Appendicitis pain is usually felt on the right side of the abdomen and/or around the belly button. It starts very suddenly and within 24 hours of initial inflammation of the appendix. Appendicitis pain can be accompanied by other symptoms, like nausea, vomiting, loss of appetite or fever.
The appendix is a part of the large intestine and is located in the lower right abdomen. It is described to be shaped like a finger cut off of a glove. This organ can become obstructed for many reasons, like accumulation of stool, swollen lymph nodes or intestinal worms, which can all contribute to bacterial growth and inflammation of the appendix.
Symptoms of appendicitis should be urgently assessed to avoid further complications, like appendix rupture.
Appendicitis pain location
Appendicitis pain initially starts in the center of the abdomen, and can be described as diffuse and felt around the belly button. After a few hours, however, the pain can start to be felt in a more specific spot.
Appendicitis pain is classically reported to be felt in the right lower abdomen, however this type of pain can also be a sign of another condition, like Crohn’s disease, intestinal inflammation, a right ovarian cyst or an inguinal hernia. Learn more about what can cause right-side abdominal pain.
In most cases, the pain begins as a vague or cramping feeling around the belly button. Over time, the pain becomes sharper and more intense, and usually moves to the lower right side of the abdomen. This pattern of pain is one of the most typical signs of appendicitis and happens in about half of all cases
Lower left abdominal pain
Pain in the lower left abdomen is rarely associated with appendicitis, however it can be a sign of pancreatitis, intestinal inflammation, trapped gas, an inguinal hernia or a left ovarian cyst. Read more about what can cause left-sided abdominal pain and what to do.
What appendicitis pain feels like
Appendicitis pain starts suddenly and is sharp. Some people may experience a mild or weak pain at the start, but it comes more intense and constant over time. This pain often worsens with coughing, sneezing or walking.
Although appendicitis pain is normally felt in the lower right abdomen, appendicitis pain can also be felt around the belly button. It can also be felt in the entire abdomen, which is generally what happens when the appendix ruptures.
At the beginning, the pain is usually hard to pinpoint and may feel crampy or like a stomach ache. As the inflammation gets worse, the pain becomes more intense, steady and easier to locate in the lower right abdomen. This pain tends to get worse with movement and doesn’t go away on its own. In more advanced cases, other symptoms can also appear, such as:
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Loss of appetite (very common)
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Nausea and vomiting, usually after the pain begins
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Low-grade fever (between 99°F and 101°F)
Many patients also report bloating, constipation or trouble passing gas. Read more about appendicitis symptoms that can emerge.
How long does appendicitis pain last?
Appendicitis pain usually begins within the first 24 hours of appendix inflammation and tends to get worse as time passes. In most cases, the pain becomes more intense over 1 to 2 days, especially if the appendix is not treated.
On average, symptoms last between 15 to 29 hours before people seek medical help, but the pain can continue for several days. The risk of serious complications, like a ruptured appendix, increases after 48 hours and becomes much higher after 72 hours.
Appendicitis pain usually does not go away on its own. It continues until the appendix is surgically removed, which is why early medical care is important.
What to do
When pain in the lower right abdomen is constant and accompanied by other symptoms, live fever, loss of appetite, and nausea, you should seek medical attention for assessment and diagnosis.
Diagnosis of appendicitis is confirmed through a physical assessment, in which the doctor will palpate the abdomen, as well as lab tests and imaging tests. The doctor will likely order an abdominal ultrasound to visualize the appendix and look for signs of inflammation.
If appendicitis is confirmed, treatment involves surgical removal of the appendix, known as an appendectomy. It is preferably completed within 24 hours of the initial diagnosis.
Comparison with other causes of abdominal pain
Appendicitis pain can sometimes be confused with other conditions, like gastroenteritis or gas-related pain.
The table below outlines key differences between appendicitis, gastroenteritis, and gas pain, including onset, location, type of pain, and associated symptoms:
Any sudden, intense abdominal pain that presents with a fever, vomiting or blood in the stool should be urgently assessed.