Mythbusters: Do you really need your appendix?

Dodgy curry? Or appendicitis???

What is the appendix? No, we’re not talking about that insightful section we all love to add to the end of our essays. Instead, we’re referring to that tiny little, finger-shaped pouch that sits in the lower right abdomen between your small and large intestines.

So now we’re on the same page, I have one quick question for you: have you ever wondered what the appendix actually does? Except get inflamed and give us agonising appendicitis? (When you’re struck by extremely bad luck that is!)

Many of us silently curse the presence of this useless and troublesome little organ. If you’re of Asian origin, you may even have memories of your elders yelling at you for jumping around after meals, warning you that such reckless behaviour will give you appendicitis. But if it really is such a killjoy, one can’t help but wonder: why did human evolution not get rid of the damned thing?

The appendix has evolved up to 41 times in the past 11 million years, suggesting it is not as redundant as many believe. 

A group of scientists, led by assistant professor Heather F. Smith from Arizona College of Osteopathic Medicine at Midwestern University, performed an extensive study on the human appendix to understand its evolution in mammals. Their research discovered that the organ has evolved up to 41 times in the past 11 million years, suggesting it is not as redundant as many believe. Though the exact details of this evolutionary history still remain a mystery, Smith’s group may be on to something.

While researchers around the world continue to crack their brains, trying to understand the physiological function(s) of the human appendix, the current leading hypothesis is that it acts as natural reservoir for beneficial intestinal bacteria.

This would mean that rather than being a pointless organ, it serves a protective function in human health by keeping certain infections at bay.

Smith’s group is the first to statistically prove that there is an association between the presence of an appendix and the ‘concentration’ of lymphoid tissue, and thus the immune hypothesis of appendix evolution.

It is the safe house of beneficial intestinal bacteria, especially in times of high immune activity and illness.

In addition, a study carried out in 2012 by Dr James Grendell and his team from Winthrop University Hospital has shown that patients without an appendix were four times more likely to suffer from Clostridium difficile (C. difficile) recurrence than patients with an appendix. This bowel infection is common even in places with good medical systems, and whilst it does not compete well with the normal flora of the human gut, it can quickly take over when normal gut flora is depleted.

While the true function of human appendix is still an area of active pursuit among many gastroenterologists and immunologists, for the time being, our best bet would be that the human appendix is an important secondary immune organ.

Image: Nydorf, Seymour, 1914-2001, (U.S. National Archives and Records Administration)

Image: Nydorf, Seymour, 1914-2001, (U.S. National Archives and Records Administration)

It is the safe house of beneficial intestinal bacteria, especially in times of high immune activity and illness.

And if that doesn’t sway you of its necessity, just remember that it can also come in handy during reconstructive surgery too (doctors use it to recreate a ‘sphincter muscle’ for patients who have had their bladder removed!).

Nonetheless, even though the human appendix may play a role in the gut’s local immunity, one must not cling to it if they have appendicitis. If left untreated the appendix can burst and cause life threatening infections, which I believe probably outweighs the potential harm of removing this misunderstood little organ.

 

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