Could this pain be appendicitis?

Abdominal pain is common, but appendicitis is the worry that often sits at the back of people’s minds when pain starts to feel different.

Maybe it began as a vague ache and is now sharper. Maybe walking, coughing or standing upright makes it worse. Or maybe you feel unwell and cannot tell whether this is a stomach bug or something that needs urgent care.

Most abdominal pain is not appendicitis. It may be linked to indigestion, trapped wind, constipation or a stomach bug. But appendicitis can be difficult to recognise at first, and the pattern of pain often matters more than one symptom on its own.

Doctors look at where the pain started, how it has changed, whether it is becoming more localised, and whether it is happening alongside symptoms such as fever, nausea, vomiting or loss of appetite.

Where does appendicitis pain usually start?

One of the most important clues to appendicitis is how the pain changes.

It often starts as a vague ache or cramping pain around the belly button. At this stage, it can be difficult to pinpoint exactly where the pain is coming from.

Over several hours, the pain commonly moves to the lower right side of the abdomen, where it becomes sharper, more constant and easier to locate.

The area may feel tender, and simple movements such as walking, coughing, laughing or changing position can make the pain worse. This can happen when inflammation spreads from the appendix to the lining of the abdomen, making the pain more focused.

Symptoms do not always follow the same pattern, but pain that starts vaguely and then becomes more localised to the lower right side is a classic sign of appendicitis.

Does appendicitis always cause pain on the right side?

Not always, especially at the beginning.

Many people notice the first discomfort around the belly button before the pain shifts. Others may have symptoms that do not follow the typical pattern. This can be more common in children, older adults and pregnant people.

This is why doctors do not rely on one symptom alone. They look at the overall picture, including how the pain has developed, where it is now, whether it is getting worse and whether other symptoms are present.

Pain that becomes stronger, more localised or more persistent over several hours deserves medical attention, particularly if it occurs with fever, nausea, vomiting or loss of appetite.

What other symptoms can happen with appendicitis?

Although pain is usually the main symptom, appendicitis can cause other symptoms too. These may include:

• Loss of appetite
• Nausea or vomiting
• Fever
• Feeling generally unwell
• Bloating
• Constipation or diarrhoea

Not everyone will have all of these symptoms, especially in the early stages.

What matters most is the pattern. Symptoms of appendicitis tend to persist or worsen rather than gradually settle. If abdominal pain is becoming more severe and other symptoms are appearing, it is important not to ignore them.

How can appendicitis feel different from common stomach pain?

Many common causes of abdominal pain improve with time. Indigestion, trapped wind and mild stomach upsets often come and go, fluctuate during the day or gradually start to ease.

Appendicitis tends to behave differently.

Rather than improving, the pain often becomes steadily worse over several hours. It may become more localised, more constant and more noticeable when moving around.

Features that can be more concerning include:

• Pain that becomes stronger or more persistent
• Pain that moves towards the lower right side of the abdomen
• Increasing tenderness in one area
• Pain that worsens when walking, coughing or changing position
• Fever, vomiting or loss of appetite alongside worsening pain
• Symptoms that continue to progress rather than settle

These signs do not automatically mean you have appendicitis, but they are reasons to seek medical advice. Abdominal pain can have many different causes, and some need urgent treatment.

How is appendicitis diagnosed?

Diagnosing appendicitis starts with a discussion about your symptoms.

A doctor will usually ask where the pain began, where it moved, how quickly it developed and whether symptoms such as fever, nausea or vomiting are present. They may also ask whether movement, coughing or walking makes the pain worse.

Examining your abdomen helps identify areas of tenderness and signs of irritation. Depending on the situation, further tests may be recommended. These can include blood tests, urine tests, pregnancy testing where appropriate, and imaging such as an ultrasound scan or CT scan.

Appendicitis can sometimes be difficult to diagnose in its early stages because its symptoms can resemble several other conditions. This is one reason why medical assessment is important when symptoms are worsening or following a concerning pattern.

When should I seek urgent medical help?

Seek urgent medical advice through NHS 111, an urgent treatment centre or A&E if abdominal pain is becoming worse, more localised or is accompanied by fever, vomiting, loss of appetite or increasing tenderness.

Go to A&E or call 999 immediately if:

• The pain is severe or rapidly worsening
• Your abdomen feels hard, swollen or extremely tender
• You feel faint, confused, very weak or short of breath
• You cannot keep fluids down
• The pain spreads across the abdomen
• A child has worsening abdominal pain
• You feel something is seriously wrong

Prompt assessment is important because untreated appendicitis can sometimes lead to complications, including rupture of the appendix and infection within the abdomen.

If the pain is changing, do not wait it out

Appendicitis often follows a recognisable pattern. The pain may begin as vague discomfort before becoming more focused, persistent and severe over time.

Not every abdominal pain is appendicitis. However, pain that is worsening, becoming more localised, or occurring alongside symptoms such as fever, vomiting or increasing tenderness should not be ignored.

Rather than focusing on one symptom, pay attention to how the pain is behaving. If it is progressing instead of settling, seeking medical advice promptly is the safest approach.

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Medically Reviewed
Last reviewed on 17/06/2026