Introduction
The symptoms of irritation of the appendix are the same as those of appendicitis. The main symptom is a stabbing pain in the right lower abdomen. Other symptoms such as nausea, vomiting or fever can also occur. The distinction between the two clinical pictures can only be made by observing the clinical course of the disease and by further diagnostics.
The typical symptoms of appendicitis
These are the typical symptoms of appendicitis: More information can be found here: Symptoms, causes and therapy of an appendicitis
- Pain in the right lower abdomen
- Loss of appetite
- Nausea and vomiting
- Fever
- Chills
- Increased pulse rate
Symptoms of appendicitis without evidence of infection are called appendicitis. This occurs most frequently in children between the ages of 9 and 14 years. Appendicitis itself is not dangerous, but since it occurs most frequently in children, who often have an atypical appendicitis, a medical examination should always be performed.
The symptoms of appendicitis can vary greatly in intensity and severity. The most common symptoms include abdominal pain and abdominal cramps, which can range from a slight feeling of pressure to severe pain. Nausea, vomiting and loss of appetite are also common symptoms of appendicitis. In rare cases there is even fever and chills, although in most cases there is already an inflammation of the appendix. An irritation of the appendix can be an early sign of an appendicitis and should therefore be taken seriously, because an irritation of the appendix can often be treated with medication, whereas an acute appendicitis always requires surgical intervention.
Pain with appendicitis
In the early stages of appendicitis, the pain is distributed around the upper abdomen and around the navel. Later, after about 4 to 24 hours, they migrate to the right lower abdomen. There they remain.
This migration of pain is typical for appendicitis. In some cases there are variations in the position of the appendix. Then the pain can also be felt in the flanks or in the lower abdomen, depending on where the appendix lies in the body.
In pregnant women the localization of the pain is higher than in non-pregnant women. Pain in the right lower abdomen is typical both for an irritation of the appendix and for an inflammation of the appendix. The pain is specifically localized in the right lower abdomen, since this is where the appendix is usually located.
In the initial phase of an irritation of the appendix, the pain can also be diffuse around the navel. Only after a few hours does the pain shift to the right lower abdomen. Here they are then perceived as stabbing or cramping.
Pain in the left lower abdomen is not necessarily typical of appendicitis, but it can also occur, for which there are various causes. Classically, in the case of appendicitis, the pain begins in the middle of the upper abdomen and then moves to the right lower abdomen. However, the spread of the pain depends on the position of the appendix, normally the appendix is located in the right lower abdomen and therefore causes pain here.
In rare cases, however, the appendix may be located further to the middle or left in the lower abdomen, causing pain in the left lower abdomen. Another very typical feature of appendicitis is the so-called “pain of release”, in which the patient presses deep into the left lower abdomen and holds it for a few seconds, which also causes pain in classic appendicitis, and then suddenly releases. In the case of appendicitis, this causes even more pain in the right lower abdomen, the pain of letting go.
However, pain in the left lower abdomen is far more often the cause of other diseases than appendicitis. Among the most common are diseases of the large intestine, in the form of protrusions that can become inflamed, the so-called diverticulitis, diseases of the urinary tract – ascending urinary tract infections or ureteral stones – and in women also diseases of the ovaries and fallopian tubes. For an exact differentiation and diagnosis of the pain, a doctor should always be consulted as soon as possible, since many of the above-mentioned clinical pictures can have an acute course.
At first, the pain is perceived as dull and diffuse. In this phase, it is not possible to assign an exact localization to the pain.As soon as the pain has migrated to the right lower abdomen, it is described as sharp and bright by the patient. If complications such as a perforation, i.e. a rupture of the appendix, occur, the pain is temporarily reduced.
Then strong pain appears over the entire abdomen. This condition is described in medical terminology as peritonitis. Do you have further questions about the pain of an appendicitis?
colicky abdominal pain is the strongest pain, with cramping and painful pain character. For an appendicitis these pains are rather untypical, but also cannot be excluded. More often, colicky abdominal pain is the cause of a disease of the pancreas, accompanied by belt-like pain in the upper abdomen, kidney or gallstones, whereby gallstones are usually the cause of complaints after high-fat meals.
The provocation of pain is part of the diagnostic work-up of appendicitis. Initially, pain can be provoked by pressure on the right lower abdomen alone. The pain often lies on the connecting line between the navel and the upper front edge of the pelvic bone or on the line between the two pelvic bones.
Another possibility is to exert pressure on the left lower abdomen and then release it quickly. The pain is then typically felt in the right lower abdomen. A vibration can also provoke the pain well.
For example, a vibration can be triggered by jumping on one leg. Finally, lifting the right leg against resistance can also provoke the pain. Especially in children and adolescents, the typical symptoms of appendicitis can also be absent.
One speaks then of an atypical symptomatology. The children do not perceive any pain, which can then lead to a delayed diagnosis. This is especially the case with small children.
In this case, attention should be paid to conspicuous behavior of the children, such as a stooped position or sparse movements on the examination couch. Even in older patients, pain is not necessarily a symptom of appendicitis. The patients report a feeling of pressure rather than a stabbing pain. The course of the pain is also different. Instead of the acute course, which can worsen within hours, older patients typically show a creeping course of pain.
