How Doctors Diagnose Appendicitis

Medically Reviewed By William C. Lloyd III, MD, FACS
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Young female Caucasian patient on exam table with female Caucasian doctor feeling abdomen

Appendicitis is a common condition. It’s inflammation of a small pouch in the colon called the appendix. Doctors treat it by removing the appendix. This is called an appendectomy. A classic sign of appendicitis is severe pain in the right lower belly area. Even though this is a hallmark symptom, many problems can cause the same type of pain. Your doctor will need to find the cause of your symptoms before considering surgery. Here's what you can expect and how to help your doctor make an accurate diagnosis.

Don’t Ignore Your Symptoms

If you are having severe pain in your belly or abdomen, tell your primary care doctor right away or go to an emergency room. Appendicitis is serious because it can progress to a more serious infection when it’s not treated. The good news is appendicitis is easily treated. Most people do very well, but the sooner it’s diagnosed and treated, the better.

You can’t tell if you have appendicitis by yourself. Not everyone has the same kind of belly pain or the same symptoms. For instance, the pain may not be as severe as you might expect, or you may have pain around the belly button area, fever, or nausea and vomiting

Share Your Symptoms and Medical History 

Your doctor will ask you many questions about your pain and other symptoms. Answering questions may be difficult if you are in pain, so your doctor will likely give you pain medication. If possible, bring someone with you that knows your health history and how your recent condition has progressed. You can write down your symptoms to help you remember. Be sure to bring a list of your allergies, other known conditions, and the medicines you take. 

Your doctor will evaluate your symptoms and medical history along with a physical exam. Your doctor will: 

  • Check your vital signs including blood pressure, and temperature.

  • Listen to your belly with a stethoscope. Appendicitis may reduce the normal sounds made by the colon. 

  • Touch or press certain places on your belly. The way it feels in different spots can be a sign of appendicitis.

  • Perform a rectal exam, in some cases. Appendicitis can cause rectal pain.

  • Perform a pelvic exam on women of childbearing age. Your doctor will examine the female reproductive organs to rule out conditions that mimic appendicitis. 

Lab Tests for Appendicitis 

After an exam, your doctor will want to do some lab tests. The results will show problems that typically occur with appendicitis. Your doctor will also use the test results to rule out other causes of your symptoms. This helps your doctor make the best treatment decisions for you.

  • Blood tests. A complete blood count (CBC) shows inflammation or infection in the body. A chemistry panel reveals dehydration and fluid and electrolyte imbalances.

  • Pregnancy test. Some problems of pregnancy, such as morning sickness or a miscarriage, can appear like appendicitis. Doctors also use this test to make sure they use medications that are safe during pregnancy

  • Urine test. A urinalysis can help show a bladder infection, kidney stone, or poor kidney function. It also helps your doctor choose medications that are safe for your kidneys.

Imaging Tests for Appendicitis

Your doctor will likely order one or more of the following noninvasive imaging tests if you have signs of appendicitis. They help diagnose appendicitis or find other reasons for your symptoms.

  • Abdominal ultrasound can show inflammation or a burst appendix. The test involves pressing and moving a wand-like device gently over your belly. You may feel a little pressure on your belly during this test.

  • CT scan creates an X-ray-based image of your belly area. Your doctor can see much more detail with a CT scan compared to a regular X-ray or ultrasound

  • MRI also creates a detailed picture of your belly area. But unlike a CT scan, it does not involve X-rays. 

Making the Diagnosis

Conditions other than appendicitis can cause low belly pain. Uterine fibroids, pancreatitis, and other types of intestinal inflammation can cause it. Your doctor will need to do a thorough evaluation to find the cause of your symptoms. Call your doctor right away if you have abdominal pain or symptoms that concern you. The sooner your doctor diagnoses and treats you, the sooner you will feel better.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Nov 25
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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