We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress
Sign In
Advertise with Us

Download Mobile App


ATTENTION: Due to the COVID-19 PANDEMIC, many events are being rescheduled for a later date, converted into virtual venues, or altogether cancelled. Please check with the event organizer or website prior to planning for any forthcoming event.

Appendectomy Linked to Higher Risk of Microscopic Colitis

By LabMedica International staff writers
Posted on 23 Jun 2022
Print article
Image: Colonic biopsy with features of collagenous colitis. Trichrome stain highlights irregular subepithelial collagen with entrapment of capillaries and inflammatory cells (Photo courtesy of Catherine E. Hagen, MD)
Image: Colonic biopsy with features of collagenous colitis. Trichrome stain highlights irregular subepithelial collagen with entrapment of capillaries and inflammatory cells (Photo courtesy of Catherine E. Hagen, MD)

The most common symptom of microscopic colitis is chronic, watery, non-bloody diarrhea. Episodes of diarrhea can last for weeks, months, or even years. However, many people with microscopic colitis may have long periods without diarrhea.

Appendectomy has been suggested to cause immunomodulating effects in the colon, and earlier studies have shown an inverse relationship between appendectomy and ulcerative colitis, and celiac disease. A cohort study estimated microscopic colitis (MC) to affect 1 in 115 women and 1 in 286 men and accounts for up to 20% of cases of chronic diarrhea among individuals >65 years of age.

A team of medical scientists led by the Karolinska Institutet (Stockholm, Sweden) examined data from the ESPRESSO cohort on 14,520 patients with microscopic colitis who were matched by sex, age, year of biopsy, and residential county to 69,491 controls without microscopic colitis. Of the patients with microscopic colitis, 9,836 had lymphocytic colitis and 4,684 had collagenous colitis. Patients underwent biopsy for microscopic colitis from 1990 to 2017.

The exposure was previous appendectomy, defined as appendectomy at least one year prior index biopsy demonstrating MC, or matching date in controls. Appendectomy was identified using surgical procedure codes and the NOMESCO system. The nomenclature defining complicated and non-complicated appendicitis is not standardized, therefore, complicated and non-complicated appendicitis was defined with surgical procedure codes in combination with ICD (7-10th revisions) codes.

The investigators reported that almost half of patients were diagnosed with microscopic colitis at ages 50 to 70 (43.2%), and 72% were women. Only 4.3% of patients with microscopic colitis had been diagnosed with another form of IBD. Prior to matching, 7.6% of patients with microscopic colitis and 5.1% of controls underwent an appendectomy ≥1 year earlier. Uncomplicated appendicitis was the most common diagnosis. A post-hoc analysis that stratified patients by age at appendectomy showed similar results across all subgroups.

Among over 14,500 patients, those who previously underwent an appendectomy had an overall higher risk of developing microscopic colitis (adjusted odds ratio [aOR] 1.50, 95% CI 1.40-1.61), and this relationship held true for its subtypes. The risk remained elevated even 10 years after an appendectomy (aOR 1.41, 95% CI 1.30-1.52), and the highest associated risk among patients with complicated appendicitis was seen 5 to 10 years after appendectomy.

The authors concluded that the pathophysiology of microscopic colitis is thought to be associated with a dysregulated immune response in the gut mucosa, in genetically predisposed individuals, and infiltration of T-helper cells 17 (Th17) in the lamina propria of colon has been observed, the and that appendicitis has been linked to upregulation of the Th17 pathway. The study was published on June 15, 2022 in the journal Clinical Gastroenterology and Hepatology.

Related Links:
Karolinska Institutet

Gold Supplier
SARS-CoV-2 Assay
Infliximab Immunoassay
Data Management Software
Dual-Channel Optical Coagulation Analyzer

Print article
IIR Middle East



view channel
Image: OneDraw Blood Collection Device significantly reduces obstacles for drawing blood (Photo courtesy of Drawbridge Health)

Near Pain-Free Blood Collection Technology Enables High-Quality Testing

Blood tests help doctors diagnose diseases and conditions such as cancer, diabetes, anemia, and coronary heart disease, as well as evaluate organ functionality. They can also be used to identify disease... Read more


view channel
Image: The global infectious disease IVD market is expected to hit USD 57 billion by 2030 (Photo courtesy of Pexels)

Global Infectious Disease IVD Market Dominated by Molecular Diagnostics Technology

The global infectious disease in vitro diagnostics (IVD) market stood at USD 113.7 billion in 2021 and is expected to grow at a CAGR of -7.41% from 2022 to 2030 to hit around USD 56.89 billion by 2030,... Read more
Copyright © 2000-2022 Globetech Media. All rights reserved.