All of us experience this misfortunate of an upset stomach. Still, we each contend with bouts of abdominal pain, diarrhea, vomiting, or constipation (gross maybe, but true!). But do you know how to tell if it’s a common stomachache or appendicitis?

Appendicitis is not very common – with only about 5 percent of the U.S. population developing the condition. Those who have will tell you just how painful an inflamed appendix can be. (If this includes you, please feel free to share your story by leaving a comment below!)

Appendicitis is also a severe condition. Jennifer Caudle, D.O., a family physician, and professor of medicine says:

“If it is not treated, your appendix can rupture, which can be life-threatening.”

With that said, here are 5 signs of possible appendix troubles you shouldn’t ignore:

“In the United States, appendicitis is the most common cause of acute (short-term) abdominal pain requiring surgery. Over 5% of the population develops appendicitis at some point.” ~ National Institute of Diabetes and Digestive and Kidney Diseases

Indeed, not every case of appendicitis leads to a ruptured appendix, delaying medical assistance significantly increases this risk.

1. It feels like the worst stomach pain of your life.

No, this isn’t an exaggeration. Appendicitis can feel like the worst stomach pain of your life.

Usually, this pain expands from the belly button to the lower-right side of the abdomen. (The appendix is a 3.5-inch tube that lies in the lower-right section of the large intestine.) When pain surfaces in this area, the abdominal wall may be inflamed.

Prolonged, severe stomach pain is never a good sign. Whether or not it’s appendicitis, it’s essential that you seek medical attention.

2. You have no appetite, or are nauseous and throwing up. 

Dr. Dan Gingold, an emergency physician at Mercy Medical Center in Baltimore, Maryland, states “Inflammation of the appendix sometimes impacts other aspects of the GI tract … and leads to nausea and vomiting.”

Not everyone with appendicitis experiences these symptoms, but experiencing abdominal pain while feeling nauseous and throwing up necessitates a visit to the emergency room.

3. You’ve got a nasty case of brain fog.

Appendicitis can affect the nervous system, which may lead to foggy thinking, confusion, and fatigue. Lack of focus, poor memory, and diminished cognitive abilities are the primary signs of brain fog.

Dr. Gingold explains the brain fog effect: “It’s not that anything is going on in the brain – just that the infection is getting worse and expending a lot of body resources including oxygen, so the brain doesn’t get enough and doesn’t work normally.”

4. You’re shaking all over while running a fever. 

The presence of both chills and fever indicates there’s inflammation somewhere in your body. Chills and fever while feeling severe pain in the abdomen may point to appendicitis.

Cedrek McFadden, M.D., a board-certified GI surgeon at the University of South Carolina School of Medicine, says when experiencing appendicitis, “the body responds by releasing several chemicals that ring the alarm and bring fighter cells to the area, which can manifest as localized pain as well as whole-body symptoms like fever and chills.”

5. You’re going to the bathroom every couple of minutes – and it hurts.

For some people, the appendix is situated right next to the bladder in the lower abdomen; as such, inflammation of the appendix can both inflame and irritate the bladder, resulting in the need to pee – and then pee again.

Not only do you have to pee a lot, but it hurts when you go. The only two possible explanations are a urinary tract infection (UTI) or appendicitis. Either way, a trip to the hospital is in order.