The role of appendicectomy in the subsequent development of inflammatory bowel disease: a UK-based study

Several studies have shown an inverse relationship between appendicectomy and subsequent development of inflammatory bowel disease (IBD), although these findings remain contentious. This study aims to further elucidate the role appendicitis/appendicectomy has in the development of IBD.

All patients undergoing appendicectomy at Hereford County Hospital between 1986 and 2005 were identified from pathology records. Those already diagnosed with IBD were excluded. Age- and sex-matched controls were randomly selected from a database of orthopaedic clinic attendees. Those with prior history of IBD or appendicectomy were excluded. The incidence of IBD was determined by cross-referencing with the histology database, colonoscopy database and IBD register.

Three thousand eight hundred twenty-nine patients were included in each group, with mean follow-up of 12 +/- 5.9 years. Twelve patients in the appendicectomy group developed IBD. Mean age at diagnosis was 30.3 years, and mean interval from appendicectomy of 3.7 years. Age at appendicectomy and appendicectomy for appendicitis conferred no benefit (Mann-Whitney test, p = 0.991). Eleven patients in the control group developed IBD, with no significant differences in any of the measured outcomes.

This study has shown no relationship between appendicitis/appendicectomy and development of IBD.