Appendix irritation


The appendix sits in the right lower abdomen of the human being. Accordingly, pain in the right lower abdomen is typical of appendicitis. The appendix irritation corresponds to a preliminary stage to appendicitis, which does not always have to end in appendicitis.

Since the symptoms can often not be clearly classified, the diagnosis is often difficult for the attending physician. Both appendicitis and appendicitis are more common in children between the ages of nine and fourteen. The word appendix irritation is usually used incorrectly in popular parlance because it is not really an irritation of the appendix, but rather an irritation of the appendix (Appendix vermiformis) that originates from the appendix.


Typical for irritation of the appendix are pain in the right lower abdomen, which can develop into cramps.
The pain that results from irritation of the appendix often begins around the belly button and then shifts to the right lower abdomen. The pain often changes in intensity and can also regress in the meantime.

In many patients, when the abdominal wall is touched, the local muscles contract and the pain intensifies. Even light touch from a blanket or clothing can cause severe pain. In this case one speaks of a Defense tensionwhich indicates irritation of the peritoneum and often occurs as part of what is known as a current abdomen. This hardening of the abdominal wall does not occur in all patients, so that the absence of these symptoms does not rule out irritation of the appendix. In terms of reflection, the affected patients adopt a relieving posture by pulling their legs up while lying down in order to relax the abdominal cavity and avoid the pain.

At the same time as the pain, there is often a loss of appetite, vomiting, fever, chills and an increased pulse. Due to the diffuse symptoms of appendicitis irritation, the pain is often dismissed as harmless abdominal pain and not treated further, so that dangerous appendicitis can occur.

A rather atypical clinical picture with diffuse pain often occurs, especially in small children. In older patients, on the other hand, the irritation often occurs without fever and without severe pain. In pregnant women, the appendix has often slipped upwards, so that the typical pressure pain may be absent. This also applies to people with an unusual appendix location.

Read more on the topic: Symptoms of appendix irritation

Typical signs of irritation of the appendix

Typical signs are above all the classic pain symptoms, as already mentioned above, in connection with nausea, fatigue and a slight fever.
A sensitive stomach, which is already painful when touched, as well as nausea and even regular vomiting are other very common symptoms, which, however, suggest inflammation. Fever, temperature differences and fatigue are very unspecific and also occur with many other diseases, but can increase suspicion. The appendix tests described below can be a very good indicator of irritation of the appendix if they are carried out correctly and are therefore sufficient in connection with typical pain symptoms to justify therapy.

Fever with irritation of the appendix

Fever is a very common symptom. It usually occurs in connection with a general fatigue and weakness.
A typical sign of irritation of the appendix is ​​a temperature difference of more than one degree in axillary and rectal measurements, whereby the rectal temperature is increased.However, a strong and long-lasting fever rather suggest advanced irritation or inflammation of the appendix. Sudden attacks of chills are also a sign of worsening and that irritation has turned into inflammation.

Back pain with irritation of the appendix

Back pain is a rare but possible symptom of appendicitis or appendix complaints.
The appendix is ​​usually found in a typical location in the right lower abdomen of humans. As with everything, however, there are exceptions. It can be the case that the process extends backwards and comes to rest in an area behind the actual abdominal cavity. In this case, back pain mainly occurs, while abdominal pain is only weakened or does not occur at all.

Read more on this topic at: Causes of back pain

Causes of appendix irritation

The appendix appendix consists of many Lymph follicles.
If the connection between the appendix and the outgoing appendix is ​​blocked, secretion builds up in the appendix. This allows bacteria from the large intestine to multiply and lead to irritation or inflammation. This accumulation of secretions is usually caused by hardened, thickened stool.

A kinking of the appendix due to an unfavorable position in the abdomen can also lead to a build-up of secretion and thus to irritation, but this rarely occurs. Fruit kernels, worms or foreign bodies can also cause a blockage. Intestinal infections can also spread to the appendix and cause irritation.

Due to the various possible causes, the cause should always be clarified in the event of appendectal irritation or inflammation. The appendix plays an important role in the immune system, especially in children. The lymph nodes in the appendix area react to bacteria in the intestine. In the context of irritation of the appendix, pathogens trigger a defense reaction that leads to swelling of the mucous membrane. The mucous membranes become more sensitive and secrete a secretion. These reactions are painful. When the mucous membrane starts to swell again, the pain disappears.

However, at the moment of pain, it is often difficult for the attending physician to differentiate between irritation of the appendix and a more dangerous appendicitis, which is why patients are often admitted to hospital for safety, as an acutely inflamed appendix has to be removed immediately, otherwise it can become life-threatening Breakthrough of the appendix so that the inflammation spreads into the abdomen and on the peritoneum (peritoneum) can spread and lead to life-threatening inflammation there.

