I recognize appendicitis in children by these symptoms


Appendicitis is a disease that is particularly common in children and should definitely be treated by a doctor.
There are various symptoms that can indicate whether appendicitis may be present. The assessment of whether appendicitis is the most likely cause of the symptoms can ultimately only be made by an experienced surgeon. Ultimately, appendicitis can only be detected or excluded by surgical removal of the organ. Typical symptoms of appendicitis in children are severe or increasing abdominal pain, fever, and listlessness.

Overview of possible symptoms

The main symptom in which appendicitis should be considered in the child is abdominal pain, which is reported in the right lower abdomen. At the beginning of the disease, however, the symptoms are often more localized in the right upper abdomen or in the middle around the navel. In the case of small children, the problem is that they are often unable to give precise details of where the pain is greatest. In the course of appendicitis, the pain usually becomes increasingly severe. The child then often only wants to lie down and may even adopt a curved relieving posture.

In addition to pain, a typical symptom of appendicitis is fever. At best, the temperature should be measured rectally. However, a normal measured body temperature does not rule out appendicitis.

Many children who develop appendicitis experience nausea as an accompanying symptom and may vomit. In addition, they usually have no or at least less appetite.

The child's abdomen can also be hardened with appendicitis and light pressure often increases the existing pain. Another symptom that can occur is constipation.

Diarrhea, on the other hand, suggests gastrointestinal flu as the cause of the symptoms, but in some cases it can also occur with appendicitis. Since the symptoms are often ambiguous and an assessment by laypeople is hardly possible, the child should be examined promptly by a doctor in the event of abdominal pain that does not subside or worsens, as well as other of the possible symptoms mentioned.

Further detailed information can be found here: Symptoms of appendicitis


Fever is a non-specific symptom that can occur in all kinds of inflammatory reactions in the body, among other things.
The most common cause of fever in children are harmless infections, for example of the respiratory tract or the gastrointestinal tract, which usually and do not require any special treatment. However, fever can also accompany appendicitis.

In the case of abdominal pain in connection with fever, such a disease should therefore be considered. Typical of a fever reaction in appendicitis is a significant increase in the rectally measured temperature with often only slightly increased values ​​in the mouth, ears or under the arm. Such a constellation reinforces the suspicion that appendicitis may be present, but like all other symptoms does not in itself constitute evidence. Conversely, appendicitis can also be present if no fever can be measured.

stomach pain

Abdominal pain is one of the most common health problems in children. These can have a multitude of possible causes, with only a few cases of a serious illness requiring treatment.
Appendicitis should be considered if the child does not otherwise have any stomach pain, or if it is particularly severe or appears unusual. The child's behavior should also be observed. If the child is less active because of the abdominal pain and does not want to run or play anymore, a serious illness should be considered. If in doubt, the child should be presented to the family doctor or pediatrician as soon as possible in the event of severe or steadily increasing abdominal pain.

You might also be interested in: Baby Abdominal Pain - What Could Be The Cause?

Hardening of the entire abdomen

A hardening of the abdomen in a child can have various causes and can also occur with appendicitis.
However, often the hardening of the abdomen is the result of digestive problems that lead to constipation. Excessive bloating of the intestinal loops due to intestinal gases can also be a cause.

In appendicitis, the abdomen usually remains soft and can be pressed in, but depending on the progression of the inflammation with pain-related defensive tension in the middle upper abdomen or right lower abdomen.

However, if the entire abdomen feels hard and any manipulation of the abdominal wall leads to severe pain and defensive tension, a doctor should be consulted as soon as possible, as there is probably an inflammation of the peritoneum and thus the entire abdominal cavity. Peritonitis, too Peritonitis called, is a serious complication of appendicitis.

The peritoneum is a double-layered skin that lines all organs in the abdomen. In the context of appendicitis, intestinal bacteria can escape into the abdominal cavity - the most common pathogen here is the intestinal bacterium Escherichia coli, which infect the peritoneum and thus lead to inflammation of the entire abdominal cavity. This is a life-threatening infection that requires therapy as soon as possible.

Loss of appetite

If a child who normally eats well and happily suddenly loses their appetite, it is often because they are sick. Often harmless diseases such as gastrointestinal flu or a cold are possible causes of loss of appetite.
A serious illness such as appendicitis can also manifest itself as a loss of appetite as an accompanying symptom. As a rule, however, abdominal pain also occurs, which usually continues to increase as the disease progresses.


Appendicitis can be related to constipation. On the one hand, a long-term constipation or a tendency to hard stool can be a cause of appendicitis, as the intestinal passage is slowed down and infection of the appendix with intestinal bacteria is promoted.

