Appendicitis or Gas: How to Differentiate the Pain?

Gas discomfort and appendicitis pain can be differentiated by the way the discomfort evolves. Discover the similarities and differences.

Reviewed and approved by the doctor Leonardo Biolatto.

Written by Luis Rodolfo Rojas Gonzalez

Last update: 18 October, 2023

Abdominal pain can be caused by a wide variety of diseases. Often, discomfort in the abdomen is caused by the accumulation of gas. However, this could also be a warning sign of appendicitis. Are you interested in knowing how to find out if it’s appendicitis or gas pain? Here’s how.

Appendicitis is a common gastrointestinal condition in hospital wards. It’s an inflammation and infection of the cecal appendix, a small pouch attached to the cecum in the lower right side of the abdomen.

On the other hand, gas accumulation in the intestine can also cause abdominal discomfort. This can result from unintentional consumption of air during feeding or from excessive gas production by intestinal bacteria.

Symptoms of appendicitis

Acute appendicitis is the most common cause of non-traumatic abdominal surgery worldwide. It’s most common between the second and third decades of life, with a similar prevalence in men and women.

Severe abdominal pain is the usual symptom of this condition and can sometimes be mistaken for gas. Studies estimate that 50 to 60% of patients experience cramping pain in the upper abdomen or around the navel, which later migrates to the right lower quadrant.

Similarly, the following symptoms are frequent:

• Fever
• Vomiting
• Dizziness and nausea
• Loss of appetite
• Diarrhea or constipation
• A feeling of abdominal distention

The symptoms are more evident in later stages of the disease. It’s normal for people to lie on their sides with their thighs flexed. The pain usually becomes more intense when coughing, sneezing or pressing on the abdomen.

Symptoms of a ruptured appendix

One of the most serious complications of acute appendicitis is appendiceal rupture or perforation. This situation is common when there’s a delay in treating it.

In most cases, rupture of the appendix occurs 36 to 72 hours after the onset of the condition. However, this period of time may vary from person to person.

It’s common for patients to experience a certain relief from pain once the perforation occurs. However, this situation causes the leakage of intestinal material into the abdominal cavity, favoring infection of the peritoneum or peritonitis.

Peritonitis is a severe medical condition that requires emergency treatment. Some of the associated symptoms are the following:

• Abdominal tenderness
• Nausea and vomiting
• High fever and chills
• Increased heart rate
• Skin pallor and sweating
• Severe abdominal pain that worsens with pressure and movement

Appendicitis in childhood

Appendicitis in young children is a major challenge. It’s characterized by severe stomach pain that prevents activity.

Other common symptoms include the following:

• Vomiting
• High fever
• Irritability
• Decreased or loss of appetite
• Abdominal tenderness to touch

Studies estimate that more than 50% of children have above 15,000 leukocytes and a CRP above 20 milligrams per milliliter (mg/ml). If appendicitis is suspected, don’t hesitate to seek medical help, as children won’t always be able to describe the symptoms very well.

Appendicitis in pregnancy

It’s sometimes possible to develop appendicitis during pregnancy. The clinical manifestations are similar to those that occur in non-pregnant people. However, in these cases, the appendix is located higher up, so the pain may be in the right upper quadrant.

Symptoms of gas pain in the abdomen

In most cases, the initial symptoms of appendicitis can be mistaken for gas pain in the abdomen. Studies state that abdominal gas comes primarily from three sources:

1. Ingested air
2. Intestinal production
3. Diffusion from the blood

The accumulation of gas usually causes distension of the intestinal loops and abdominal discomfort. However, gas pain can be felt anywhere in the abdomen, unlike in appendicitis.

In fact, some people may have chest discomfort, along with frequent belching, flatulence, abdominal bloating, and stomach cramps. Gas pain can last from a couple of minutes to several hours and disappear without treatment.

When to seek medical attention?

Acute abdominal pain is a warning sign that something is wrong in the intestines. In most cases, gas discomfort is temporary, however, it’s vital to remain vigilant if it persists beyond 24 hours.

Similarly, it’s advisable to seek medical attention in cases of abdominal discomfort accompanied by bloody stools, weight loss, constipation, diarrhea, or persistent vomiting. These manifestations are associated with chronic digestive diseases or tumor disorders.

On the other hand, appendicitis itself is a situation that requires immediate professional attention. The condition should be suspected if pain begins in the upper abdomen and then settles in the lower right side.

How is appendicitis diagnosed?

The diagnosis of appendicitis is clinical and relies on laboratory methods to confirm its presence. Physicians usually perform a detailed physical examination with emphasis on the abdominal cavity.

It’s common for the physician to press certain points in the abdomen to look for signs of appendicitis. If the abdominal pain worsens when the right lower quadrant is pressed and released, the appendix may be inflamed. In addition, some patients often have a rigid abdomen due to intestinal irritation.

Similarly, the specialist may ask for blood tests to evaluate the white blood cell count, platelets, and red blood cells. Occasionally, abdominal ultrasound is useful to analyze the state of the colonic architecture.

Medical treatment of appendicitis

The therapeutic plan for appendicitis is based on the surgical removal and extraction of the inflamed appendix. This procedure is performed in the following ways:

• Open surgery: This is performed through an incision in the right lower quadrant of the abdomen. It’s useful in perforated appendicitis with a risk of peritoneal infection.
• Laparoscopic surgery: This is the most commonly used method because it’s less invasive. It’s performed by means of a flexible tube with a camera, called a laparoscope.

An extensive study published in Cochrane compared both methods, suggesting several benefits of the laparoscopic approach. For example, the intensity of pain on the first day, the incidence of wound infections, the length of hospital stay, and the time to return to work are lower in adults.

Both types of appendectomy require the implementation of antibiotic therapy measures to reduce the risk of infection. People can resume their normal lifestyle after a couple of weeks.

Gas pain relief remedies

In most cases, dietary habits are responsible for gas pains. Therefore, it’s essential to apply changes in intake to reduce these discomforts. To do so, it’s advisable to consult a nutritionist.

Broccoli, cauliflower, beans, dairy products, carbonated beverages, and fats are some of the foods related to gas discomfort. Drinking peppermint tea, chamomile tea, and apple cider vinegar diluted in water may be helpful in relieving this discomfort.

Two gastrointestinal conditions with marked differences

Abdominal gas pains are often similar to the discomfort produced at the beginning of appendicitis. However, the evolution of both is very different. In this sense, gas discomfort is usually generalized and disappears after several hours, while appendicitis pain intensifies and is located in the lower right part of the abdomen.

Appendicitis is usually accompanied by nausea, vomiting, and fever. Therefore, if you have these symptoms, don’t hesitate to seek professional help as soon as possible.