Appendicitis is caused by an inflamed appendix and requires immediate medical attention. This article discusses the differences between IBS and appendicitis, testing for each condition, and symptoms you should not ignore.
What Is Appendicitis?
Appendicitis is a serious health condition in which the appendix becomes inflamed and fills with pus. This may happen due to a blockage caused by fecal matter, a swollen lymph node, a foreign object, or in rare cases, a tumor.
When appendicitis occurs, the appendix needs to be removed immediately via an appendectomy to prevent it from bursting, as this can lead to life-threatening complications.
When an appendix ruptures, its contents can spill into your abdominal cavity, leaving you at risk for a severe and potentially lethal infection known as peritonitis. Although the ultimate treatment for a ruptured appendix is usually an appendectomy, your healthcare provider may first start you on a course of antibiotics to reduce the risk of postoperative infection.
Symptoms of Acute Appendicitis
There are several ways to tell if you have acute appendicitis and need immediate medical attention. The first is that the onset of pain is often abrupt and centered around the belly button.
Among the other signs of acute appendicitis are:
Pain that worsens and moves to the lower right part of your abdomenPain that worsens with movement or coughingLoss of appetiteNauseaVomitingLow grade feverChills
Risk of Unnecessary Surgery
Because the complications of acute appendicitis are so serious, surgeons typically err on the side of caution and choose to remove the appendix of anyone whose symptoms indicate appendicitis.
This leads to a high rate of what is called a “negative appendectomy,” which is the removal of a non-inflamed appendix. The rate of negative appendectomies is approximately 15%, even with the use of modern diagnostic technology.
Because the symptoms of appendicitis and IBS overlap, people with IBS appear to be at a higher risk for unnecessary surgeries in general, including negative appendectomies. Research suggests that this may be because people with IBS are more likely to seek treatment and tend to be more anxious than those without.
“Chronic Appendicitis”
One of the main differences between IBS and appendicitis is that the former is chronic and the latter is acute. While people with IBS can have acute outbreaks of symptoms, the disease tends to be something they live with on an ongoing basis.
However, there is a small group of scientists who argue that some people have chronic appendicitis, otherwise known as recurrent appendicitis, appendicopathy syndrome, or neurogenic appendicopathy.
If such a condition were to exist, it could very well masquerade as IBS. Both syndromes involve recurrent abdominal pain (often worsened by a large meal) and chronic diarrhea, constipation, or both.
The only differentiating factor may be that the recurring pain is in the lower right corner of the abdomen in people with chronic appendicitis.
Telling the Difference
Given that many IBS patients undergo unnecessary surgery, most experts strongly advise against an appendectomy for a person who has IBS—unless there are signs of acute appendicitis.
This typically involves a battery of tests to confirm that appendicitis is involved, including:
A physical exam, including palpation and a digital rectal exam (DRE) Blood tests to check for a high white blood cell count (a sign of infection) Urine tests, called urinalysis, to make sure that a urinary tract infection or kidney stone isn’t causing your pain Imaging tests, including an abdominal X-ray, abdominal ultrasound, computerized tomography (CT) scan, or magnetic resonance imaging (MRI)
A Word From Verywell
It is important to note that the symptoms and severity of appendicitis can vary dramatically from one person to the next. If you suspect your appendix is the cause of your symptoms, call your healthcare provider immediately. Do not wait.
If your appendix were to rupture, the pain may ease up but only temporarily. In addition to worsening pain, your abdomen will be very sensitive to the touch and all of the aforementioned symptoms will re-emerge, but invariably worse.
Even if your pain turns out to be IBS (or some other condition), it is better to be safe than sorry.
