Chart — Gastrointestinal
Appendicitis vs Diverticulitis Chart
Mirror images on opposite sides of the abdomen: RLQ inflammation in the young (appendicitis) and LLQ inflammation in older adults (diverticulitis). Both inflame, both can perforate — and both forbid laxatives and enemas while acute.
Educational use only. Imaging confirms; presentations vary (and a long appendix can present atypically). Correlate with the full picture. This material supports nursing education and exam review. It is not medical advice and is not a substitute for clinical judgment, institutional policy, or medical direction. Always follow facility protocols and current provider orders.
Side by Side
| Feature | Appendicitis | Diverticulitis |
|---|---|---|
| Pain location | RLQ (McBurney's point); often starts periumbilical and migrates | LLQ ('left-sided appendicitis') |
| Typical age | Adolescents and young adults | Older adults (low-fiber, diverticulosis history) |
| Hallmark signs | Rebound, Rovsing's, psoas, obturator; anorexia, low-grade fever | LLQ tenderness, fever, change in bowel habit, possible palpable mass |
| Diet / management | NPO → appendectomy + antibiotics | Bowel rest (clears → low-fiber) + antibiotics; high fiber to PREVENT (not during a flare) |
| Complications | Rupture → peritonitis, abscess | Perforation/peritonitis, abscess, fistula, obstruction, bleeding |
| Don't | No heat, no laxatives/enemas pre-op | No laxatives/enemas in an acute flare |
Exam Traps
- ✦RLQ + young + migrating pain = appendicitis; LLQ + older + fever = diverticulitis.
- ✦Appendicitis is usually surgical (appendectomy); uncomplicated diverticulitis is usually medical (bowel rest + antibiotics).
- ✦Diverticulitis fiber rule flips: high fiber PREVENTS, bowel rest TREATS the flare.
- ✦Neither gets laxatives or enemas while acute — perforation risk.
- ✦Sudden pain relief in appendicitis = rupture → peritonitis.
Related Resources
Standards & sources
Fact-checked Jun 21, 2026This page is written to align with American College of Gastroenterology (ACG) / AGA · ASPEN (nutrition support). It is an educational summary, not a citation of any single document — always verify specific doses, values, and protocols against current guidelines and your facility policy. How we source content →