Bolin, T. D. et al. Appendicectomy as a therapy for ulcerative proctitis. Am. J. Gastroenterol. 104, 2476–2482 (2009).

Appendicectomy may have a therapeutic role in ulcerative proctitis, according to a new study published in the Amercian Journal of Gastroenterology.

Conflicting data have been reported regarding the modulation of disease course by appendicectomy in patients with ulcerative colitis. Terry Bolin and his team from The Prince of Wales Hospital, Sydney, performed appendicectomy in 30 patients with ulcerative proctitis and assessed the influence of this surgery on disease acitivity. “The function of the appendix remains unclear although our team would regard it potentially as the immune driver of the colon,” explains Bolin.

Although not randomized or blinded, their observational study is one of the largest to be published on this topic. 90% of patients achieved a significant improvement in disease activity following appendicectomy; disease activity was unchanged in the remaining 10%. 40% of patients had complete resolution of symptoms at 12 months, such that all pharmacological treatments were withdrawn, and Bolin confirms that these patients remain symptom-free to date. The time required for complete resolution of symptoms after surgery ranged from 1 month to 12 months (median 3 months).

“These findings are quite dramatic and they signify a potential change in the therapy of resistant proctitis,” says Bolin. The team hope that other researchers will replicate their findings and they plan to endoscopically assess all their patients to determine histologic resolution of disease.