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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Assessment online. A doctor can judge whether your pain could be appendicitis and how urgently you need a hospital; diagnosis and treatment are in hospital.
- What it is: swelling and infection of the appendix, a finger-sized pouch joined to the large bowel in the lower right of the tummy.
- Typical pain: starts around the belly button, then moves to the lower right side over a few hours and gets worse, especially when you move or cough.
- How common: about 8% of people in Europe have appendicitis during their lifetime, most often between the ages of 10 and 30.
- Emergency: call 112 or go to an emergency department for severe tummy pain, pain that has moved low on the right, or confusion, pale or blotchy skin or difficulty breathing.
Do not book a video appointment if you think you have appendicitis: pain that started around the belly button and has moved low on the right, severe tummy pain, or pain that has spread across your whole tummy. Go to an emergency department or call 112, and do not drive yourself. Call 112 for confusion, pale or blotchy skin, or difficulty breathing.
Can an online doctor help with appendicitis?
No, appendicitis cannot be treated online: it is diagnosed with an examination, blood and urine tests and often a scan, and treated in hospital, usually with an operation. What a doctor by video can do is go through tummy pain that might be appendicitis and tell you plainly whether you need a hospital now, consider the other causes, and help with recovery afterwards. If you already think you have appendicitis, go to an emergency department rather than waiting for a video call.
How an online consultation helps with possible appendicitis
- Urgency made clear: Whether your pain needs an emergency department now, and what to tell the staff when you get there.
- Other causes considered: Pain low on the right can also come from the bowel, the kidneys, the bladder, the gallbladder or, in women, the ovaries or a pregnancy.
- Help after an operation: Wound care, pain, constipation, and getting back to work, driving and sport.
- Antibiotic-only treatment followed up: What to watch for if your appendicitis was treated with antibiotics alone, and when to go back.
What the doctor checks in an online assessment of possible appendicitis
The doctor asks first about the signs that mean a hospital now. The doctor asks about:
- Warning signs: severe pain, pain spreading across the tummy, confusion, pale or blotchy skin, or difficulty breathing.
- How the pain started: around the belly button or elsewhere, and whether it has moved low on the right.
- What makes it worse: moving, walking, coughing, or pressure on the tummy.
- Other symptoms: feeling or being sick, loss of appetite, a high temperature, constipation or diarrhoea, or peeing more than usual.
- Pregnancy: whether you could be pregnant, and the date of your last period.
- Your health: earlier operations, long-term conditions and the medicines you take.
If the doctor thinks you could have appendicitis, you will be told to go to an emergency department straight away. Do not drive yourself, and take a list of your medicines with you.
What are the symptoms of appendicitis?
The main symptom is tummy pain that starts around the belly button and, after a few hours, moves to the lower right side, where it becomes constant and gets worse. The symptoms usually develop in this order:
Swipe sideways to compare →
| When | What happens | What you notice |
|---|---|---|
| First hours | The appendix is blocked and starts to swell | Pain around the belly button or the middle of the upper tummy, often mild at first; loss of appetite, feeling sick |
| Usually 12 to 24 hours after it starts | The inflamed appendix irritates the tummy lining nearby | Pain moves to the lower right, becomes sharp and constant, and is worse when you walk, cough or press on it |
| As it goes on | The infection builds | A high temperature, being sick, constipation or diarrhoea, not being able to pass wind |
| If the appendix bursts | Infection spreads into the tummy | The pain may ease briefly, then becomes severe and spreads across the whole tummy |
What does appendicitis pain feel like?
Often mild and vague at first, then sharp, constant and more severe than any pain you have had before. It is worse when you move, cough or sneeze, and may ease slightly if you pull your knees up to your chest. Pain that feels worse when pressure on the sore area is released, called rebound tenderness, is one of the signs a doctor checks for.
Can appendicitis pain come and go?
Usually not: the pain of appendicitis gets steadily worse over hours. A rare, grumbling form, called chronic appendicitis, irritates the appendix on and off over a long time and affects about 1% of people. New pain that comes and goes still needs a doctor, and pain that is getting worse needs urgent assessment.
