Direct answer: Appendicitis can cause abdominal pain that starts near the middle of the abdomen and moves towards the lower right side, often becoming worse over hours. Loss of appetite, nausea, vomiting, fever, abdominal swelling, constipation or diarrhoea may occur, but not everyone has the typical pattern. Suspected appendicitis needs urgent in-person medical assessment because symptoms can worsen and a perforated appendix can cause serious infection.
What is appendicitis?
Appendicitis is inflammation of the appendix, a small pouch attached to the beginning of the large bowel. The condition can progress from inflammation to perforation, abscess or infection within the abdomen. Early assessment matters because symptoms overlap with many other abdominal, urinary and gynaecological conditions.
A symptom list cannot confirm appendicitis. Diagnosis depends on the history, examination and, when appropriate, laboratory or imaging tests.
Common appendicitis symptoms in adults
Possible features include:
- pain that begins around the navel or middle of the abdomen and later settles towards the lower right side;
- pain that becomes worse when walking, coughing, moving, taking a deep breath or travelling over a rough road;
- loss of appetite;
- nausea or vomiting, often after the pain begins;
- fever or feeling generally unwell;
- abdominal swelling or tenderness;
- constipation, diarrhoea or difficulty passing gas; and
- pain that steadily worsens over several hours.
Not every patient develops every symptom. Older adults, pregnant patients and people with altered immunity may have less typical symptoms. The location of pain can also vary with the position of the appendix.
When abdominal pain needs urgent assessment
Seek urgent in-person care when abdominal pain is persistent or worsening, especially if it moves to the lower right abdomen or occurs with fever, vomiting or loss of appetite. Emergency assessment is particularly important for:
- sudden severe pain or pain spreading across the abdomen;
- a rigid, very tender or increasingly swollen abdomen;
- fainting, confusion, severe weakness or difficulty breathing;
- repeated vomiting or inability to keep fluids down;
- pain with pregnancy or possible pregnancy;
- blood in vomit or stool; or
- pain that briefly improves and then returns more severely.
These findings do not prove that the appendix has perforated, but they require urgent evaluation for appendicitis and other serious conditions.
What else can cause similar pain?
Right-sided or lower abdominal pain can have many causes. Possibilities include gastroenteritis, urinary infection, kidney stones, bowel obstruction, inflammatory bowel disease, an abdominal hernia, pelvic inflammatory disease, an ovarian cyst complication, ovarian torsion, miscarriage or ectopic pregnancy. In women and girls who could be pregnant, pregnancy testing and gynaecological causes may need particular attention.
Do not assume that pain is appendicitis because it is on the right side, and do not dismiss severe pain because it is not in the textbook location.
How clinicians assess possible appendicitis
The clinician will ask when the pain began, where it started, how it has changed, and whether there is vomiting, fever, appetite loss, bowel or urinary change, previous surgery, medication use or pregnancy possibility. Examination may include checking different parts of the abdomen for tenderness, guarding or pain with movement.
Tests may include:
- blood tests for inflammation, infection, anaemia, dehydration or electrolyte disturbance;
- a urine test to look for urinary infection or kidney-stone clues;
- a pregnancy test when relevant; and
- ultrasound, CT or another imaging test selected for the individual patient.
No single symptom or test is perfect in every patient. Sometimes observation and repeat examination are necessary, while a very concerning clinical picture may require prompt surgical review.
What not to do while seeking care
- Do not delay assessment in order to search for a cheaper package or wait for symptoms to become “typical.”
- Do not repeatedly press a painful abdomen to test it yourself.
- Do not take leftover antibiotics as a substitute for examination.
- Do not use herbal mixtures or strong laxatives to force a bowel movement.
- Do not eat or drink heavily when urgent surgery may be possible; follow instructions from the receiving clinical team.
If you have already taken pain medicine, tell the clinician what you took, the dose and the time. Appropriate pain relief does not remove the need for diagnosis.
How appendicitis may be treated
Treatment is individualised. Appendectomy—surgery to remove the appendix—remains a common treatment. It may be performed through small incisions with a camera or through an open incision, depending on the patient, available expertise, findings and complications. Antibiotics are also used, and selected uncomplicated cases may sometimes be managed without immediate surgery under an appropriate clinical protocol. Antibiotics are not a do-it-yourself alternative, and recurrence or treatment failure may occur.
A perforation, abscess or widespread infection may require additional drainage, abdominal cleaning, longer antibiotic treatment, closer monitoring or a different operative plan.
Questions to ask at the hospital
- What diagnoses are being considered besides appendicitis?
- Which examination or test findings support the diagnosis?
- Is urgent surgical review needed?
- Is the appendix uncomplicated, perforated or associated with an abscess?
- What treatment options are suitable in this case, and why?
- If surgery is recommended, will an open or laparoscopic approach be considered?
- Who will provide surgery and anaesthesia, and what emergency support is available?
- What costs may arise from consultation, tests, imaging, medicines, theatre, admission and follow-up?
- What warning signs should trigger immediate return after discharge?
Seeking appendicitis care in Enugu
When choosing where to seek care, prioritise timely examination, access to laboratory and imaging support when needed, qualified surgical and anaesthesia assessment, theatre capability, infection control, admission monitoring and a clear referral pathway. Emergency abdominal pain should not be handled as a routine online booking enquiry.
Christian Miracle Hospital in Enugu provides hospital-based assessment for abdominal pain and appendix-related surgical care. The appropriate plan depends on examination, investigations and the responsible clinical team. Confirm current clinician availability and facility arrangements through the official hospital contact page.
Medical review and appointment information
Medical review: This guide was reviewed for general medical accuracy and women’s-health differential considerations by Prof. Obioma Okezie, Professor of Obstetrics & Gynaecology; Fellow, West African College of Surgeons (FWACS); Fellow, International College of Surgeons (FICS); and Fellow of the National Postgraduate Medical College of Nigeria. This wording does not identify him as an appendix-surgery subspecialist. The surgeon responsible for an individual case should explain the diagnosis, operative plan and alternatives. Last medical review: 28 August 2026.
Appointments and enquiries: Contact Christian Miracle Hospital on WhatsApp: 0806 811 7438. WhatsApp is not an emergency service and should never delay urgent in-person assessment.
Frequently asked questions
Does appendicitis always start on the right side?
No. Pain commonly starts near the navel and later moves to the lower right abdomen, but the pattern can vary. Persistent or worsening abdominal pain requires assessment even when the location is unusual.
Can appendicitis occur without fever or vomiting?
Yes. Some patients do not have all the typical symptoms. Diagnosis should not be based on fever or vomiting alone.
Can an ultrasound always diagnose appendicitis?
No. Ultrasound can be useful, particularly in children, younger adults and pregnancy, but the appendix may not always be clearly seen. The clinical team may use repeat examination or another imaging method when appropriate.
Can antibiotics cure appendicitis?
Selected patients with uncomplicated appendicitis may be considered for antibiotic treatment under medical supervision. Surgery remains common, and antibiotic-only care can fail or be followed by recurrence. The decision requires proper assessment.
How quickly should I seek care?
Promptly. Appendicitis can worsen over hours, and untreated disease can perforate. Do not wait for every textbook symptom to appear.
Medical disclaimer
This article provides general education and cannot diagnose abdominal pain, replace examination or select treatment for an individual patient.