Is the Appendix the most underrated organ?

Until I started studying, I had NO idea what the appendix did or where it lived in the body. None. All I knew was that it fell into the same ‘non-essential’/ often removed category as the gall bladder, adenoids and tonsils... and that it could cause a whole lot of pain if it’s cranky.

Fast forward 15 years, and I now have WHOLE new appreciation for this odd little organ… in fact, it might just be one of my favourites! 😉

The Appendix as a Microbial Wing Man.

The appendix is a small pouch of tissue attached to the large intestine. Since it’s identification (more than 400 years ago) and until the 21st century, its function in the human body was unknown. Charles Darwin and many others believed the appendix was a 'useless remnant of evolution', proposing that it previously served in the digestion of an ancestral diet of leaves.

We NOW know that theory is incorrect. This this little worm-shaped organ has an important role to play and it evolved out of necessity.

The appendix is rich in immune cells and is part of the gut-associated lymphoid tissue (GALT), acting as a reservoir for gut microbes. The appendix also has some pretty prime real estate to act as a “safe house” for beneficial microbes, right off the large intestine (a microbial hot spot!), so it can act swiftly, before any harmful bacteria can take up residence!The appendix can help repopulate the gastrointestinal tract in times of necessity or when the gut microbiome undergoes radical depletion (following antibiotics and/ or intestinal infection for example). No appendix means no quick acting wing-man for the gut microbiome.

Given its role in immunity and gastrointestinal health, there are question marks over whether an appendectomy (removal of the appendix) is appropriate for certain people (those with an increased risk for colorectal cancer, gall stones or cardiovascular disease for example). After the removal of the appendix, there is also data to suggest an increased risk for conditions such as Crohn’s disease, Ulcerative colitis, Lupus and controversially, Parkinson’s Disease (Chung et al, 2021; Chung e al 2018, Song et al, 2020). Of course there are many instances where it cannot be avoided, but current data suggests that instant removal may not be necessary or indicated in every instance.

Given the appendix is part of our gut and has some important microbial duties, several studies have also looked at the role of the appendix in brain health via the gut-brain axis. As we know the gut and the brain talk to each other instantaneously and in several different ways. It’s been postulated that removal of the appendix can result in disturbance of this ‘messaging’ and no back up ‘wing-man’ for the microbes in times of crisis.All of this information confirms the our updated understanding of the appendix.

We can now be confident that the appendix is not a redundant or useless organ.

Quite the contrary, it helps us maintain gut, immunological and perhaps even neurological balance!