When the symptoms do not fit the pattern
Appendicitis can be less painful, start more slowly or hurt somewhere else in pregnancy, in young children and in older people. Older people may have sudden confusion, and some people need to pee more than usual. Some people with appendicitis have none of the typical symptoms.
Where is your appendix, and what does it do?
Your appendix is on the right side, in the lower right part of your tummy. It is a small pouch, about the size of a finger, joined to the start of the large bowel. Its usual position is about a third of the way along a line from the bony point at the front of your right hip to your belly button, a spot doctors call McBurney’s point, where the pain of appendicitis often settles.
Nobody knows for certain what the appendix does. If it has a function, it is a small one, possibly helping to make antibodies in childhood. You do not need your appendix, so removing it is not harmful.
What causes appendicitis, and who gets it?
Appendicitis usually starts when something blocks the appendix, and it then swells and becomes infected. The blockage can be:
- hard poo, sometimes a hardened stone called an appendicolith
- swollen lymph tissue in the wall of the appendix, after an infection
- rarely, a growth or a parasite
In many cases the cause is not clear. Appendicitis can happen at any age, but it is most common between 10 and 30, and rare in babies under 12 months. The lifetime risk is about 9% in the United States, 8% in Europe and 2% in Africa, and it is one of the most common reasons for emergency surgery on the tummy.
How serious is appendicitis? The stages
Appendicitis is a medical emergency, because an inflamed appendix can burst, in some people within 36 hours of the first symptoms, and spread infection through the tummy. Untreated, it goes through five stages:
- Inflammation: the blocked appendix swells and becomes infected.
- Loss of blood supply: the swelling cuts off the blood supply, and the wall of the appendix starts to die.
- Gangrene and bursting: the dead wall gives way, and the appendix bursts.
- Abscess: a pocket of pus, or a mass, forms around the appendix.
- Peritonitis: infection spreads through the lining of the tummy, which can lead to sepsis.
A burst appendix needs urgent surgery and antibiotics, and can also cause a bowel blockage and problems in pregnancy. In people over 50, the appendix has burst in 55% to 70% of cases, and symptoms are less typical at older ages, so new tummy pain in older age needs prompt assessment.
How do you know if you have appendicitis? Can you check at home?
You cannot reliably check for appendicitis at home, and doctors advise against trying to diagnose it yourself. Even in hospital, no single test always confirms it. Doctors combine:
- an examination, feeling the tummy for pain, tenderness and swelling
- blood tests for signs of inflammation, and a urine test
- a pregnancy test, when it could be relevant
- an ultrasound scan, and sometimes a CT scan, or an MRI scan in pregnancy
- scores that weigh up the findings, and sometimes watching the symptoms for a few hours
If appendicitis is very likely, or the appendix may have burst, surgeons may operate without further tests.
Appendicitis or something else?
Pain low on the right has other causes, which is one more reason not to wait at home guessing. They include:
- a urine infection, or kidney stones
- gallstones
- irritable bowel syndrome or Crohn’s disease
- diverticulitis, which a small number of people feel on the right
- in women, pelvic inflammatory disease, a burst ovarian cyst or an ectopic pregnancy
What might the doctor recommend for pain that could be appendicitis?
What happens next depends on how the pain started, where it is now and how unwell you are. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| Pain that started around the belly button and has moved low on the right | Emergency assessment in hospital | No | Go to an emergency department now |
| Severe pain, pain spreading across the tummy, or feeling very unwell | Emergency treatment | No | Call 112 now |
| Pain low on the right, and you could be pregnant | Urgent assessment, including for ectopic pregnancy | No | Urgent in-person care |
| Mild tummy pain that is not getting worse, with no other symptoms | Assessment of the likely cause, and clear signs to watch for | Yes, to assess | If the pain gets worse, moves low on the right, or new symptoms start |
| Recovering from appendix surgery | Advice on pain relief, wound care and constipation | Yes | If the wound is red, leaking or bleeding, or you have a high temperature |
| Appendicitis treated with antibiotics alone | Watching for the symptoms coming back | Yes | If the pain comes back: go back to hospital |
Not sure whether your tummy pain needs a hospital? A doctor can tell you in one consultation how urgently you need to be seen.
See available times →How is appendicitis treated?
