If you want to understand the 4 stages of appendicitis, you’re in the right place. Appendicitis is one of those medical emergencies that can start with mild belly pain but quickly turn into a life-threatening condition if not treated in time. Knowing the stages helps you recognize symptoms early and take action fast.
In this guide, I’ll explain the four stages, symptoms, causes, diagnosis, and when to rush to the hospital — in a simple and clear way.
What Is Appendicitis?
Appendicitis is the inflammation of the appendix — a small tube-shaped organ attached to the large intestine.
When the appendix gets blocked or infected, it starts swelling and filling with pus.
If not treated early, it can burst and spread infection inside the abdomen.
The 4 Stages of Appendicitis
Appendicitis develops step-by-step, progressing from a mild inflammation to a dangerous rupture. Here are the four stages you must know:
1. Stage 1: Early Appendicitis (Simple or Catarrhal Appendicitis)
This is the first and mildest stage. The appendix becomes swollen due to blockage or infection, but it hasn’t burst yet.
Symptoms in Stage 1
- Mild stomach pain (around the belly button)
- Low-grade fever
- Nausea
- Loss of appetite
- Slight discomfort on the right side of the abdomen
What’s happening inside the body
- The appendix lining gets inflamed.
- Mucus builds up inside.
- Pain is mild and may come and go.
Treatability
This stage is highly treatable.
Doctors may manage it with antibiotics, but surgery (appendectomy) is often recommended to prevent complications.
2. Stage 2: Suppurative Appendicitis (Pus Formation)
This is where things start getting worse. Infection increases, and pus begins to fill the appendix.
Symptoms in Stage 2
- Sharp pain on the lower right side of the abdomen
- Fever increases
- Vomiting or constant nausea
- Pain gets worse when walking or coughing
- Bloating
What’s happening inside the body
- Infection spreads deeper into the appendix.
- Pus starts collecting.
- Pressure builds up, making the pain sharper.
Treatability
Medical treatment is still possible, but surgery is usually necessary to prevent the next dangerous stage.
3. Stage 3: Gangrenous Appendicitis
If left untreated, the appendix’s blood supply gets blocked. This causes the tissue to die — known as gangrene.
Symptoms in Stage 3
- Severe, constant abdominal pain
- High fever
- Rapid heartbeat
- Weakness or dizziness
- Pain may temporarily reduce (dangerous sign)
What’s happening inside the body
- The appendix begins to rot due to lack of blood supply.
- Toxins leak out, increasing the risk of rupture.
Important: If pain suddenly becomes less, it may mean the appendix is about to burst — this is a medical emergency.
Treatability
Surgery is the only option now.
Delaying increases the risk of rupture within hours.
4. Stage 4: Perforated or Ruptured Appendicitis
This is the most dangerous stage. The appendix bursts, releasing bacteria and pus into the abdomen.
Symptoms in Stage 4
- Sudden sharp pain followed by temporary relief
- High fever
- Severe abdominal swelling
- Inability to pass gas or stool
- Extreme weakness
- Vomiting
- Severe infection (peritonitis)
What’s happening inside the body
- The appendix has ruptured.
- Infection spreads throughout the abdominal cavity.
- Abscesses may form.
Treatability
Emergency surgery is required.
Patients often need:
- IV antibiotics
- Drainage of abscess
- Longer hospital stay
If untreated, it can lead to sepsis, which is life-threatening.
Causes of Appendicitis
The blockage of the appendix usually triggers appendicitis. Common causes include:
- Hard stool (fecalith)
- Swollen lymph nodes due to infection
- Parasites
- Digestive tract infection
- Ulcers
- Trauma to the abdomen
How Doctors Diagnose Appendicitis
To confirm appendicitis, doctors may use:
1. Physical examination
- Pressing the abdomen
- Checking for rebound tenderness
2. Blood tests
To detect infection or high white blood cells.
3. Urine test
To rule out urinary infections or kidney stones.
4. Ultrasound
Safe and commonly used.
5. CT Scan
Most accurate for diagnosing appendicitis.
Treatment Options for Appendicitis
Treatment depends on the stage:
Early Stages
- IV antibiotics
- Observation
- Surgery (appendectomy)
Advanced Stages (gangrene or rupture)
- Emergency surgery
- Drainage of infected fluid
- Long-term antibiotics
When to See a Doctor Immediately
Go to the hospital if you experience:
- Severe lower right abdominal pain
- Pain that gets worse quickly
- High fever
- Vomiting + abdominal pain
- Belly becomes hard or swollen
- Sudden pain relief (danger of rupture)
Appendicitis can worsen within 24–72 hours, so don’t wait.
Complications of Delayed Appendicitis
Delaying treatment can cause:
- Appendix rupture
- Blood infection (sepsis)
- Abdominal abscess
- Peritonitis
- Intestinal blockage
These can be life-threatening.
Final Thoughts on the 4 Stages of Appendicitis
Understanding the 4 stages of appendicitis helps you recognize how fast the condition can get dangerous. Early detection and treatment are the key to preventing complications like rupture or infection. If you ever experience sharp right-side abdominal pain, don’t wait — get medical help immediately.