Friday, May 24, 2019

'Clear Relationship' Between Appendectomy and Parkinson's

An analysis of the health system records of more than 62 million people in the United States has found a link between appendix removal and raised risk of developing Parkinson's disease.

The researchers compared data on people who had undergone an appendectomy, or appendix removal, to those who had not were more than three times more likely to develop
Parkinson's disease later on. The findings are further evidence of a connection between the gut and the brain in Parkinson's disease.

In a gastroenterology abstract about the study, the authors suggest that what is missing from the research on appendix removal and Parkinson's disease risk is "large-scale epidemiological data." Lead study author Dr. Mohammed Z. Sheriff, who works as a physician at University Hospitals Cleveland Medical Center and Case Western Reserve University, also in Cleveland, OH, is presenting the findings at the 2019 Digestive Disease Week meeting that takes place May 18–21 in San Diego, CA.

Parkinson's is a disease that gradually destroys cells in a part of the brain that helps control movement. The symptoms of Parkinson's include movement rigidity, tremor, slowness, and balance difficulties. Because it most often strikes older people, the number and proportion of individuals living with Parkinson's disease are rising in aging populations. As yet, there is no cure and no treatment that slows down Parkinson's disease. An avenue that scientists are pursuing concerns alpha-synuclein, which is a protein that features in the development of Parkinson's disease. Although it is not clear what function it serves in those without the disease, alpha-synuclein forms toxic clumps called Lewy bodies in the brains of people with Parkinson's disease. Dr. Sheriff says that more recent research has found clumps of alpha-synuclein in the digestive tract of people in the early stages of Parkinson's disease.

Of the 62.2 million patient records that they analyzed, the team identified 488,190 people who had undergone an appendectomy. Of these, 4,470 individuals (0.92%) went on to receive a diagnosis of Parkinson's disease. Of the remaining 61.7 million people, only 177,230 individuals (0.29%) received a Parkinson's disease diagnosis. The team also found that the more than three times higher likelihood of developing Parkinson's disease following an appendectomy was not dependent on age, sex, or race.

My Take:

Medical science has long held that the appendix is a vestigial organ, having no function in the human body. While some sceptics say that it is the surgery itself rather than the removal of the appendix that is the causative factor, I think this study should give pause to those who believe that appendectomies have no long term detrimental effects.

We know that the appendix contains a small sampling of the microbiome of the gut. This may well act as a reservoir to replenish microbes in the gut following infection or antibiotic therapy.

Similar studies have shown a ‘clear relationship’ between removal of the appendix and certain cancers. In holistic health, the appendix is thought to play a pivotal role in the GALT (gut associated lymphoid tissue), the primary immune system of the body.

Bottom Line:
If at all possible, keep your appendix. Some physicians are advocating treatment of appendicitis with antibiotic therapy rather than surgery. Others decry the automatic removal of the appendix whenever any other abdominal surgery is performed.

Source: May 10, 2019 NIH

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