Your appendix is on the right side, in the lower right part of your belly, near where the small intestine joins the large intestine. Appendicitis pain usually starts around the belly button and then moves down to that lower right spot, where it gets sharper and easier to point to. But the pain doesn’t always follow that pattern, and in some people it shows up somewhere else.
Appendicitis is a medical emergency. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that if you think you or your child might have it, you should see a doctor or go to the emergency room right away. A burst appendix can cause a life-threatening infection inside the belly. If you think it’s an emergency, call 911.
The video above describes the typical pattern of appendicitis using a child as the example: pain first around the belly button, then nausea and vomiting an hour or two later, then, an hour or two after that, pain that moves down to the lower right side, where the appendix is. The video calls that progression very suggestive of appendicitis, while noting that appendicitis can come in many different forms. For the full guide to symptoms, tests and treatment, see Appendicitis Symptoms Explained.
Where is your appendix?
The appendix is a small, finger-shaped pouch that hangs off the large intestine. NIDDK places it in the lower right part of the abdomen. Cleveland Clinic describes it as sticking out from the lower right end of the large intestine and notes that nobody knows for sure what it does.
What side is your appendix on: left or right?
Right. All of the sources we used place the appendix, and the typical pain of appendicitis, on the lower right side of the belly. That said, Cleveland Clinic points out that some people with appendicitis feel pain somewhere other than the lower right belly. Pain on another side doesn’t rule it out, especially if it keeps getting worse.
What is McBurney’s point?
McBurney’s point is the spot doctors use to mark the most typical location of the appendix. Cleveland Clinic explains how to find it: imagine a line from the bony bump at the front of your right hip to your belly button. McBurney’s point is about two inches along that line from the hip bone, or about one-third of the way.
MedlinePlus says appendicitis pain tends to settle at McBurney’s point, which sits directly over the appendix. Tenderness there is one of the first things a doctor checks.
Where is appendix pain felt?
The pain often moves as appendicitis gets worse:
| Stage | Where it usually hurts | What the sources say |
|---|---|---|
| Early | Around the belly button or in the upper middle belly | Often vague at first. MedlinePlus says it may start minor and become sharper. |
| Later | Lower right belly, near McBurney’s point | MedlinePlus says this shift most often happens 12 to 24 hours after the illness starts. NHS says it usually moves after a few hours. |
| If the appendix bursts | Spreads across the whole belly | NHS says the pain may ease briefly, then become severe and spread across the belly. |
Cleveland Clinic describes the same shift: the pain around the belly button may hover or come and go for several hours, then moves to the lower right belly, where it becomes more focused and keeps getting worse. It also says only about half of people with appendicitis have this classic pattern, so a different pattern doesn’t mean you’re in the clear.
What does appendix pain feel like?
Sources describe appendicitis pain this way:
- It can start suddenly. NIDDK says it may wake you from sleep and may feel different from any pain you’ve had before.
- It gets worse over time. It may start mild and turn sharp and severe. NIDDK says it can worsen in a matter of hours.
- Movement makes it worse. Walking, coughing, sneezing, deep breaths and sudden movements can all make it hurt more.
- Pressing hurts, and letting go can hurt more. Pain that’s worse when pressure is released is called rebound tenderness. NHS says pulling your knees up to your chest may ease the pain a little.
Other symptoms often come with it: loss of appetite, nausea or vomiting, a low fever, constipation or diarrhea, trouble passing gas and a swollen belly. For a closer look at how fast these show up, see Appendicitis timeline: how fast it progresses.
When appendix pain shows up in a different spot
The appendix doesn’t sit in exactly the same place in everyone, and that changes where the pain is felt. American Family Physician, a journal of the American Academy of Family Physicians, notes that the variable location of the appendix causes variations in symptoms, which makes diagnosis harder, especially in pregnancy.
- During pregnancy. The American College of Surgeons says the appendix sits higher in the abdomen during pregnancy, so the pain may seem to come from the upper belly. The Merck Manual adds that pain may be less severe and the area less tender.
- Appendix behind the colon. When the appendix lies behind the colon (doctors call this retrocecal), Cleveland Clinic says it can irritate a hip muscle called the psoas, so moving the hip may hurt.
