Does Appendicitis Cause Diarrhea? Gastroenterologist Explains.

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Does appendicitis cause diarrhea? And how is it common?

Diarrhea and bowel irregularity can be early symptoms of appendicitis. However, the initial symptoms of appendicitis (such as diarrhea) are not specific and aren’t present in all cases.

In a 1997 study on children with appendicitis, 33% had diarrhea with appendicitis (reference).

Another more extensive 2007 study found that diarrhea was a symptom of early appendicitis in 16% of patients (reference)

Early appendicitis is challenging to diagnose. In addition, the presence of diarrhea in the early stages of appendicitis will make the diagnosis even harder.

The symptoms of gastroenteritis and appendicitis are essentially the same in the early stages.

Moreover, early appendicitis can be even difficult to detect by abdominal ultrasonography, making it difficult for your doctor to diagnose it.

Differences between appendicitis diarrhea and gastroenteritis diarrhea.

In both children and adults, it can be challenging to differentiate in the early stages of appendicitis.

Over time, the symptoms of appendicitis begin to develop (the pain increases, and it becomes localized with severe tenderness in the lower right abdomen). Therefore, time can be your only way to confirm that diarrhea is due to appendicitis.

The following are the main differences (reference):

Appendicitis diarrhea (early stage)
Enteritis diarrhea
1. Abdominal pain Location
around umbilicus then shifts to the right.Anywhere, mainly in the lower central abdomen
2. Improvement of pain after defecation
NoYes (partial or complete)
3. Nausea onset
After the onset of pain.Before the onset of pain
None or slightNone or slight
Pain on touching the abdomen (tenderness)
May not present around the umbilicus in the early stages.Mild or none.
in <50% of cases (children)in >50% of patients (children)
Abdominal pain progression

-Increases over time

-becomes more localized (lower right)

starts severe and often decreases over time.
White blood cell count
10000″}”>often > 10000Often < 10000

What are the earliest symptoms of appendicitis?

Appendicitis is difficult to diagnose in its early stage. You and your doctor can miss appendicitis diagnosis, especially if there is diarrhea.

We will discuss the symptoms of early appendicitis in detail to help you differentiate the cause of diarrhea.

1. abdominal pain:

Abdominal pain is the most common symptom of appendicitis; it occurs nearly 100% of the time. If you have diarrhea without abdominal pain, appendicitis is unlikely.

Abdominal pain is the first sign of appendicitis (it proceeds diarrhea most of the time).

Appendicitis pain commonly starts around the umbilicus by can be anywhere in your abdomen (upper abdominal, lower right abdomen, or the upper right abdomen  (reference).

As time passes and inflammation increases, the pain often becomes more constant and severe. It tends to localize in the lower right abdomen.

2. Other early non-specific symptoms of appendicitis:

  • Indigestion (dyspepsia).
  • Flatulence (Distension, passing gas).
  • Irregular bowel movements (diarrhea or constipation).
  • Generalized malaise (body aches and fatigue).
  • Sometimes, mild fever.
  • Nausea and vomiting (often follows the pain).


Can chronic appendicitis cause diarrhea?

Chronic appendicitis is a rare and difficult-to-diagnose condition. Some refer to the recurrent mild appendicitis pain that comes and goes as (relapsing appendicitis).

Until nowadays, there is no clear scientific evidence of chronic appendicitis (reference).

So, recurrent lower right abdominal pain with diarrhea can be a sign of functional bowel disease such as IBS rather than chronic appendicitis.

If you have chronic or recurrent diarrhea and lower right abdominal pain, It is better to discuss the issue with your doctor.

With the help of investigations (imaging and laboratory tests), your doctor is the only person who can tell you if you have appendicitis or it is just a functional bowel disease. 

Does appendicitis diarrhea has a specific color?

Diarrhea can occur in a subset of appendicitis patients. However, no specific color or severity of diarrhea can predict appendicitis.

Severe or watery yellow diarrhea can occur with gastroenteritis as well as appendicitis. However, it is not a specific sign for appendicitis unless severe lower right abdominal pain and tenderness.

Bloody diarrhea is not usual for appendicitis. If you have bloody diarrhea is better to call your doctor to figure out the cause. Common causes are dysentery, and anal fissures, and IBD.