Read more on the topic:

  • Causes of appendicitis
  • Task of the appendix

Can irritation of the appendix be triggered by stress?

Stress alone is very unlikely to cause appendicitis, but it plays an important role in connection with other symptoms.
Persistent stress suppresses the immune system and can disrupt the intestinal flora. It is therefore possible to participate or intensify the irritation.


Often times, the pain resembles irritation of the appendix, symptoms of ovarian inflammation, cystitis, or kidney stones. Therefore, abdominal pain must always be clarified through differential diagnosis in order to be able to make a clear diagnosis.

There are many examination methods that can be used to diagnose irritation or inflammation of the appendix. During the examination, the doctor scans certain pressure points that are typical for appendicitis / inflammation. For example, one of these is the Lanzpunkt, which lies on an imaginary line between the two front bone protrusions on the iliac bone. The Lanz point is where the middle and right thirds meet. If at this point pain can be resolved by applying pressure, this test is positive. Another point that can be checked for pain is what is called McBurney point. It is located on a confessional line between the navel and the right front upper iliac edge, between the outer and middle third of the connecting line.

Furthermore, the doctor can check whether the patient is suffering from letting go suffers. Pressure is applied to the painful area in the lower abdomen and then suddenly released. A positive letting go pain is when the pressure on the area relieves the pain and letting go leads to severe pain again. The pain of letting go of the diagnosis can also be triggered on the opposite side, this is referred to as the so-called contralateral pain of letting go - also as Blumberg sign known.

Another test is to ask the patient to hop on the right leg. If the pain increases in movement, it is probably caused by irritation of the appendix, which is known as typical vibration pain.

Whether there is irritation or inflammation is decided by an ultrasound examination of the abdomen and a blood sample. When the blood is drawn, increased levels of white blood cells, an increased CRP level (C-reactive protein) and an increased sedimentation rate. Computed tomography can sometimes help to make the diagnosis. In women, gynecological examinations are also carried out for clarification, for example to rule out fallopian tube inflammation.

Read more on the topic: Diagnostics for appendicitis

What tests are there for appendix irritation?

There are numerous tests available to diagnose irritation of the appendix or appendix. However, these tests are only specific with regard to determining the location of the “appendix”. This means that it is very easy to test that it is probably the appendix.
However, it is very difficult to distinguish between irritation and inflammation. A doctor should be consulted to specify this. There are, for example, the two pressure points already mentioned above in the right lower abdomen, which are often very painful (the so-called “McBurney point” and “Lanz point”). In another test, there is pain when releasing a depressed area in the left lower abdomen, as the pressure wave reaches the right and is painful there. Patients often experience pain when pulling their right leg against resistance. From time to time a temperature difference can also be determined with an axillary and rectal temperature measurement.

Duration of appendix irritation

If there is only irritation and no inflammation, it is a self-limiting process that usually only lasts a few days.
On the first day, the symptoms gradually increase, which then last for a while and then subside. Improvements and deterioration may occur again and again during the irritation. The course is very variable here.
In addition to acute irritation, there are also patients with chronic irritation of the appendix.
These people have complaints several times a year, although these can vary in duration and intensity. In such a case, it is advisable to remove the appendix surgically in order to finally end the disease. If, in the case of acute irritation, the symptoms worsen so much within the first and second day that severe pain and pronounced nausea occur, a doctor should be consulted immediately, as inflammation is very likely.

Read more on this topic at: Duration of appendix irritation

How long will you be on sick leave?

How long you are on sick leave in the event of irritation of the appendix depends on the extent and duration of the symptoms.
After the examination, the doctor will assess for how many days there has been an incapacity for work and, if necessary, call the patient in for a check-up as soon as possible. If the symptoms persist or worsen, in some cases hospitalization for possible appendicitis must be made. The length of time you are on sick leave then depends on how quickly and how the disease can be treated (for example through an operation). If there are no complications, you will be on sick leave between two days and a week if the appendix is ​​irritated.


In contrast to appendicitis, the administration of antibiotics is sufficient for appendicitis, so that appendicitis can be prevented. Since irritation of the appendix can turn into life-threatening appendicitis if left untreated, a doctor should be consulted immediately if it is suspected. If only for that reason, because of the similar symptoms, appendicitis is difficult to differentiate from appendicitis. In some cases, the irritation disappears even without further therapy.

Therapy with natural remedies should initially be avoided, as it should first be clarified to what extent there is a risk of appendicitis or even a rupture of the appendix. However, if inflammation is ruled out and there is definitely irritation of the appendix, so-called Schüssler salts can be used to support healing.

When do you need antibiotics?