- Children. The Merck Manual says pain in children may be spread across the belly rather than in the lower right. NIDDK notes that children may have none of the typical symptoms.
- Older adults. Pain may be less severe and the belly less tender, according to the Merck Manual. NHS adds that older people may have sudden confusion.
Appendix pain location in women
In women, the appendix sits close to the ovaries, fallopian tubes and uterus. Cleveland Clinic notes that this closeness means appendicitis symptoms can resemble pelvic conditions, and MedlinePlus says appendicitis can be hard to detect in women of childbearing age. Right-sided pain in a woman can also come from an ovarian cyst, a twisted ovary or an ectopic pregnancy, all of which need prompt care too. We cover this in Appendicitis symptoms in women.
Other causes of lower right belly pain
Not every pain in the lower right belly is appendicitis. Cleveland Clinic and NHS list conditions that can cause similar symptoms, including:
- urinary tract infection or kidney stones
- gallstones, gastroenteritis (stomach bug) or a blocked intestine
- inflammatory bowel disease, such as Crohn’s disease, or irritable bowel syndrome
- diverticulitis or pancreatitis
- pelvic inflammatory disease, endometriosis, an ovarian cyst or an ectopic pregnancy
MedlinePlus notes that pain in one spot is more likely to come from a problem in an organ, such as the appendix, gallbladder or stomach. You can’t sort these out at home. A doctor uses an exam, blood and urine tests, and often an ultrasound or CT scan.
Go to the ER if
Get medical help right away, or call 911, if you have:
- belly pain that started around the belly button and moved to the lower right side
- belly pain that keeps getting worse, or is worse when you move, cough or walk
- sudden, sharp belly pain
- a belly that is rigid, hard or very tender to the touch
- vomiting and you can’t pass stool
- vomiting blood or blood in your stool
- trouble breathing
- belly pain while pregnant, or when you could be pregnant
NHS advises not driving yourself if the pain is severe. Call 911 or have someone take you. Don’t take medicine for belly pain without checking with a health care provider first.
Frequently asked questions
Where is appendix pain in females?
In the same place as in males: usually around the belly button at first, then the lower right belly. Because the ovaries and fallopian tubes are close by, appendicitis in women can be confused with pelvic problems. During pregnancy, the pain may seem higher up in the belly.
What does appendix pain feel like at first?
Often a vague pain or ache around the belly button or upper middle belly. It may be mild at first, then get sharper and move to the lower right side. Some people say it feels unlike any pain they’ve had.
Is appendix pain constant?
It usually becomes constant and keeps getting worse. Cleveland Clinic says early pain around the belly button may come and go for several hours before it moves and settles in the lower right belly.
Can appendix pain be on the left side?
The appendix is on the right, and typical appendicitis pain is on the lower right. Cleveland Clinic notes some people feel pain somewhere else. If you have worsening belly pain on either side, get checked.
How do I check my appendix at home?
You can’t diagnose appendicitis at home. Pain that’s worse when you move, cough or jump is a warning sign (see the jump test), but no home check can rule it out. If you think it might be appendicitis, see a doctor or go to the ER.
Find a doctor
If you think you have appendicitis, go to the emergency room; don’t wait for an office appointment. An appendectomy is done by a general surgeon. General surgeons on Best Docs Network include Dr. Jason Harrison, Dr. Robert Santaella and Dr. Robert Pollard, all in Dallas-Fort Worth.
Sources
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, NIH): Definition & Facts for Appendicitis
- NIDDK: Symptoms & Causes of Appendicitis
- NIDDK: Diagnosis of Appendicitis
- MedlinePlus (National Library of Medicine, NIH): Appendicitis
- MedlinePlus: Abdominal pain
- Cleveland Clinic: Appendicitis
- NHS: Appendicitis
- Merck Manual Consumer Version: Appendicitis
- American College of Surgeons: Appendectomy
- American Family Physician (American Academy of Family Physicians): Acute Appendicitis: Efficient Diagnosis and Management (2018)
This article is for general information only and is not medical advice. Talk with a qualified health professional about your own situation. If you think you may have a medical emergency, call 911.
