Abdominal Pain: Is it IBS or Appendicitis?

  • IBS and appendicitis can cause similar symptoms.
  • The only differentiating factor is the location of the pain.
  • Appendicitis can be life-threatening. 

Irritable bowel syndrome (IBS) can cause severe pain that may sometimes mimic appendicitis. Patients and even doctors sometimes have a tough time differentiating the two conditions based on symptoms alone.

But there still are ways to determine if your abdominal pain is caused by IBS or an inflamed appendix.

What Is Appendicitis?

Appendicitis is a condition marked by an inflamed appendix filled with pus. The condition may occur due to an obstruction caused by fecal matter, a swollen lymph node, a foreign object, or even a tumor.

When you have appendicitis, you need immediate appendectomy to remove your appendix to prevent it from bursting and putting your life in danger.

A ruptured appendix can lead to a lethal infection known as peritonitis when the content of your appendix spills into your abdominal cavity. Appendectomy is the ultimate treatment for a ruptured appendix, but you may also need to be on antibiotics to prevent postoperative infection.

Symptoms of Acute Appendicitis

You can tell if someone has acute appendicitis and needs immediate medical attention through the following symptoms:

  • Abdominal pain that is abrupt and centered around the belly button.
  • Pain that moves to the lower right part of your abdomen
  • Pain that worsens with movement or coughing
  • Appetite loss
  • Nausea
  • Vomiting
  • Low fever
  • Chills

IBS vs. Appendicitis

One of the main clues that you have appendicitis is that the abdominal pain moves from the navel to the abdomen’s right lower quadrant. IBS usually causes pain that is centered in the middle of the abdomen.

Risk of Unnecessary Surgery

Acute appendicitis can cause severe complications, so most surgeons usually perform an appendectomy on anyone with appendicitis symptoms. However, this has led to a15% rate of “negative appendectomy,” or removing a non-inflamed appendix. 

Because of the similar symptoms of appendicitis and IBS, people with IBS tend to be at a higher risk for negative appendectomies. According to research, this may be because IB patients tend to seek treatment and be more anxious about their symptoms than those without.

“Chronic Appendicitis”

IBS is a chronic condition, which means that people who have it may experience acute outbreaks of symptoms, but live with the disease on an ongoing basis. Appendicitis, on the other hand, is acute. 

However, a small group of scientists says that some people have chronic appendicitis, recurrent appendicitis, appendicopathy syndrome, or neurogenic appendicopathy. However, their idea is not widely recognized among medical professionals. 

The theory is that appendicitis is related to the partial or intermittent blockage in the appendix.

And if there is such a condition as chronic appendicitis, the symptoms could very well mimic IBS symptoms since both conditions involve recurrent abdominal pain that often gets worse after a large meal, chronic diarrhea, and/or constipation. 

The only difference may be that in chronic appendicitis, the recurring pain is in the abdomen’s lower right corner.

Telling the Difference

With the high rate of negative appendectomy among IBS patients, most experts warn against an appendectomy for IBS patients unless symptoms point to acute appendicitis. A series of tests will be done to confirm an appendicitis diagnosis, including:

  • A physical exam, including palpation and a digital rectal exam (DRE)
  • Blood tests to check for infection
  • Urine tests to make sure o rule out urinary tract infection or kidney stones
  • Imaging tests

If the doctors suspect IBS, they will recommend colonoscopy or endoscopy to check for lactose intolerance and bacterial overgrowth.


Appendicitis symptoms and their severity can vary dramatically in individuals. If you think you have appendicitis, call your doctor immediately. 

A ruptured appendix can cause persistent pain and a tender stomach. While the pain may subside, it will re-emerge along with other appendicitis symptoms, but they may worsen.

Source: Very Well Health

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