Acute appendicitis, bathrooms, and diet in Britain and Ireland

Hospital discharge rates after acute appendicitis were analysed in relation to the provision of household amenities and diet in 73 areas of England and Wales, nine health board areas in Scotland, and all eight health board areas of Eire. The rates of acute appendicitis correlated with the percentage of households lacking amenities, in particular fixed baths and hot water systems. Consumption of green vegetables was an additional influence on the geographical distribution of the disease. These findings support a relation between appendicitis and hygiene, which would explain both the rise and fall of the disease during this century.