a doctor will perform a physical exam. They may also ask questions about the person’s symptoms and medical history.

They may also use various diagnostic tools, including:

  • Blood tests: These tests can check for dehydration, fluid or electrolyte imbalances, or signs of infection, such as high white blood cell counts.
  • Ultrasounds, X-rays, or MRI scans: These tests allow the doctor to see the person’s abdominal organs and structures.
  • Urinalysis: This test can help rule out kidney stones and urinary tract infections.
  • Pregnancy tests: This test can rule out pregnancy as a cause of a person’s symptoms.

Most people with appendicitis require surgery, or appendectomy, to remove the appendix and repair any surrounding tissue or organ damage.

Prompt surgery reduces the risk of appendix rupture and other complications.

A surgeon will usually perform appendectomy using one of two procedures: open surgery or laparoscopic surgery. The sections below will discuss these, plus some other options, in more detail.

Open surgery

In open surgery, the surgeon will remove the appendix through an incision in the abdomen, either above or beside the appendix.

Laparoscopic surgery

In laparoscopic surgery, the surgeon will create several smaller incisions and insert specialized surgical tools and a tiny tube with a camera and light.

Laparoscopic surgery typically has a quicker recovery time, less pain, and less scarring than traditional open surgery.

Other treatments

To address complications, healthcare professionals may also use other treatments, such as:

  • antibiotics
  • removing infected abdominal tissue
  • draining pus from the abscess or infection site
  • blood transfusions
  • intravenous electrolyte or fluid therapy

There is usually no way to prevent appendicitis. Some people even have a higher risk of developing it.

(Video) Early Signs & Causes of Appendicitis Explained by Dr.Berg

Risk factors for appendicitis include:

  • Age: Most people get appendicitis at 10–20 years of age.
  • Sex: Males are more likely to develop acute appendicitis generally, but females are more likely to develop it at 14–25 years of age.
  • Low fiber diet: A low fiber diet can potentially cause fats, undigested fiber, and inorganic salts to build up in the appendix and cause inflammation or obstruction.
  • Genes: Studies suggest that genetics can play a role in appendicitis.

Several home remedies can help relieve excessive gas, including:

  • swallowing less air, such as by eating slowly or using a straw when drinking
  • quitting smoking
  • eating smaller, more frequent meals
  • consuming fewer foods and drinks that cause gas
  • avoiding carbonated drinks
  • making sure that dentures and other dental devices fit properly
  • taking over-the-counter anti-gas medications, such as simethicone
  • massaging the abdomen
  • taking lactose tablets before consuming dairy, if lactose intolerant
  • practicing stretches and yoga poses that encourage gas passing, if possible
  • consuming easily digestible foods, such as those heavily cooked or stewed
  • drinking herbal teas, such as peppermint, fennel, or ginger

Many conditions can cause stomach pain, especially if they affect the digestive tract or abdominal organs.

These include:

Most people with temporary mild-to-moderate abdominal pain have gas or symptoms of indigestion.

However, appendicitis is the most common cause of severe abdominal pain requiring surgery, and at least 5% of people in the United States develop it at some point in their lives.

A person should talk to a doctor about any minor symptoms they have. If any moderate-to-severe symptoms of appendicitis occur, a person should seek emergency medical care to prevent the risk of serious complications.

(Video) Is this a stomach ache or appendicitis

Most people recover well if they receive a diagnosis and treatment early enough.


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