Appendicitis Vs. Diverticulitis: Causes, Symptoms, and Treatment

Medically reviewed by: Gary H. Hoffman, MD

If you experience sharp pain in the lower abdomen along with fever, nausea, and vomiting, the two most common culprits for your condition would be appendicitis or diverticulitis.

But what exactly is the difference between these two health conditions?

Keep on reading to find out!

What is Appendicitis?

In simple words, appendicitis is inflammation of the appendix — a finger-like outpouching that projects from the lower right part of your large intestine.

It can cause sharp pain that can occur anywhere in your abdomen but most commonly originates around the navel and migrates to the lower right side of your abdomen. As the inflammation progresses, the pain typically worsens and eventually becomes very severe.

What Causes Appendicitis?

In most cases, the exact cause of appendicitis isn’t known. However, many experts believe it develops when the appendix becomes blocked or obstructed.

A few potential causes of a blocked appendix include:

  • Abdominal trauma or injury
  • Accumulation of hardened stool
  • Digestive tract infection
  • Enlarged lymphoid follicles
  • Intestinal worms
  • Inflammatory bowel disease
  • Tumors or abnormal outgrowths inside the appendix

Lastly, although appendicitis can affect anyone, some people are more likely to develop this condition than others.

Some risk factors for developing appendicitis include:

  • Age. Appendicitis can occur at any age but it most commonly occurs in individuals between 10 to 30 years of age.
  • Sex. Males usually have a higher likelihood of developing appendicitis than females.
  • Family history. Individuals with a family history of appendicitis are at a greater risk of developing the condition.

What are the Symptoms of Appendicitis?

Initially, appendicitis pain presents as “mild cramping” in your abdomen near your belly button. The pain then shifts to the lower right area of your abdomen — where your appendix is located — and gets much more intense a few hours after onset.

The pain usually:

  • Appears suddenly
  • Increases in intensity when you cough, inhale deeply, or move
  • Is intense enough to wake you up or prevent you from sleeping
  • Is more severe and different from any other type of abdominal pain you’ve experienced before
  • Worsens in a matter of hours

Apart from abdominal pain, other signs and symptoms also commonly seen in appendicitis include:

  • Low-grade fever
  • Indigestion
  • Vomiting
  • Nausea
  • Abdominal bloating and swelling
  • Loss of appetite
  • Constipation or diarrhea
  • Inability to pass gas

Call your doctor immediately if you have pain in the right lower area of the abdomen and any other classic symptoms of appendicitis. An inflamed appendix can quickly become a life-threatening medical emergency!

Lastly, it’s important to note that the site of your pain may vary slightly depending on the position of your appendix and age.

For instance, when you’re pregnant the pain may appear to come from higher up in the abdomen because of the baby pushing on the appendix.

How is Appendicitis Treated?

Most people with appendicitis will need to undergo a surgery called an appendectomy. This procedure involves the removal of the inflamed appendix from the body.

Before surgery, you may receive some intravenous (IV) antibiotics to limit and treat the infection. And some mild cases of appendicitis might even get better with antibiotic treatment alone.

But more often than not, you will need to undergo surgery, especially if your appendix has ruptured.

Appendectomies can be performed using one of the two methods outlined below:

  • Laparoscopic appendectomy: Nowadays, most appendectomies are performed laparoscopically. Laparoscopic surgery is similar to robotic surgery, and creates small holes in your abdomen to insert surgical tools and a narrow scope with a camera and light. This approach is minimally invasive and allows patients to recover faster, with less scarring and pain.
  • Open appendectomy: This method involves making a cut in the abdomen to open it up. This “open” approach is usually used when an inflamed appendix has burst and infected the surrounding parts of the abdomen.

Now that you know what appendicitis is, let’s discuss diverticulitis and how it’s different from appendicitis.

What is Diverticulitis?

Diverticula are small pouches or sacs that form inside the walls of the digestive tract. These sacs are often found in the colon (large intestine). If these sacs become infected, you get a condition called diverticulitis.

What Causes Diverticulitis?

Although the exact cause of diverticulitis isn’t known, the following factors can increase the risk of developing it:

  • Genetics
  • Diet lacking in fiber and high in animal fats
  • Obesity
  • Constipation
  • Smoking
  • Weakened immunity
  • Lack of physical activity
  • Certain drugs, like steroids, NSAIDs, and opioids
  • Changes in normal gut bacteria

What are the Symptoms of Diverticulitis?

The symptoms of diverticulitis can vary from mild to severe and often include abdominal pain.

But unlike appendicitis, the pain of diverticulitis most commonly occurs in the lower left side of the abdomen and increases in intensity over several days (not hours). Sometimes, however, the pain can also affect the right side of the abdomen.

Some other common signs and symptoms of diverticulitis include:

  • Abdominal bloating
  • Diarrhea
  • Constipation
  • Nausea
  • Vomiting
  • Fever
  • Chills
  • Blood in feces
  • Rectal bleeding

If you experience any of these symptoms along with pain in the left lower abdomen, get in touch with your doctor right away.

How is Diverticulitis Treated?

Once the diagnosis of diverticulitis has been made, it’s treated according to its severity. Some individuals may need to visit the hospital and even undergo surgery. However, most of the time, it can be treated at home.

For mild, uncomplicated diverticulitis, doctors may suggest:

  • Taking antibiotics to clear any bacterial infections.
  • Taking painkillers
  • Following a liquid diet for a few days until your digestive tract heals. You can then gradually add solid foods to your diet once your symptoms improve.
  • Resting in bed and using heating pads on your abdomen.
  • Adding more fiber to your diet after you’re better to prevent future attacks.

For complicated and more severe cases of diverticulitis, you may need to be hospitalized. Treatment at the hospital generally involves:

Lastly, depending on the type of complication, you may also need to have surgery. Surgery for diverticulitis is done if:

  • You have serious complications, such as perforation, bowel abscess, obstruction, or fistula formation in the gut wall
  • You have a positive history of multiple previous attacks of uncomplicated diverticulitis
  • You have a weak immune system

The surgical treatment for diverticulitis includes:

  • Primary bowel resection: Surgeons remove the diseased segments of your bowel and reconnect the healthy parts (anastomosis). Depending upon the degree of inflammation, you may have a minimally invasive laparoscopic or robotic procedure or an open surgery.
  • Bowel resection with colostomy: If your colon is so inflamed that it’s not possible to reconnect the healthy parts, the surgeon will have to perform a colostomy. This involves making an opening (stoma) in the skin of your abdomen, which is connected to a healthy segment of your colon. This allows waste matter to pass through the stoma into a bag. Once the inflammation has settled, the colostomy may be reversed and the intestine rejoined.

Now you Know the Difference Between Appendicitis and Diverticulitis!

Appendicitis occurs when the appendix (a specific structure attached to the right side of the large intestine) gets inflamed. On the other hand, diverticulitis is the inflammation of diverticula, which are abnormal pouches that form in the large intestine.

Although both conditions have different risk factors, they can both cause abdominal pain. The pain of appendicitis is usually located in the right lower side of the abdomen, and worsens in a matter of a few hours.

On the other hand, the pain of diverticulitis is usually located in the left lower side of the abdomen, and worsens in a matter of a few days.

Finally, the treatment of appendicitis is usually surgery, where the inflamed appendix is removed from the body. In contrast, diverticulitis can be treated with drugs and bowel rest in mild cases. If complications arise, surgery may be required.