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Protective role of appendicectomy on onset and severity of ulcerative colitis and Chron's disease

Radford-Smith, Graham L., Edwards, J. E., Purdie, David M., Pandeya, Nirmala, Watson, M., Martin, Nicholas G., Green, Adele, Newman, Beth M., & Florin, Timothy H. (2002) Protective role of appendicectomy on onset and severity of ulcerative colitis and Chron's disease. Gut: an international journal of gastroenterology & hepatology, 51(6), pp. 808-813.

Abstract

BACKGROUND AND AIMS: Recent studies on appendicectomy rates in ulcerative colitis and Crohn's disease have generally not addressed the effect of appendicectomy on disease characteristics. The aims of this study were to compare appendicectomy rates in Australian inflammatory bowel disease patients and matched controls, and to evaluate the effect of prior appendicectomy on disease characteristics. METHODS: Patients were ascertained from the Brisbane Inflammatory Bowel Disease database. Controls matched for age and sex were randomly selected from the Australian Twin Registry. Disease characteristics included age at diagnosis, disease site, need for immunosuppression, and intestinal resection. RESULTS: The study confirmed the significant negative association between appendicectomy and ulcerative colitis (odds ratio (OR) 0.23, 95% confidence interval (CI) 0.14-0.38; p<0.0001) and found a similar result for Crohn's disease once the bias of appendicectomy at diagnosis was addressed (OR 0.34, 95% CI 0.23-0.51; p<0.0001). Prior appendicectomy delayed age of presentation for both diseases and was statistically significant for Crohn's disease (p=0.02). In ulcerative colitis, patients with prior appendicectomy had clinically milder disease with reduced requirement for immunosuppression (OR 0.15, 95% CI 0.02-1.15; p=0.04) and proctocolectomy (p=0.02). CONCLUSIONS: Compared with patients without prior appendicectomy, appendicectomy before diagnosis delays disease onset in ulcerative colitis and Crohn's disease and gives rise to a milder disease phenotype in ulcerative colitis.

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ID Code: 9261
Item Type: Journal Article
Additional URLs:
Keywords: Adult, Age of Onset, Appendectomy, Appendix[pathology], Case, Control Studies, Colectomy, Colitis, Ulcerative[pathology], Colitis, Ulcerative[prevention & control], Colitis, Ulcerative[therapy], Crohn Disease[prevention & control], Crohn Disease[therapy], Female, Human, Immunosuppressive Agents[therapeutic use], Male, Odds Ratio, Smoking[adverse effects]
ISSN: 0017-5749
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Gastroenterology and Hepatology (110307)
Divisions: Current > Research Centres > Centre for Health Research
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2002 BMJ Publishing Group Ltd and the British Society of Gastroenterology
Copyright Statement: Reproduced in accordance with the copyright policy of the publisher.
Deposited On: 03 Sep 2007
Last Modified: 11 Aug 2011 02:56

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