Relationship between the appendix and ulcerative colitis: A new discovery

Abstract

The appendix was once considered to be vestigial and useless organ. However, in recent years, research has confirmed that the appendix is associated with human immune function and exerts an anti-inflammatory effect through regulating the gut microbiota. Ulcerative colitis (UC) is a chronic and nonspecific inflammatory bowel disease associated with genetics, the environment, immunity, and alterations in the gut microbiota. Multiple studies have shown that the appendix and UC are closely related. With the advent of ultraslim subscopes allowing direct visualization (cholangioscopes), innovative methods for endoscopic diagnosis and treatment of appendicitis with appendix preservation have been successfully implemented. This has not only shifted the traditional approach to diagnosing and treating appendicitis, but has also opened the way for new insights and discoveries in exploring the relationship between the appendix and UC.

Keywords: Appendix; Ulcerative colitis; Inflammation; Immunity; Gut microbiota

Core Tip: Investigating the relationship between the appendix and ulcerative colitis (UC) is crucial for understanding of UC pathogenesis. Appendectomy is superior to standard medical therapy alone in maintaining remission in patients with UC, suggesting that the appendix is a priming site for UC. Other studies have shown that appendectomy increases the risk of colorectal resection and colorectal cancer in UC. Therefore, further research is needed to establish whether the connection is clinically relevant. This review highlights the need for ongoing research to elucidate the complex relationship between the appendix and UC, providing valuable insights with significant promise for developing novel therapeutics.