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Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study
BACKGROUND AND OBJECTIVE: Appendectomy may modulate the risk of inflammatory bowel disease through an effect on the gut microbiota. This study investigated the associations between appendectomy and incidence of Crohn’s disease (CD) or ulcerative colitis (UC), with an emphasis on the influence of age...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341190/ https://www.ncbi.nlm.nih.gov/pubmed/35902208 http://dx.doi.org/10.1136/bmjgast-2022-000925 |
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author | Fantodji, Canisius Jantchou, Prévost Parent, Marie-Elise Rousseau, Marie-Claude |
author_facet | Fantodji, Canisius Jantchou, Prévost Parent, Marie-Elise Rousseau, Marie-Claude |
author_sort | Fantodji, Canisius |
collection | PubMed |
description | BACKGROUND AND OBJECTIVE: Appendectomy may modulate the risk of inflammatory bowel disease through an effect on the gut microbiota. This study investigated the associations between appendectomy and incidence of Crohn’s disease (CD) or ulcerative colitis (UC), with an emphasis on the influence of age and time post appendectomy. METHODS: This cohort study included 400 520 subjects born in Québec in 1970–1974 and followed until 2014. Administrative health data were used to ascertain appendectomy and cases of CD and UC. Cox proportional hazards models with time-dependent variables (appendectomy and time elapsed post appendectomy) allowed for the estimation of HRs and 95% CIs. RESULTS: A total of 2545 (0.6%) CD cases and 1134 (0.3%) UC cases were identified during follow-up. Appendectomy increased the risk of CD (HR=2.02; 95% CI: 1.66 to 2.44), especially when performed at 18–29 years of age. The risk of CD was increased in the first 2 years, and decreased significantly after ≥15 years post appendectomy. Appendectomy appeared to protect against UC (HR=0.39; 95% CI: 0.22 to 0.71). The risk of UC was not associated with age at appendectomy, but decreased with time elapsed post appendectomy (HR=0.21; 95% CI: 0.06 to 0.72, comparing ≥5 with 0–4 years after appendectomy). CONCLUSIONS: The increased risk of CD related to appendectomy in young adults may result from detection bias, but physicians should have a low threshold for suspicion of CD in young symptomatic adults with a history of appendectomy. A strong protective effect of appendectomy against UC was observed after 5 years. |
format | Online Article Text |
id | pubmed-9341190 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-93411902022-08-17 Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study Fantodji, Canisius Jantchou, Prévost Parent, Marie-Elise Rousseau, Marie-Claude BMJ Open Gastroenterol Inflammatory Bowel Disease BACKGROUND AND OBJECTIVE: Appendectomy may modulate the risk of inflammatory bowel disease through an effect on the gut microbiota. This study investigated the associations between appendectomy and incidence of Crohn’s disease (CD) or ulcerative colitis (UC), with an emphasis on the influence of age and time post appendectomy. METHODS: This cohort study included 400 520 subjects born in Québec in 1970–1974 and followed until 2014. Administrative health data were used to ascertain appendectomy and cases of CD and UC. Cox proportional hazards models with time-dependent variables (appendectomy and time elapsed post appendectomy) allowed for the estimation of HRs and 95% CIs. RESULTS: A total of 2545 (0.6%) CD cases and 1134 (0.3%) UC cases were identified during follow-up. Appendectomy increased the risk of CD (HR=2.02; 95% CI: 1.66 to 2.44), especially when performed at 18–29 years of age. The risk of CD was increased in the first 2 years, and decreased significantly after ≥15 years post appendectomy. Appendectomy appeared to protect against UC (HR=0.39; 95% CI: 0.22 to 0.71). The risk of UC was not associated with age at appendectomy, but decreased with time elapsed post appendectomy (HR=0.21; 95% CI: 0.06 to 0.72, comparing ≥5 with 0–4 years after appendectomy). CONCLUSIONS: The increased risk of CD related to appendectomy in young adults may result from detection bias, but physicians should have a low threshold for suspicion of CD in young symptomatic adults with a history of appendectomy. A strong protective effect of appendectomy against UC was observed after 5 years. BMJ Publishing Group 2022-07-28 /pmc/articles/PMC9341190/ /pubmed/35902208 http://dx.doi.org/10.1136/bmjgast-2022-000925 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Inflammatory Bowel Disease Fantodji, Canisius Jantchou, Prévost Parent, Marie-Elise Rousseau, Marie-Claude Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study |
title | Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study |
title_full | Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study |
title_fullStr | Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study |
title_full_unstemmed | Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study |
title_short | Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study |
title_sort | appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study |
topic | Inflammatory Bowel Disease |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9341190/ https://www.ncbi.nlm.nih.gov/pubmed/35902208 http://dx.doi.org/10.1136/bmjgast-2022-000925 |
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