On the other hand, constipation or a lack of bowel movements can be the result of appendicitis, as the inflammatory reaction can inhibit the movements of the intestinal muscles. If a child who has otherwise never had digestive problems suddenly suffers from constipation and also reports abdominal pain, appendicitis should be considered as a possible cause and a doctor should be presented as soon as possible. On the other hand, normal bowel movements do not rule out appendicitis. Diarrhea makes gastrointestinal flu more likely as the cause of the symptoms, but it can also occur in appendicitis.

Read more about this at: Constipation in children

Duration of symptoms

It is not possible to make a general statement about how long the symptoms of appendicitis last. There are also different courses.

With severe inflammation of the appendix, abdominal pain becomes increasingly severe within a few hours to a few days. The symptoms usually only subside after the therapy, which usually consists of surgical removal of the appendix.

In some cases, however, if you have mild appendicitis or irritation, you can first observe how the symptoms develop. Sometimes these decrease significantly by the next day and completely disappear again within the next few days without the need for an operation.

In exceptional cases, appendicitis can also be successfully treated with antibiotics. However, if the symptoms persist or even increase after waiting or after an attempted antibiotic therapy, the inflamed appendix must usually be surgically removed.

You can also find important information about therapy at: Diagnosis and therapy of appendicitis

What is appendix irritation in children?

One speaks of appendicitis when symptoms of appendicitis are mild. However, it is not a medically clearly defined term. If symptoms such as abdominal pain in the right lower abdomen and accompanying complaints are present, but these are not so severe in their severity that they require immediate action, the doctor often classifies them as irritation of the appendix.

One observes in the course whether there is a decrease in the symptoms. If these remain the same or even increase further, appendicitis can be assumed and surgical therapy is usually required.

The symptoms of appendicitis in children therefore correspond to those of appendicitis, but to a lesser extent. In most cases, abdominal pain is the main symptom. This usually occurs diffusely in the middle or upper abdomen and then migrates to the right lower abdomen within a few hours. Symptoms such as nausea and vomiting, constipation, fever or diarrhea can also occur. In addition, a change in behavior in the child is often noticeable. This can, for example, consist in the child being noticeably calm and no longer wanting to run around or play.

Additional information:

  • Appendicitis - symptoms, causes, therapy
  • Duration of appendix irritation

Do jumping and moving make the pain worse?

It is typical of appendicitis in children that the pain is aggravated by hopping and moving. Hopping in particular leads to a particular pain stimulus on the inflamed appendix due to the resulting vibrations in the abdomen.

Movements such as running can also be enough to make the symptoms worse. Often children with appendicitis avoid such movements on their own. A sign of the illness can therefore be that an otherwise very active child suddenly no longer wants to run or jump.

The aggravation of pain caused by hopping and moving is particularly clear in children, in whom the appendix turns over behind the actual appendix. There it rests directly on a large trunk muscle that is tensed when running and hopping, so that these movements trigger pain in appendicitis. Conversely, in a child who can hop on the right leg without discomfort, severe appendicitis can be ruled out with a high probability.

Worsening of symptoms

In most cases, if appendicitis is not diagnosed or treated, there is a risk of symptoms getting worse. The pain in the stomach usually increases steadily, so that at some point the child can only lie in a relieving position with legs drawn up.

The inflammatory reaction can also cause the appendix to break through into the free abdominal cavity. Paradoxically, this first manifests itself in a sudden relief of pain. In the further course, without treatment, increasing, diffuse pain occurs again throughout the abdomen. In addition, the general condition of the child can worsen, making them apathetic or even unconscious.

In the worst case, appendicitis that is not treated in good time can be fatal even in an otherwise healthy child. A doctor should therefore be consulted at the latest if symptoms such as abdominal pain worsen over the course of the day.

Also read: Ruptured appendix

What symptoms do I have to see a doctor with?

It is not always easy to estimate which symptoms you should see a doctor with a child. With appendicitis, abdominal pain is usually the main focus. If the child suffers from abdominal pain and it does not subside or even increases steadily, appendicitis should be considered.

If the child also has a fever, reports nausea or even vomits, a visit to the doctor is recommended. Even if only a harmless gastrointestinal flu could be present, a possible appendicitis can be detected in good time by the examination of the doctor.

It is also advisable to see the child with the doctor if the child exhibits other behaviors that are unsettling, such as loss of appetite, fatigue or extreme restlessness. In some cases, especially in very young children, appendicitis is difficult to recognize because the typical symptoms such as pain in the lower abdomen are missing or cannot be specified.

Also interesting: Tests to detect appendicitis