Appendicitis Myths and Facts: Don’t Wait Till It Bursts - Dr Natasha Vaz

Appendicitis has long been associated with the image of a person doubled over in pain, clutching their right lower abdomen and rushing to the emergency room. But the reality is far more nuanced.

Not every case of appendicitis presents as a textbook emergency, and this misunderstanding can lead to dangerous delays in treatment. The belief that one can "wait till it bursts" before taking it seriously is one of the most harmful myths surrounding this common surgical condition.

As a General surgeon, let me walk you through some of the most common myths I hear from patients and the facts behind them.

Myth 1: Appendicitis Always Means Intense Pain on the Right Side

This is the classic image: someone doubled over with pain in the right lower abdomen. While that does happen, it's not always how it starts. Early symptoms are often vague; many people first feel a dull ache around the belly button, general discomfort, bloating, or even mild back pain.

These can be easy to ignore or mistake for something minor like gas or indigestion. Unfortunately, by the time the pain shifts to the lower right side and becomes severe, the appendix may already be inflamed or close to rupturing.

Myth 2: If It’s Not Severe, It Can Wait

I can’t stress this enough: waiting is not a good idea when it comes to suspected appendicitis. The appendix can go from mildly inflamed to ruptured in just 48–72 hours.

A ruptured appendix doesn’t just cause more pain. It releases infection into your abdominal cavity, leading to peritonitis or even sepsis, both of which can be life-threatening. So if you’re unsure whether your symptoms are serious enough, it’s always better to get them checked.

Myth 3: Antibiotics Alone Can Fix It

Yes, there have been some studies exploring antibiotics as a treatment for uncomplicated appendicitis. And in very select cases, they can be used under close medical supervision.

But for the majority of patients, surgery remains the most definitive and safest option. Relying on antibiotics at home without proper diagnosis can lead to complications, especially if the appendix worsens or bursts without you realising it.

Myth 4: It Has to Be Dramatic to Be Dangerous

Another thing I often see is people underestimating their symptoms simply because they’re not in “a lot” of pain. But not everyone experiences appendicitis the same way.

Children, elderly patients, and pregnant women, for example, often present with atypical or subtle signs. That’s why we rely not just on symptoms, but also on clinical exams, blood tests, and imaging like ultrasounds or CT scans to confirm the diagnosis.

Myth 5: Surgery Is Risky, So Delay It If You Can

Modern appendectomy, especially the laparoscopic kind, is a very safe and routine procedure. Catching appendicitis early and removing the appendix before it ruptures means a much smoother recovery.

Delaying surgery makes everything more complicated—longer hospital stays, more medications and a higher risk of infection.

So, when should you come in? Here are some signs I tell my patients to look out for:

● Abdominal pain that starts near the belly button and moves to the right lower side

● Pain that gets worse with movement, coughing, or pressing

● Loss of appetite

● Nausea or vomiting

● Low-grade fever

● A sense that something just “feels wrong”

Even if it doesn’t seem serious at first, trust your gut. If the symptoms persist or evolve, don’t wait it out, come see a doctor.

A Word on “Silent” Appendicitis:

There’s also a less common form we call chronic or “smouldering” appendicitis. It causes on-and-off discomfort that can last for weeks. It’s often misdiagnosed as indigestion or irritable bowel syndrome.

But even this low-grade inflammation can progress and cause trouble later. If you’ve had repeated episodes of unexplained abdominal pain, it’s worth getting checked out.

To conclude, I would want everyone to remember: Don’t wait for your appendix to burst. Appendicitis isn’t always dramatic. Sometimes, it whispers before it shouts. And in surgery, we’d much rather operate early and easily than deal with complications from a rupture.

So if you or someone you care about has abdominal symptoms that don’t feel right, don’t ignore them. Get a proper evaluation. It could save you a lot of pain—and in some cases, even save your life.

Disclaimer: The views expressed in this article are of the author and not of Health Dialogues. The Editorial/Content team of Health Dialogues has not contributed to the writing/editing/packaging of this article.