Dear Appendix: I’m Sorry

The little "worm" that could

Dear Appendix,

I’m sorry I ever doubted you. I’m sorry that I believed all those people who said you were an ancient relic, obsolete to us modern humans. I’m sorry that I ever cursed you when I felt right lower quadrant pain, wondering if I should just be done with it and free myself from the nuisance of this “useless” organ.

See, we have this stuff called “normal flora” living in and on our bodies. These are microorganisms, primarily bacteria, that under normal operating procedures do not cause infection; in many cases, they are actually mutually beneficial to us. One of the biggest sources of them is our gut. And apparently, the vermiform appendix–this little “worm” in our abdomen–is a storehouse for them. So, when the normal flora in our intestines gets disrupted (like after infection and antibiotic use), the appendix might be what’s driving their recolonization so things can get back to normal ASAP.

This is what a recent study found:

Individuals without an appendix were four times more likely to have a recurrence of Clostridium difficile… Recurrence in individuals with their appendix intact occurred in 11% of cases. Recurrence in individuals without their appendix occurred in 48% of cases.  (From http://blogs.scientificamerican.com/guest-blog/2012/01/02/your-appendix-could-save-your-life/; italics original.)

Now, if you don’t know what Clostridium difficile is, count your blessings. In the medical business, it’s so common, we have a short-hand name for it: “C. diff.” And unless you like debilitating diarrhea and endless abdominal cramping, this is a bacterium you never want to piss off. And there’s a certain irony to it: you typically become ill from C. diff after taking antibiotics, which disrupts the “normal operating procedures” of your intestinal normal flora. This gives C. diff a chance to take over and really show us all its got, manifesting symptoms like diarrhea and cramping. To treat it, you may have to take more antibiotics, potentially setting off a vicious cycle of infection and re-infection. As the study cited above found, that cycle of re-infection appears to be more common in those without an appendix than in those who still take theirs to bed with them.

While you may never face C. diff as an adversary, the appendix may very well be what’s helping you to recover after other nasty microbes take over your intestines in a similar way. It may be that we just haven’t appreciated what we had because it’s what the appendix keeps from happening, rather than what it does outright, that makes it so crucial for our day-to-day survival.

So, dear appendix, I’m sorry. Just as I’ve learned to appreciate your friend the spleen, I am coming to understand that maybe I am better off with you than without you. Can you forgive me?