This following study explores the impact of appendectomy on the clinical course of Crohn’s disease (CD), revealing significantly lower hospital admission rates among individuals with a history of appendectomy. The research, conducted through a nationwide population-based cohort study, matched patients with CD who had undergone appendectomy with those who hadn’t.
Results indicated that:
- Patients with an appendectomy, regardless of timing or appendicitis history, experienced milder disease progression, with reduced rates of CD-related hospitalizations and lower initiation rates of biologic treatments.
- Additionally, appendectomy before CD diagnosis resulted in decreased rates of colorectal resection, particularly in those without appendicitis.
However, limitations include the nonrandomized, observational, register-based design and potentially a milder disease phenotype in the observed group compared to their matched comparator. The study is also limited by a lack of information on clinical covariates, such as body mass index and tobacco use.
In summary, the findings suggest a potential biological causal relationship between appendectomy and CD clinical course, which can be explained by the fact that the appendix influences the colon and rectum, where CD primarily manifests rather than the small bowel.
Anders Mark-Christensen, Eskild Bendix Kristiansen, Søren Laurberg, Rune Erichsen, Prior Appendectomy Is Associated With a Milder Clinical Course in Crohn’s Disease: A Nationwide Population-based Cohort Study, Inflammatory Bowel Diseases, 2024;, izae059, https://doi.org/10.1093/ibd/izae059