At a Glance

Q: What causes appendicitis?
A: Appendicitis happens when the appendix gets blocked, leading to swelling and infection. Learn what triggers it and how doctors treat it.

• Appendicitis = inflammation of the appendix.
• Ignoring symptoms can lead to a burst appendix.
• Treatment options include surgery or medication.

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After thousands of years, the appendix, a finger-shaped organ at the end of the colon, no longer serves an obvious purpose. 

It’s believed that it once produced bile and helped early humans digest large amounts of vegetables. Today, some scientists hypothesize that it provides immune system support.

For most people, the appendix stays tucked away in the abdomen, a relic from the past. However, for some, it can cause a heap of trouble. About 5 to 9% of people will develop appendicitis, inflammation of the appendix, in their lifetime. 

What is appendicitis?

The appendix sits at the end of the colon, where the large intestine meets the small intestine. Sometimes, hard stool or foreign objects block the opening of the appendix. 

“Whenever the exit for the appendix gets blocked,” Dr. Nate Han, a general surgeon, says, “it creates a perfect environment for the normal bacteria in our colon to propagate. And as it’s propagating, gas is being produced and the appendix is dilated.” 

This causes appendicitis, or inflammation of the appendix. On rare occasions, the blockage can be caused by tumors in the colon or abdomen. 

Symptoms 

The classic sign of appendicitis is pain in the belly button that slowly migrates to the lower right side of the abdomen. 

“As the appendix is dilating,” Dr. Han says, “the pain actually goes to the belly button. That’s part of how the nerve receptors develop as we’re a fetus. However, when the appendix continues to dilate and become inflamed, it irritates the abdominal wall, and that’s when the pain begins to migrate.” 

However, some people experience no pain or only pain in the lower right side. In extreme cases, other symptoms may include nausea and vomiting. 

If left untreated, the appendix can burst and cause a life-threatening condition known as sepsis. Dr. Han advises everyone to get checked by their primary care provider or seek immediate care if they have persistent pain that becomes intolerable. 

“Some people try to ignore it, but if your pain isn’t getting better or is progressively getting worse, that’s when you want to come in to get evaluated.” 

Treatment options 

Sometimes, appendicitis is treated with medication, but there is about a 20% recurrence rate with this treatment option. Because of this, Dr. Han says the “gold standard” treatment is an appendectomy to remove the appendix. 

“That is done laparoscopically with small incisions,” he says. 

This is a routine, safe procedure, and most patients go home the same day due to its noninvasive nature. 

Appendicitis can be life-threatening if left untreated. If you experience symptoms, don’t wait to seek care.