Appendectomy Associated With IBD, C diff, and Other GI Disorders

Using the National Healthcare Insurance Service (NHIS) database of Korea, researchers found that patients who underwent appendectomy are at increased risk for developing Crohn disease, colorectal cancer, ulcerative colitis (UC), sepsis, and Clostridium difficile infection (C diff).

The appendix is generally considered to play a role in maintenance of the gut-microbiome immune-system, but data that clarify why an appendectomy might lead to various bowel diseases are lacking.

Researchers identified adult patients who received an appendectomy between 2005 and 2013, to be matched against a control group of patients who had who had not received an appendectomy. The cohorts were matched for comorbidities and frequency of health care resource utilization; 486,844 patients were included in the analysis.

Research revealed incidence-rate ratio (IRR) of Crohn disease, ulcerative colitis, C diff, sepsis, and colorectal cancer after appendectomy or the index date.

"Patients who underwent appendectomy showed a significantly higher incidence of Crohn’s disease (IRR 4.40, 95% confidence interval (CI) 3.78–5.13) and ulcerative colitis (IRR 1.78, 95% CI 1.63–1.93) compared to the control group during the 5-year follow-up period. The associations between appendectomy and Clostridium difficile infection, sepsis, and colorectal cancer were all found to be significant," the authors concluded.

--Angelique Platas

Reference:

Lee S, Jang EJ, Jo J., Park SJ, Ryu HG.  Long-term impacts of appendectomy associated with increased incidence of inflammatory bowel disease, infection, and colorectal cancer. Int J Colorectal Dis Published February 16, 2021.  doi.org/10.1007/s00384-021-03886-x