Recognize the Signs of Appendicitis – Pain in Lower Right Side

Recognize the Signs of Appendicitis – Pain in Lower Right Side

Recently, my 15-year-old daughter began complaining about having pain in her lower right side. After countless hours in the emergency room, trips to the doctor, CT scans and blood tests, the diagnosis is that they aren’t sure. Her white cell counthas dropped back to normal, so that is a good sign. However, it could easily have been appendicitis, and could still be and the infection just isn’t “to that point” yet. After this experience, I realized it’s a good idea to become familiar with the symptoms of an appendix attack, so you know when to go to the doctor, when to stay home, or when to head out to the emergency room.

Just What Is an Appendix?

The appendix is a small, tube that is hollow. It’s lies in the area where the small intestine and large intestine join forces. For some people, the appendix is short and for others a bit longer. The appendix also can vary as far as actual position in the abdominal cavity, but usually rests on the lower right side of the body for most individuals.

The appendix can be anywhere from 2 to 20 cm long, but averages about 11 cm. The appendix is not thought to have an actual use in modern day humans, so it can be removed without impacting quality of life.

Public Domain Image
Source: Gray’s Anatomy

Signs of Appendicitis

According to WebMD, a local ER doctor and my family doctor, the signs of appendicitis include:

  • Pain in the lower right quadrant of the belly.
  • Pain might start around belly button and radiate down.
  • Pain might stretch around to the back.
  • Loss of appetite
  • Fever
  • High white cell count
  • Nausea
  • Vomiting
  • Diarrhea or constipation
  • Inflamed appendix (usually shows up on CT scan)
  • Swollen abdomen
  • Pain when moving or coughing


When you first arrive at your doctor’s office, he will likely do an exam, pressing on your abdomen in the area where your appendix sits to determine how tender the area is. Questions the doctor might ask include:

  • When did the pain start?
  • What does the pain feel like?
  • On a scale of one to ten, how bad is the pain?
  • Are you nauseous?
  • Have you had diarrhea?
  • Does it hurt when you move?
  • Does it hurt when you cough?
  • Have you been ill recently? If so, what type of illness?

Staff will likely ask for a urine sample and draw blood to check your white cell count. If that is high, a CT scan will be ordered. Your doctor may choose to order this scan anyway to be on the safe side. In most cases, an infected appendix will show up as swollen on a CT scan, but not in all cases. Even if the hospital sends you home, follow-up with your family doctor and return promptly should your fever spike, symptoms worsen or you begin to throw up.

If the appendix is inflamed on the CT scan, the only solution is an appendectomy. The doctor will schedule surgery and remove the damaged appendix. The doctor will either make a 2-4 inch incision or use laparoscopic surgery to remove the appendix. Most people spend a day or two in the hospital. Expect around three to six weeks for full recovery after this surgery. No heavy lifting, sports or other strenuous activities during this time.

Could It Be Something Else?

There are other illnesses that might mimick the symptoms of appendicitis. Each person seems to experience pain differently, but a few illnesses that can mimic an appendicitis attack include:

  • Chlamydia
  • Urinary tract infection
  • Chron disease
  • Ovarian cyst
  • Digestive gas or constipation
  • Diverticulitis
  • Right kidney infection
  • Irritable bowel syndrome
  • Kidney stones

If the CT scan and subsequent tests fail to show an inflamed appendix, as in our case, wait to see if the symptoms subside on their own. If the pain worsens or you develop other symptoms, such as vomiting and fever. If symptoms worsen, return to the emergency room, as it may still be an appendicitis attack. However, it could be any number of other issues as well. The list above is a starting point. Let the doctors run the tests needed to properly diagnose you, ask questions when needed, point out other things you’ve read it might be (respectfully, of course) and hopefully you’ll feel better soon.

Ruptured Appendix

In most cases, the person will feel ill for 24 hours or more before an appendix ruptures. If you experience the symptoms listed above, get to the doctor or hospital for diagnosis to avoid this serious issue. Once the appendix has ruptured, the person is at risk of serious infection and a problem that might have been more easily treated suddenly becomes serious.


The cause of appendicitis is not always known. Doctors at the Mayo Clinic list two potential causes:

  1. Obstruction in the opening caused by food, feces or a fecal stone.
  2. Gastrointestinal infection that transfers to the appendix and is acerbated.

In each situation, the bacteria inside the appendix create the problem by multiplying too quickly and filling the appendix with infection and pus. If the appendix is not removed, it will eventually rupture. Left untreated, a ruptured appendix can result in death.


  • “Picture of the Appendix.” WebMD. January 6, 2012.
  • “Image of Appendix.” Gray’s Anatomy. 1918.
  • “Appendicitis.” Mayo Clinic. January 6, 2012.
  • “Appendicitis.” US National Library of Medicine. July 22, 2011.
  • “Emergency Appendix Surgery Can Wait.” CBC News. September 21, 2010.
Crabby Housewife

AuthorCrabby Housewife

Lori is a full-time housewife and writer, living in the Midwest with her husband of 27 years - they have two daughters. They have a house full of pets and her house is never quite perfect.