Effects of Appendicectomy on the Course of Ulcerative Colitis

Overview

Journal Gut

Specialty Gastroenterology

Date 2002 Nov 13

PMID 12427780

Citations 35

Authors

J Cosnes

F Carbonnel

L Beaugerie

A Blain

D Reijasse

J-P Gendre

Affiliations

Soon will be listed here.

Abstract

Background: Appendicectomy reduces the risk of having ulcerative colitis. However, its effect on the natural history of ulcerative colitis remains uncertain.

Aim: To determine whether appendicectomy reduces the overall severity of ulcerative colitis.

Patients And Methods: Appendicectomy status and smoking habits were specified by direct interview in 638 patients seen consecutively between 1997 and 2000. Severity of ulcerative colitis was assessed by reviewing therapeutic needs from the onset of colitis. Additionally, the annual incidence of flare up was assessed prospectively between 1997 and 2000 in patients who had not been colectomised.

Results: The 10 year risk of colectomy was 16 (7)% in previously appendicectomised patients (n=49) compared with 33 (2)% in non-appendicectomised patients (n=589, p=0.05). Cox regression showed that previous appendicectomy and current smoking were independent factors protecting against colectomy (adjusted hazard ratio and 95% confidence intervals: 0.40 (0.20-0.78) and 0.60 (0.40-0.95), respectively). The respective proportions of appendicectomised and non-appendicectomised patients who required oral steroids and immunosuppressive therapy were not significantly different (67% v 70% and 27% v 19%, respectively). Between 1997 and 2000, ulcerative colitis was active for 48% of the time in appendicectomised patients (47 of 98 patient years) and for 62% of the time in non-appendicectomised patients (631 of 1024 patient years; p<0.01).

Conclusion: Previous appendicectomy is associated with a less severe course of ulcerative colitis. The beneficial effect of appendicectomy on the risk of colectomy is additive to that of current smoking.

Citing Articles

Protective effect of appendectomy against the onset of ulcerative colitis: A case-control study.

Cui M, Shi C, Yao P World J Gastrointest Surg. 2024; 16(12):3675-3684.

PMID: 39734436 PMC: 11650250. DOI: 10.4240/wjgs.v16.i12.3675.

Prior Appendicectomy and Gut Microbiota Re-Establishment in Adults after Bowel Preparation and Colonoscopy.

McGuinness A, OHely M, Stupart D, Watters D, Dawson S, Hair C Biomedicines. 2024; 12(9).

PMID: 39335452 PMC: 11429235. DOI: 10.3390/biomedicines12091938.

Association of diet and outdoor time with inflammatory bowel disease: a multicenter case-control study using propensity matching analysis in China.

Chu X, Chen X, Zhang H, Wang Y, Guo H, Chen Y Front Public Health. 2024; 12:1368401.

PMID: 38952728 PMC: 11215971. DOI: 10.3389/fpubh.2024.1368401.

Antibiotic Use in the 12 Months Prior to Ileal Pouch-Anal Anastomosis Increases the Risk for Pouchitis.

Barnes E, Karachalia Sandri A, Herfarth H, Jess T Clin Gastroenterol Hepatol. 2024; 22(8):1678-1686.e8.

PMID: 38556033 PMC: 11272433. DOI: 10.1016/j.cgh.2024.03.012.

The appendix and ulcerative colitis - an unsolved connection.

Agrawal M, Allin K, Mehandru S, Faith J, Jess T, Colombel J Nat Rev Gastroenterol Hepatol. 2023; 20(9):615-624.

PMID: 37081213 PMC: 10527463. DOI: 10.1038/s41575-023-00774-3.

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