Inflammation of the Appendix – How to Differentiate Between Appendicitis and Gas Pain?

Inflammation of the Appendix – How to Differentiate Between Appendicitis and Gas Pain?

Some conditions can be mistaken for stomach ailments which if not diagnosed earlier, could become a medical emergency, proving dangerous to the well-being. One of those conditions is appendicitis which we will discuss in detail in the below story.


The condition refers to painful swelling or inflammation of the appendix, a tube-like structure that projects from the colon or large intestine. Depending on the case, the condition can be acute or chronic in nature but mostly, it is considered to be a medical emergency.

How common this condition is?

Appendicitis is the most common reason of abdominal pain which leads to surgery in the United States. It is believed to be most commonly found in males than females, but some studies differ. A research conducted in South India showed that out of 2402 surgeries conducted, 54 percent (1288) were females and 46 percent (1114) were males.

It is common in people between the 10 and 30 years of age. Once the inflammation or swelling begins, there are no effective medicines to stop or prevent the condition and without timely treatment it would lead to medical emergency eventually. If left untreated for longer, the appendix can burst causing life-threatening infection.

What causes appendicitis?

The major cause of appendicitis is the blockage of the lumen, the interior lining of the appendix. This can cause infection which results in multiplication of bacteria inside causing the appendix to become inflamed, filled with pus. The obstruction to the appendix can be partial or complete; the latter might end you up in medical emergency.

There could be other reasons for blockage including:

  • Accumulation of fecal matter
  • Worms
  • Tumors
  • Trauma
  • Enlarged lymphoid follicles

Complications resulting from appendicitis

Any blockage in the appendix can cause bacteria to multiply inside leading to formation of pus. Other complications include:

  • Compression of local blood vessels
  • Gangrene due to lack of blood flow to the appendix
  • Formation of abscess in case of leakage
  • Ruptured appendix can cause peritonitis which is the swelling of the tissue lining of the abdominal wall
  • Chances of inflammation of other organs due to rupture which includes bladder, cecum (cavity in which the large intestine begins) and sigmoid colon.
  • Appenditis

Signs and symptoms – How can we differ appendix pain from gas

The most common symptoms of appendicitis are gas-related pain and indigestion. In certain cases, one could feel like gas being trapped and unable to expel out. So, for people experiencing mild discomfort related to gas, then he or she can take over-the-counter medicine for heartburn such as ranitidine (Zantac) or omeprazole (Prilosec) and check if it gives relief from their symptoms.

If the pain persists more than a day and becomes unbearable, then one should contact the doctor right away. Other unusual symptoms related to appendicitis include:

  • Sudden pain arising around the bellybutton or lower right side of the abdomen
  • Nausea
  • Vomiting
  • Loss of appetite
  • Constipation
  • Indigestion
  • Diarrhea
  • Swelling in abdomen
  • Inability to expel gas
  • Low-grade fever

Often the pain intensifies can worsen while moving, coughing, sneezing or taking deep breaths. Some people may feel that passing stool will relieve their discomfort. Also people with special conditions may not experience above set of symptoms. These include people with HIV, diabetes, cancer, who are using steroids or an obese person.

Infants and young children might feel trouble in eating or feel unusually sleepy. Older children may feel constipation and expel small stools containing mucus. Older adults may be asymptomatic initially but later can experience severe problems when the appendix comes close to rupture.

People who are suspect they have appendicitis, they should avoid taking enema or any other laxative for relieve in constipation as this could result in rupture of appendix.

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Appendicitis in pregnancy

Appendicitis can affect the pregnant women on the same rate of non-pregnant women. When it strikes, it usually occurs in the second or third trimester. And since nausea, vomiting and abdominal pain are common during gestation, it would be difficult to diagnose appendicitis.

Pregnant women are more likely to experience rupture than non-pregnant women. If diagnosis is delayed, it can cause loss of baby. So, prompt action is needed in case of any discomfort that persists for longer time.

What is the diagnosis process of appendicitis?

The condition has to be addressed without further delay as it could create life-threatening complications. The doctor will be examining the medical history of the affected person before checking physical symptoms such as tenderness in the lower right side of the abdomen.

If rupture occurs the stomach would become swollen and hard on touching. Pregnant women may have to undergo pelvic examination to check for possible gynecological complications such as ectopic pregnancy.

The doctor would have to perform several tests before confirming the diagnosis. These include:

  1. Blood test – A complete blood count (CBC) will let the doctor know if there is a bacterial infection.
  2. Urine test – Urinalysis will rule out if urinary tract infection or kidney stone is the cause of pain.
  3. Imaging tests – For determining the presence of any abscess or other such problems, the doctor may order X-ray, CT scan or ultrasound.

Is surgery the only option to treat appendicitis?

The condition usually involves surgery and the type of surgery will depend from case to case. Before the surgical process, the person might be given antibiotics to prevent spread of infection. The process basically involves:


In case the abscess hasn’t ruptured, the doctor would first give antibiotics and then drain the abscess using a tube inserted through the skin. After this the appendix can be removed several weeks later. In case of rupture, the entire appendix will be removed.

The surgery is performed using a laparoscope since the instrument is less invasive and takes less time for recovery. The doctor will make an incision in the abdomen and insert a video camera to remove the appendix. You may have to spend a few days in the hospital after the surgery and additional few weeks for complete recovery. After surgery you may feel tenderness in the area which will resolve over the time. You might also experience constipation on a temporary basis. Liquid diet and fiber-rich foods may help.

In some rare cases, the person with appendicitis may get better without any surgery. This may apply on people who experience minimal pain and diagnostic tests are negative. In such cases, only antibiotics followed by liquid diet may resolve the symptoms.


Appendicitis is a condition that demands immediate attention of the doctor. It cannot be prevented; however, it is less common in people who eat fiber-rich foods. So, this condition cannot be taken as granted. The symptoms may confuse common men until it becomes serious enough to put their life at risk.

Surgery is the only foolproof option to treat this condition. So, the best bet is to talk to the doctor if the symptoms persist for a longer period of time.


1. Appendicitis. read more
2. Surgical removal of appendix. read more
3. Appendicitis - A retrospective survey in South India. 
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