In literature, the appendix is the part at the back of some books that adds material to help explain the work, show statistics, or provide a bibliography (book list). Does this mean that the appendix in the human body is an optional add-on, too?
Yes and no. It might surprise you to know that about 300,000 people in the U.S. have their appendices removed each year in a procedure called an appendectomy. The odds are one in twenty that any one of us will need this surgery.
Appendicitis is the most common reason to have an appendectomy. The medical condition is caused by a blockage or obstruction in the appendix. The blockage may, in turn, be caused by a buildup of fecal matter, mucus, or parasites. Inflammation and infection are the results.
Oddly enough, removing the appendix doesn’t seem to matter much to the rest of the body which carries on quite well without it.
But before we go any further, let’s take a closer look at this often-overlook organ. The appendix is a thin 2- to 4-inch pouch located where the small intestine meets the large intestine, in the lower right abdomen.
The weirdest thing about the human appendix is that no one knows for sure exactly what purpose it serves. Some researchers speculate that the organ stores good bacteria, releasing them to restart a probiotic colony in the digestive tract after diarrheal disease.
Because modern living features some of the most hygienic conditions in world history, humans overall are exposed to fewer bacteria than our ancestors. Is this the reason why the appendix no longer works – did it fail the “use it or lose it” test over thousands of years?
“Once the bowel contents have left the body, the good bacteria hidden away in the appendix can emerge and repopulate the lining of the intestine before more harmful bacteria can take up residence. In industrialized societies with modern medical care and sanitation practices, the maintenance of a reserve of beneficial bacteria may not be necessary. This is consistent with the observation that removing the appendix in modern societies has no discernable negative effects,” according to Assistant Professor of Experimental Surgery at Duke University Medical Center William Parker, Ph.D.
Carrying this line of thought further, there may be so few harmful bacteria now, as compared with even one hundred years ago, that the immune system has forgotten how to tell the difference between good and bad germs.
The hygiene hypothesis wonders if the immune system mistakes helpful, probiotic bacteria for harmful, antibiotic ones, freaks out, and kills the probiotic bacteria stored in the appendix? The result of this mass murder of innocent helper bacteria might be the cause for the most common disease to strike the appendix:
“This over-reactive immune system may lead to the inflammation associated with appendicitis and could lead to the obstruction of the intestines that causes acute appendicitis. Thus, our modern health care and sanitation practices may account not only for the lack of a need for an appendix in our society but also for much of the problems caused by the appendix in our society,” Parker said.
Whatever the cause, due to its functional uncertainty, the human appendix has been called “vestigial,” something that was important at one time in human evolution but is now obsolete.
One reason why we don’t know that much about our own appendices is that laboratory testing usually starts with non-human subjects. But the appendices found in other animals are too different from ours to draw meaningly conclusions, limiting research efforts.
Loren G. Martin, who teaches physiology at Oklahoma State University, reported that endocrine cells vital to developing “various biological control (homeostatic) mechanisms” appear in the appendix of a human fetus near the 11th week of gestation.
In adults, the appendix is linked to the immune system. Martin explained that “the function of the appendix appears to be to expose white blood cells to the wide variety of antigens, or foreign substances, present in the gastrointestinal tract” and “the appendix probably helps to suppress potentially destructive humoral (blood- and lymph-borne) antibody responses while promoting local immunity.”
The adult appendix has a high concentration of immune cells within its walls. It functions as a lymphoid organ, helping immune cells called lymphocytes (specifically, B cells) to mature. B cells produce antibodies which attack invading bacteria, viruses, and toxins.
Not only that, the appendix aids the production of certain molecules that help direct the movement of lymphocytes to other parts of the body.
The appendix produces an antibody called Immunoglobulin A (IgA) which is key to mucosal immunity, “immune system responses that occur at mucosal membranes of the intestines, the urogenital tract and the respiratory system, i.e., surfaces that are in contact with the external environment.”
In advanced cases of appendicitis, the inflamed and infected organ may actually rupture – tear apart. The patient feels sudden, excruciating pain around the navel which moves to the lower right part of the stomach, accompanied by nausea and vomiting. Seek medical assistance immediately.
A ruptured appendix can be life-threatening as the infection spreads throughout the rest of the body. Surgery is required to remove the diseased organ and cleanse the abdominal cavity of toxins.
Another complication of a torn appendix happens to about 20 percent (one in five) of patients who have had an appendectomy. Abscesses – pockets of infection – develop in the abdominal cavity about two weeks post-surgery. When this happens, a surgeon passes a tube through the abdominal wall to drain the infection, followed by a course of antibiotics. After the infection has been controlled, the patient receives an appendectomy.
Because of its relationship to the immune system, it should come as no surprise that the way to avoid appendicitis is to bolster your body’s natural defense system by eating lots of fresh, fibrous fruits and vegetables. Dietary fiber softens the stool and helps the body eliminate waste. It also feeds the good gut bacteria stored in the appendix.
Keeping in mind that there is no fool-proof way to prevent appendicitis, here is a short list of appendix-friendly foods to skew the odds in your favor:
- Vegetables such as broccoli and Brussels sprouts
- Root vegetables and tubers, including sweet potatoes, onions and jicama
- Organic psyllium seed husk, flax hemp and chia seeds
- Berries (in moderate amounts)
- Raw almonds
- Green beans
The symptoms of appendicitis include:
- Sudden pain that begins on the right side of the lower abdomen
- Sudden pain that begins around your navel and often shifts to your lower right abdomen
- Pain that worsens if you cough, walk or make other jarring movements
- Nausea and vomiting
- Loss of appetite
- Low-grade fever that may worsen as the illness progresses
- Constipation or diarrhea
- Abdominal bloating
If you or your child experience any of the above physical signs, see a healthcare professional as soon