Appendicitis is treated in hospital, usually with surgery to remove the appendix, called an appendicectomy, done as soon as possible. Guidelines advise against delaying it beyond 24 hours from admission, and keyhole surgery is the preferred approach. The operation usually takes about an hour, under general anaesthetic.
Can appendicitis be treated without surgery?
Sometimes. Antibiotics alone are a safe alternative for some adults with uncomplicated appendicitis and no appendix stone, or when the infection has not spread and surgery would be high risk. Appendicitis comes back in up to 39% of people within 5 years of antibiotic-only treatment. For a mass around the appendix, antibiotics usually come first, with surgery a few weeks later if symptoms continue.
What you can do yourself
- If you think you have appendicitis, go to an emergency department or call 112, and do not drive yourself.
- Take a list of the medicines you take.
- After surgery, go back to your usual activities when you feel ready, and avoid strenuous sport until you have fully recovered.
- Eat fibre and drink fluids if you are constipated after surgery, and ask a pharmacist about a mild laxative.
- Do not drive until you can do an emergency stop safely, and finish any antibiotics.
Prescription treatment
A prescription is never issued without a consultation. Appendicitis is treated in hospital, with antibiotics and usually an operation, and no medicine at home replaces that. After treatment, the doctor may advise on pain relief and recommend a mild laxative for constipation. Strong opioid painkillers are never prescribed online. If the doctor prescribes, use the prescription at a pharmacy near you.
What does not help
Waiting at home to see whether the pain settles. Trying to diagnose appendicitis yourself, including by pressing on your tummy. Driving yourself to hospital.
Recovery after appendix surgery
Most people recover in 1 to 2 weeks and are fully recovered within 6 weeks; it takes longer after a burst appendix. After keyhole surgery you may go home the next day, and after open surgery or a complication you may stay a few days. Expect some pain, small wounds, and constipation or diarrhoea for several days. Complications are rare: wound infection, bleeding, an abscess, or scar tissue that later blocks the bowel.
Special situations
Pregnancy
Symptoms are less typical in pregnancy, so tummy pain needs prompt assessment in person. Ultrasound is the first scan, with MRI if it is unclear. Antibiotics alone are not recommended in pregnancy, and keyhole surgery is used when an operation is needed.
Older people
Symptoms can be milder or unusual, sudden confusion may be the main sign, and the appendix has more often burst by the time of diagnosis. New tummy pain in older age needs prompt assessment.
Appendicitis while travelling in Europe
Suspected appendicitis is an emergency wherever you are: call 112 or get someone to take you to the nearest emergency department. After treatment abroad, keep the discharge letter, including whether you had surgery or antibiotics alone, because it matters if the pain comes back.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When appendicitis is assessed online, and when you need in-person care
Assessed online: tummy pain where it is unclear whether a hospital is needed, other likely causes of the pain, recovery after an appendix operation, and follow-up after antibiotic-only treatment.
In-person care: any suspected appendicitis, every examination, blood test, scan and operation, and any pain that is severe, getting worse or has moved low on the right.
When to get in-person care
Call 112 or go to an emergency department now for:
- severe tummy pain
- pain that started around the belly button and has moved low on the right
- pain that eases and then becomes severe and spreads across the whole tummy
- confusion, pale or blotchy skin, or difficulty breathing
- vomiting blood or material like coffee grounds
Get medical advice the same day for:
- tummy pain that is gradually getting worse or not going away
- tummy pain with a high temperature, being sick or loss of appetite
- new tummy pain in pregnancy or in older age
- pain coming back after appendicitis was treated with antibiotics alone
- a wound after appendix surgery that is getting more sore or red, bleeding or leaking pus, or a high temperature
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about the pain: say where it started, where it is now and when it began, and mention any vomiting, temperature or chance of pregnancy.
- Leave with a plan: what to do, what to take and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Tummy pain can have more than one cause. Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call. If you have an emergency sign listed on this page, call 112 instead.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Gastroenteritis can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about appendicitis
What side is your appendix on?
The right side. Your appendix is in the lower right part of your tummy, joined to the start of the large bowel, which is why the pain of appendicitis usually settles low on the right.
