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By Suzanne Rostler
NEW YORK, Mar 15 (Reuters Health) - People who have their appendix removed during childhood or adolescence may have a lower risk of developing a chronic intestinal disorder, researchers report.
Their study of more than 420,000 people found that those who had an appendectomy for an inflammatory condition such as appendicitis or lymphadenitis (inflammation of the lymph nodes near the intestines) before the age of 20 had a lower risk of developing ulcerative colitis years later.
Ulcerative colitis is a chronic condition characterized by diarrhea and cramping abdominal pain accompanied by inflammation and ulcer formation in the large intestine. The results are published in the March 15th issue of The New England Journal of Medicine.
However, the investigators found that those who had an appendectomy after the age of 20 and individuals who underwent the operation for reasons other than inflammatory disorders were not protected from ulcerative colitis.
The study did not investigate why appendectomy may protect against ulcerative colitis but the authors suggest that the inflammation that leads to an appendectomy--not the procedure itself--may be responsible.
"Appendicitis and ulcerative colitis (may be) alternative inflammatory responses that are genetically or environmentally determined," Dr. Roland E. Andersson from Ryhov Hospital in Jonkoping, Sweden and colleagues explain.
In an interview with Reuters Health, Dr. James F. Marion from Mount Sinai School of Medicine in New York City explained that the appendix contains a concentrated group of immune tissue that may act as a "detonator" in the gut.
"The theory is that by removing the appendix, you are removing immune tissue that might trigger ulcerative colitis in certain patients," he explained.
But it is too soon to think about using appendectomy as a preventive measure against ulcerative colitis since there is no way to predict who will develop the disorder, Andersson told Reuters Health.
SOURCE: The New England Journal of Medicine 2001;344:808-814.
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