In order to be able to differentiate between irritation and inflammation, especially when irritation first occurs, a doctor should be consulted. In the event of irritation, this would also decide whether the administration of antibiotics is necessary. This mainly depends on how severe the symptoms are, how likely it is to get worse and whether similar irritations have occurred more frequently in the past. In the case of antibiotic therapy, the combination is usually used Metronidazole and ciprofloxazine prescribed.

Which home remedies help?

Since the appendix is ​​not directly connected to the digestive tract, but only "hangs" on it, it is very difficult to counteract irritation with home remedies.
A light diet is recommended, however, as constipation can be the cause of the irritation. Another option is to strengthen the immune system to counteract inflammation. It can also help to keep the body warm. However, direct warming of the abdomen is not recommended as this can support inflammation. Ultimately, however, home remedies only play a supporting role.

Cooling or warming?

While cooling tends to relieve acute inflammatory pain in joints and muscles, warmth should be used for abdominal pain. A hot water bottle or a cherry stone pillow can help alleviate the pain caused by irritation of the appendix. However, care must be taken that the skin does not get too hot, otherwise burns can quickly occur. Heat can also promote inflammation.
If the pain remains the same or increases, however, a doctor should be consulted or alerted as soon as possible, as the appendix irritation can quickly turn into life-threatening appendicitis. Warming the abdomen as well as a relieving posture with legs drawn up can help to get through the waiting time until the doctor arrives.

Homeopathy for appendix irritation

Similar to the home remedies, it is important that a medical examination has been carried out first in order to rule out inflammation.
If there is no need for an operation, antibiotic or symptomatic therapy can be accompanied by homeopathic remedies such as Schüssler salts. This must be clarified with the appropriate alternative practitioner, who will prescribe this.

How should you eat if you have irritation of the appendix?

In the event of irritation of the appendix, certain things can be observed in the diet so that the intestine is not further irritated and can recover.
If possible, you should only eat easily digestible food such as pasta or rice without sauce or rusks. High-fiber foods such as vegetables, salads and whole grain products should be avoided as long as the symptoms persist. It is also important to drink plenty of fluids in the form of water or tea.
However, in the event of symptoms that may indicate irritation of the appendix, a doctor should first be consulted. This can assess whether the irritation of the appendix can be cured with bland foods or whether therapy with an antibiotic, for example, is indicated. A hospital admission and an operation may also be necessary if there is a risk of appendicitis.

This is how one differentiates appendicitis irritation from appendicitis

The transition from irritation of the appendix to appendicitis is fluid, so that a distinction is often not clearly possible.
In case of doubt, the more dangerous, i.e. appendicitis, should be assumed until it is excluded. In addition, irritation of the appendix can always turn into appendicitis. The irritation of the appendix is ​​more likely to manifest itself through less severe symptoms such as slight abdominal pain in the right lower abdomen and possibly some nausea. A normal body temperature is also more likely to indicate irritation of the appendix.

Appendicitis, on the other hand, manifests itself as increasing abdominal pain, which often begins in the upper abdomen and then moves to the right lower abdomen. Often there is also fever, nausea and vomiting.
However, it is important to note that in some cases dangerous to life-threatening appendicitis can express itself as less pronounced symptoms and can therefore be quickly dismissed as appendicitis. This is especially true for the elderly. Therefore, whenever symptoms occur that can be caused by appendicitis as well as appendicitis, a doctor should be consulted promptly.

Read more on this topic at: Signs of appendicitis

Special features of irritation of the appendix in children

Appendicitis usually occurs between the ages of four and 25, and especially between nine and 14 years.
In children, special care should be taken in the event of irritation of the appendix, as the likelihood of having an inflammation is significantly greater. In addition, children do not have that much experience in connection with gastrointestinal cramps and usually never had an appendix irritation before with which they could compare the symptoms.
In the case of children and especially small children, a doctor should therefore be consulted first if an appendix is ​​suspected. If the doctor decides that it is simply an irritation, he will determine the necessary therapy. Children are more often admitted to the hospital, as constant observation with possibly rapid intervention may be necessary. Another peculiarity in children is the variation in the choice of antibiotics.

Also read: These are the symptoms I can tell if the child has cervical inflammation

Irritation of the appendix in pregnancy

During pregnancy, there may be irritation of the appendix, with which there is a particular risk of being misinterpreted.
On the one hand, the typical symptoms of appendicitis such as abdominal pain and nausea can also be classified as normal pregnancy symptoms. On the other hand, the growing child in the mother's body displaces the intestines, including the appendix, upwards, so that the pain in the case of appendicitis is not felt in the lower abdomen as is usual, but rather in the upper abdomen.
While appendicitis is not yet dangerous, it can also quickly develop into appendicitis, which, if left untreated, is fatal for the mother and the child-to-be. If you have new abdominal pain and nausea during pregnancy, you should therefore consult a doctor as soon as possible.

Read more on this topic at: Lower abdominal pain during pregnancy