What does appendicitis pain feel like?
Appendicitis pain usually starts as a vague pain around the belly button, then moves low on the right over a few hours and becomes sharp, constant and severe. It is worse when you move, cough or press on the area.
How do I know if I am having appendicitis?
Typical signs of appendicitis are pain that starts around the belly button and moves low on the right, with loss of appetite, feeling sick and a high temperature. Only an assessment in hospital can confirm it, so go to an emergency department if you think you have it.
Can you rule out appendicitis at home?
No. There is no reliable home test for appendicitis, and even in hospital no single test always confirms it. Do not try to diagnose it yourself: pain that is getting worse or has moved low on the right needs a doctor in person.
What are the five stages of appendicitis?
Untreated, the blocked appendix becomes inflamed, then loses its blood supply, then becomes gangrenous and bursts, then forms an abscess, and finally infection spreads through the tummy lining as peritonitis, which can lead to sepsis.
Can appendicitis pain come and go?
Usually not: it gets steadily worse over hours. A rare grumbling form, chronic appendicitis, causes on-and-off pain over a long time. Any new tummy pain that is getting worse needs urgent assessment.
Is it appendicitis or something else?
Appendicitis is a steadily worsening pain that settles low on the right, with nausea and tenderness when the tummy is pressed. A stomach bug brings vomiting and diarrhoea with crampy pain that moves around; a urinary infection burns on passing urine; in women, an ovarian cyst or ectopic pregnancy causes sudden one-sided pain, so a pregnancy test matters; kidney stones cause waves of pain into the groin; and trapped wind eases after passing it. Only an in-person examination, often with a scan, can tell.
What causes appendicitis?
Usually something blocking the appendix, such as hard poo or a small stone, or swollen lymph tissue after an infection. The appendix then swells and becomes infected. In many cases the cause is not clear.
Can appendicitis be prevented?
No. Appendicitis cannot be prevented, because it starts with a blockage that no habit reliably avoids, and it is not caused by anything you ate or did; a high-fibre diet is linked to slightly lower rates in some studies, but there is no vaccine, screening or medicine that stops it. What can be prevented is a burst appendix: knowing the pattern, pain that moves to the lower right and keeps getting worse, and going to hospital early rather than waiting it out.
What does the appendix do?
Nobody knows for certain. If it has a function, it is a small one, possibly helping to make antibodies in childhood. You do not need your appendix, and removing it is not harmful.
How quickly can an appendix burst?
In some people the appendix bursts within 36 hours of the first symptoms. When it bursts, the pain may ease briefly and then become severe and spread across the whole tummy, which needs emergency care.
Can appendicitis be treated without surgery?
Sometimes. Antibiotics alone can be used for some adults with uncomplicated appendicitis, but it comes back in up to 39% of people within 5 years. Most people have surgery, usually keyhole surgery.
How long does it take to recover from appendix surgery?
Most people recover from keyhole appendix surgery in 1 to 2 weeks and are fully back to normal within 6 weeks, with a day or two in hospital, a week off work for a desk job and 2 to 4 weeks before heavy lifting or sport; open surgery and a burst appendix with peritonitis mean a longer stay, antibiotics and a recovery of 4 to 6 weeks or more. Appendicitis has no lasting effect on digestion.
Can an online doctor diagnose appendicitis?
No. A doctor by video can judge whether your pain could be appendicitis and how urgently you need a hospital, but the diagnosis needs an examination, tests and often a scan in hospital.
- Appendicitis, NHS, National Health Service (UK), reviewed 9 August 2024.
- Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines, Di Saverio S, et al. World Journal of Emergency Surgery, 2020.
- Appendicitis, Cleveland Clinic (US), reviewed May 2023.
- Appendicitis, MedlinePlus, US National Library of Medicine, reviewed April 2025.
- Symptoms and causes of appendicitis, NIDDK, US National Institute of Diabetes and Digestive and Kidney Diseases, reviewed July 2021.
- Appendicitis, NIDDK, US National Institute of Diabetes and Digestive and Kidney Diseases, reviewed July 2021.
- Diverticular disease and diverticulitis, NHS, National Health Service (UK), reviewed 7 September 2023.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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