Each year, appendicitis sends 77,000 children in the U.S. to the hospital. About one-third of them experience a ruptured appendix, a life-threatening complication, before they reach the operating room.

Appendicitis is an emergency. Parents need to know what to look for so they can get medical care right away.

Below, get answers to commonly asked questions from parents:

Q: What is appendicitis?

A: The appendix is a small finger-shaped tube (with no known function) connected to the large intestine and located in the lower right side of the belly. If the appendix gets infected, it’s called appendicitis, which is a surgical emergency that requires prompt diagnosis and treatment.

Appendicitis is rare in infants, more common after age 10, and most common in teens and young adults in their early 20s. After age 15, twice as many boys are affected as girls. Children with a family history of appendicitis may be at greater risk. Children younger than age 4 are at the highest risk for a ruptured appendix, partly because young children don’t have classic symptoms, so diagnosis is easy to miss.

Q: What are the warning signs of appendicitis in children?

A: Children with appendicitis, especially very young children, tend to have different symptoms than adults, making it challenging to diagnose. Also, appendicitis symptoms can be similar to other medical problems so it can be tricky to tell the difference.

One of the most common symptoms of appendicitis in children is abdominal pain. However, belly pain can be caused by many other issues.

Some specific warning signs of appendicitis in children include:

• Mild/low-grade fever
• Belly pain (around the belly button, then may spread to the lower right belly)
• A feeling of pressure/fullness in the belly
• Pain in the belly may come and go at first, then grow intense and steady
• Loss of appetite
• Nausea, vomiting
• Constipation
• Gas pain
• Diarrhea (small amounts with mucus)

If you have any concerns at all, call your child’s doctor. If your child develops a high fever (104°F) and/or if belly pain gets worse and moves to the lower right side, get immediate medical attention as it could mean a ruptured appendix.

Q: What should I do if I think my child is having appendicitis?

A: If you suspect appendicitis, call your child’s doctor right away for next steps. You may need to have your child examined by their primary doctor, or the doctor may refer you to an Immediate Care Center or the Emergency Department. Don’t offer your child anything to eat or to drink and only give medications that are recommended by your primary doctor. This is important in case surgery is needed.

When you get to the ER, the doctor will likely perform a physical exam. This exam is the most important part of what your child needs. Abdominal pain is part of many benign everyday illnesses that do not require tests or surgery. If the doctor suspects appendicitis is part of the differential diagnosis, he/she will recommend a variety of tests, such as: blood work (to check white blood cell count), a urine test (to rule out a urinary tract infection), X-rays, ultrasound, CT scan and/or other tests. Appendicitis can be difficult to diagnose so your child’s doctor may wait to schedule an appendectomy until symptoms have progressed.

Q: What does an appendectomy involve?

A: An appendectomy involves surgically removing the infected appendix. The surgeon will typically use a laparoscope to remove the appendix through a small cut on the belly. Your child will probably need to stay in the hospital for at least two days. A child with a ruptured appendix might need to stay in the hospital longer. Your child will likely receive antibiotics to kill any bacteria that spread into the body.

Q: What makes the appendix burst? Is there any way to prevent it?

A: When the appendix gets blocked, bacteria can grow and cause an infection. Some things that might block the appendix are hard stool, swollen lymph nodes in the intestines, parasites and other infections. An infected appendix must be treated in the hospital with antibiotics and surgery. If it isn't, the appendix can burst about 48-72 hours after symptoms first start. A ruptured appendix can spread bacteria inside the abdomen, which is serious.

There is no way to prevent appendicitis. The most important thing for parents to remember is to get your child the right medical care quickly.

Some ways for children to maintain gastrointestinal health include:

• Eating a high-fiber diet.
• Having regular meal times.
• Drinking plenty of water (at least 8 cups a day).
• Getting regular exercise.
• Chewing food slowly and thoroughly before swallowing.
• Not smoking.
• Not holding bowel movements or straining during them.

Learn more about Jennifer McNulty, M.D., pediatric emergency medicine physician and System Medical Director, Pediatrics for Edward-Elmhurst Health.

Open around the clock, Edward-Elmhurst Health’s fully-equipped kid-friendly Emergency Departments (EDs) in Naperville and Elmhurst, and a freestanding emergency center in Plainfield, provide specialized emergency care focused on the unique needs of children.

Learn more about our pediatric emergency care and check our ED wait times.

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