[Protective effect of appendectomy on the development of ulcerative colitis. A case-control study].

AIMS To examine by a case-control study the relationship between appendectomy and subsequent ulcerative colitis development in a French population. METHODS A total of 150 patients with ulcerative colitis were matched for age (+/- 5 years) and sex, with 150 controls recruited in a preventive medicine center. The following data were collected from medical records and by standardised questionnaire in consultation or by phone: appendectomy and tonsillectomy before the onset of ulcerative colitis, smoking habits and area of residence. RESULTS The rate of previous appendectomy in patients with ulcerative colitis was 8% (12/150) compared with 30.6% (46/150) in the control group (P=0.001). There was no significant association between ulcerative colitis and tonsillectomy (25.3 and 27.3% in the control and the ulcerative colitis groups, respectively). Smoking was more frequent in the control group (36%) than in the ulcerative colitis group (25.3%) but the difference was not significant (P=0.07). In multivariate analysis, the risk of developing ulcerative colitis was significantly lower after previous appendectomy (odds ratio=0.26; 95% confidence interval: 0.13-0.55; P=7 x 10(-4)). CONCLUSION Our study confirms the inverse association between appendectomy and subsequent ulcerative colitis, in a French population, after adjusting on smoking.

[1]  M. Imamura,et al.  A patient with improvement of ulcerative colitis after appendectomy. , 2000, Gastroenterology.

[2]  I. Vlachonikolis,et al.  Appendectomy and the development of ulcerative colitis: results of a metaanalysis of published case-control studies , 2000, American Journal of Gastroenterology.

[3]  F. Frizelle,et al.  Protective effect of appendectomy on the development of ulcerative colitis , 1999, Diseases of the colon and rectum.

[4]  E. Kouroumalis,et al.  Appendectomy, tonsillectomy, and risk of inflammatory bowel disease , 1999, Diseases of the colon and rectum.

[5]  J. Hugot,et al.  Etiology of the inflammatory bowel diseases , 1999, International Journal of Colorectal Disease.

[6]  A. Ekbom,et al.  Epidemiology of inflammatory bowel disease , 1992, Current opinion in gastroenterology.

[7]  R. Logan,et al.  Appendicectomy, childhood hygiene, Helicobacter pylori status, and risk of inflammatory bowel disease: a case control study , 1998, Gut.

[8]  K. Palmer,et al.  Appendicectomy and ulcerative colitis. , 1998, Journal of the Royal College of Surgeons of Edinburgh.

[9]  D. Rampton,et al.  Appendiceal inflammation in ulcerative colitis , 1998, Histopathology.

[10]  H. Jick,et al.  Appendectomy protects against ulcerative colitis. , 1998, Epidemiology.

[11]  R. Brummer,et al.  Appendectomy and the risk of developing ulcerative colitis or Crohn's disease: results of a large case-control study. South Limburg Inflammatory Bowel Disease Study Group. , 1997, Gastroenterology.

[12]  V. Annese,et al.  Appendectomy is an independent protective factor for ulcerative colitis: results of a multicentre case control study. The Italian Group for the Study of the Colon and Rectum (GISC) , 1997, Italian journal of gastroenterology and hepatology.

[13]  N. Breslin,et al.  Surgical and Smoking History in Inflammatory Bowel Disease: A Case‐Control Study , 1997, Inflammatory bowel diseases.

[14]  B. Grandbastien,et al.  Incidences des maladies inflammatoires chroniques de l'intestin, en France : le tableau s'enrichit , 1997 .

[15]  E. Mizoguchi,et al.  Role of appendix in the development of inflammatory bowel disease in TCR-alpha mutant mice , 1996, The Journal of experimental medicine.

[16]  G. Radford-Smith,et al.  Appendectomy and tonsillectomy in patients with inflammatory bowel disease. , 1995, Journal of clinical gastroenterology.

[17]  S. Stryker,et al.  Appendiceal involvement as a skip lesion in ulcerative colitis. , 1994, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[18]  N. Harpaz,et al.  Ulcerative appendicitis in universal and nonuniversal ulcerative colitis. , 1994, Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc.

[19]  D. Coggon,et al.  Inflammatory bowel disease and domestic hygiene in infancy , 1994, The Lancet.

[20]  R. Sandler,et al.  Childhood infections and the risk of inflammatory bowel disease , 1994, Digestive diseases and sciences.

[21]  A. Davison,et al.  The appendix as a ‘skip lesion’ in ulcerative colitis , 1990, Histopathology.

[22]  B. Calkins A meta-analysis of the role of smoking in inflammatory bowel disease , 1989, Digestive diseases and sciences.

[23]  M. Langman,et al.  Childhood factors in ulcerative colitis and Crohn's disease. An international cooperative study. , 1987, Scandinavian journal of gastroenterology.

[24]  H. Kawanishi Immunocompetence of normal human appendiceal lymphoid cells: in vitro studies. , 1987, Immunology.

[25]  Q. Valensi,et al.  "Ulcerative appendicitis" occurring as a skip lesion in chronic ulcerative colitis; report of a case. , 1974, The American journal of gastroenterology.