Patients with the chronic inflammatory bowel disease ulcerative colitis might reduce their risk of a relapse by having their appendix removed, a new study suggests.
Ulcerative colitis causes inflammation and ulcers in the large intestine and rectum, with diarrhea and abdominal pain. There is no cure. Symptoms repeatedly subside and relapse and can adversely affect quality of life.
The appendix is thought to play a role in all of this by producing inflammatory proteins that trigger the body to produce cascades of immune responses, according to a report of the study published in The Lancet Gastroenterology & Hepatology.
All 197 adult patients in the current study were in remission at the start but had required treatment for an episode of active disease during the previous year.
All of them received the usual standard care. Half also had an appendectomy.
A year later, the relapse rates were 36% in the appendectomy group and 56% in the usual-care group, the researchers said.
In addition, fewer patients in the appendectomy group later developed more severe disease requiring treatment with biological agents.
There were five postoperative complications in the surgery group, including two that were labeled serious.
After accounting for patients' individual risk factors, the odds of relapse during the study were 35% lower with appendectomy.
"This significant... reduction suggests that appendectomy might be a viable additional therapeutic option for maintaining remission in ulcerative colitis," the researchers wrote.
"Furthermore, patients who underwent appendectomy were significantly more likely to maintain lower disease activity, reduce the initiation of biological agents, and improve health-related quality of life compared with patients who received standard medical therapy alone."
An editorial published with the study notes that a separate trial, still underway, is testing the benefit of appendectomy in patients whose ulcerative colitis is not in remission.
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