Does My Child Have an Upset Stomach or Appendicitis?

You’re driving back from a family outing and each time your car rolls over the neighborhood speed bumps your youngest child cries out. When you ask what’s wrong, they whimper and struggle to explain. Then you recall how earlier that day when the kids were playing outside, your child abruptly stopped and complained of a sore belly. Is it an upset stomach or could these complaints point to something more serious – like appendicitis? 

There’s no known prevention for appendicitis, which is an inflammation of the appendix. A tubular structure connected to the first part of the large intestine, the appendix itself is shrouded in mystery because its purpose or function is unknown. As to why appendicitis occurs, research suggests a small stool ball may become lodged in the appendix, causing blockage and inflammation.

Appendicitis is a medical emergency because if the blockage isn’t treated, the appendix can burst and spread infection elsewhere. Even though it can happen to anyone, appendicitis most often strikes younger people, ages 10 to 30, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Treatment usually requires removing the appendix.

Upset Stomach vs. Appendicitis

How to tell whether your child has an upset stomach or appendicitis can be challenging — and even more so, the younger the child is. The signs and symptoms of appendicitis in children and adults are similar, but an older child or teenager can more clearly describe their discomfort. Often, your child may complain of “belly pain” when appendicitis first begins and may even wake up because of the pain. A classic case will start around the belly button — but the difference will be that their belly pain continues to worsen over 24 to 48 hours, rather than letting up or going away. The pain may worsen with movement such as walking, jumping, laughing, coughing or sneezing. 

Other tell-tale signs of appendicitis include: 

• Abdominal swelling

• Low fever

• Loss of appetite

• Nausea and vomiting

• Inability to pass gas

• Constipation or diarrhea

In children, fever and pain that begin in the middle and move to the right side of the body, are two of the most valuable indicators of appendicitis, according to the National Institutes of Health. Other symptoms such as vomiting and appetite loss may occur as well, but vary among patients. 

What If I Think My Child Has Appendicitis?

Call your pediatrician right away or bring your child to the emergency department for evaluation if you think they may have appendicitis. The medical team will gather a history on your child, which may include: 

• A physical exam to evaluate your child’s abdomen

• Labs to check white blood cell count, which are typically elevated with appendicitis

• Imaging such as ultrasound or computed tomography (CT) to better evaluate 

My Child Needs Surgery — What to Expect?

When the appendix is ruptured, this can lead to abdominal infection. Once the appendix is removed, it is sent to a pathologist who also examines it to confirm the diagnosis.

What happens next will depend on the kind of appendicitis your child has: 

• For non-perforated appendicitis, we can send your child home without antibiotics after surgery. Our goal is for them to eat a regular diet and have their pain controlled before leaving the hospital and going home.

• For perforated appendicitis, we usually treat your child for 72 hours with an IV antibiotic therapy. Afterward, we want them to be able to eat a regular diet without vomiting and have bowel movements and improved belly pain while remaining fever-free. 

Symptoms to watch out for post-surgery include worsening belly pain, fevers and pain with urinating or vomiting. If you notice any of these in your child, call your doctor or come to the emergency department right away. 

But most of all, don’t worry about your child’s long-term prognosis. Our bodies work just fine without an appendix. Kids are usually back to their usual activities a week or so following surgery, no lifestyle changes required.