Medical science and the media have convinced you that your vermiform appendix is a vestigial organ, but is it? Appendectomies are performed across the world and are given little thought to what effect this has on the body. It is believed that removing your appendix is equivalent to yanking out your wisdom teeth; you will not miss either of them, and your body will still function the same without them. Most doctor’s and surgeons think so lowly of the appendix that many appendectomies occur even when the appendix is not inflamed or infected. Sometimes they yank it out if they are nearby doing surgery, just because, removing it is a precaution. I mean, everyone knows the organ is useless and just causes problems if it becomes infected, right?

How arrogant and wrong sometimes humans are when it comes to our vast medical knowledge.

What Is The Vermiform Appendix and Why Is It Important?

The vermiform appendix is a tiny narrow pouch that extends from the first part of the large bowel known as the cecum and is slightly after the ileocecal valve. A few other mammals have an appendix, rabbits being one such mammal. Lymphatic tissue (GALT) has been found in both the rabbit and human appendix. Finally, probiotic biofilm and colonization are found heavily concentrated in the appendix. 1

Our microbiome consists of probiotic microorganisms and opportunistic microorganisms that most of the time work together for the benefit of each other and the host. I know I have written a lot about the negatives of opportunistic bacteria biofilm formation, but probiotic bacteria also form biofilm to protect themselves from pathogens. Biofilm itself is not dangerous, but who is producing it is what matters. Our immune system also helps maintain those biofilms and determines which bacteria are residing underneath it is probiotic or pathogen. If the bacteria is determined to be a pathogen our immune system and our microbiome hopefully keeps it in check or eliminates it. Biofilm concentrations seem to be their highest inside of the appendix compared to the rest of the distal bowel. Biofilms are always shedding in our intestinal system, and our immune system reacts to it either positively or negatively depending on the strain. The shedding of probiotic biofilm may help to inoculate probiotic bacteria from our immune system further down the colon. 2 3 4 5

The location of the appendix, branching out from the end of the cecum is essential to the protection of the probiotic bacteria that reside there. It avoids peristalsis pushed fecal matter to prevent colonization from pathogenic microorganisms that it may contain. The appendix appears to be critical in preventing post-infectious IBS or SIBO. When your intestines come into contact with a pathogen or toxins that pathogens produce, gut junctions quickly open up, and chloride ions and water are secreted to cause diarrhea in an attempt to flush the offending matter out of the intestinal tract. If you have your appendix, the fecal matter quick passes by leaving the beneficial probiotic colony protected and after the bowels stabilized and the threat is mostly removed, the bacteria can help to recolonize the intestinal tract and aid prevent overgrowth. However, if you appendix has been removed you are at a greater chance to develop overgrowth or SIBO, it would be harder for your microbiome to bounce back and more opportunistic strains might take hold. 6 7 8 9

The appendix also contains lymphoid tissue that produces innate lymphoid cells. Innate lymphoid cells help to regulate homeostasis and inflammation within the body, and this concentration in the appendix and the cecum contribute to protecting us from allergies and autoimmune diseases caused by excessive inflammation from infections. The innate lymphoid cells produced in the appendix and cecum tend to be ILC3’s. ILC3’s are special in that they help to mediate the balance between probiotic and opportunistic pathogens by regulating inflammation, antimicrobial peptides, and the mucosal barrier. 10

Finally, the microbiome of the appendix seems to produce most of the melatonin that we find in the digestive tract. The highest concentration of melatonin in our gastrointestinal system is located in the appendix. The amount of melatonin produced by our gastrointestinal tract is four hundred times greater than what is produced by our pineal gland. Removal of the appendix may reduce the amount of melatonin produced by your digestive system. If you want to learn more about the importance of melatonin on increasing your digestive and overall health, read this blog. 11 12

How to Prevent Appendicitis and What to Do If You Have Your Removed

Prevention of appendicitis is paramount, and constipation is its primary cause. Here are some tips to prevent appendicitis and what you can do to avoid an appendectomy hopefully:

  • Relieve constipation. Use a squatty potty, eat a wide variety of seasonal fruits, vegetables, and starches (sans gluten) to increase microbiome diversity, make sure you are getting in enough magnesium, and ensure that you are staying well hydrated.
  • Maintain microbiome diversity and MMC function using prebiotics occasionally like GOS or arabinogalactan.
  • Squat when you defecate. The problems with sitting on the toilet instead of squatting are numerous. When you sit on the toilet, it makes a narrow anorectal angle. The tight anorectal angle obstructs the anus and causes you not to empty your bowels completely when you use the bathroom. When you do not completely empty your bowels, some stool is pushed back up into the colon when you stand up. Theoretically, feces back up eventually leads to appendicitis, from the irritation of the appendix from toxins and opportunistic bacteria that were supposed to be eliminated. Using a standard toilet in the industrial world might be the first correlation between the increase of appendicitis in the first world compared to third world countries where people mainly squat.
  • If you do develop appendicitis, ask your doctor about relieving it with natural antimicrobial agents (oil of oregano for example) or antibiotics instead of having an appendectomy. 13

If you have had your appendix removed like me, there are things you can do to prevent the issues associated with its removal. If you develop food poisoning or a gastrointestinal infection, proper MMC regulation, reduction of intestinal inflammation, GOS supplementation, and probiotic supplementation may be needed to prevent post-infectious IBS or SIBO. Finally, good sleep hygiene is paramount because of the reduction of circulating melatonin due to appendix removal.