[Protective effect of appendectomy on the development of ulcerative colitis. A case-control study]

A Uzan, D Jolly, E Berger, M D Diebold, P Geoffroy, P Renard, L Vandromme, L Bourgeois, F Ramaholimihaso, O Bouché, P Zeitoun, G Cadiot, G Thiéfin
Gastroentérologie Clinique et Biologique 2001, 25 (3): 239-42

AIMS: To examine by a case-control study the relationship between appendectomy and subsequent ulcerative colitis development in a French population.

METHODS: A total of 150 patients with ulcerative colitis were matched for age (+/- 5 years) and sex, with 150 controls recruited in a preventive medicine center. The following data were collected from medical records and by standardised questionnaire in consultation or by phone: appendectomy and tonsillectomy before the onset of ulcerative colitis, smoking habits and area of residence.

RESULTS: The rate of previous appendectomy in patients with ulcerative colitis was 8% (12/150) compared with 30.6% (46/150) in the control group (P=0.001). There was no significant association between ulcerative colitis and tonsillectomy (25.3 and 27.3% in the control and the ulcerative colitis groups, respectively). Smoking was more frequent in the control group (36%) than in the ulcerative colitis group (25.3%) but the difference was not significant (P=0.07). In multivariate analysis, the risk of developing ulcerative colitis was significantly lower after previous appendectomy (odds ratio=0.26; 95% confidence interval: 0.13-0.55; P=7 x 10(-4)).

CONCLUSION: Our study confirms the inverse association between appendectomy and subsequent ulcerative colitis, in a French population, after adjusting on smoking.

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