Appendiceal Appeal
They say it’s no good to anybody. They say it serves no useful purpose. But it’s hard to believe it would exist in the first place were it not for the divine plan of a deity, evolution, or some heretofore unknown life force. Is it a mere vestige of something far greater in our ancestry, or is it the key to wonders cloaked in mystery behind still another locked genomic door? It might just be a simple fellow, and yet it is part of us all and, as such, merits a closer look. What are we talking about here? Why, that enigmatic body part known as the appendix. Darwin himself was fully aware of its existence, and, yet, the conventional wisdom of his time led him to believe that it was a mere vestigial organ, a useless sac embedded in the lower right quadrant of the body, between the small and large intestines. And he knew that it was not limited to Homo sapiens, but ran the gamut of numerous animal species, including flying squirrels, to boot. Now we know, through the advances of modern technology and medical science that the appendix dates back 80 million years, and we are learning that it may be a “magic bullet” of some sort, aiding the human body in its defense against disease by releasing a flotilla of good bacteria into our guts and white blood cells into our bloodstreams when our immune systems are most in need. Yes, the appendix may be appealing, after all.
We often hear that someone we know has had an appendix removed, due to the sudden fever and excruciating lower right abdominal pain of an appendicitis attack. In fact, 1 in 20 people has an appendix taken out, with no dire consequences. That alone has given the medical community license to declare that the slimy dead-end sac known as the appendix is of little or no need to us all. Wrong! Recently, it has been suggested that the appendix is a storehouse, a Big Wal-Mart, if you will, of good bacteria. When a subject’s colon is devastated by the ravages and diarrhea subsequent to a severe case of food poisoning or any number of acute and chronic gastrointestinal maladies, the “good-for-nothing little engine that could,” otherwise known as the vermiform appendix, comes to the rescue, releasing good bacteria or normal flora into our guts to repopulate the healthy bacterial lining that forms an integral part of our gastrointestinal systems and that is often the first to go after a nasty diarrheal attack. But the job of our newfound friend, the appendix, doesn’t end there. Recent studies indicate that it may, indeed, even make, direct, and train white blood cells, which, as you may or may not know, are key to our bodies’ defenses. So, perhaps we should reevaluate the little fella we were so anxious to write off, without giving the benefit of the doubt, a proper chance, or a respite for all the medical data to come in.
Now we must determine what actually causes appendicitis, or that potentially deadly inflammation of the appendix. In reality, the prevailing opinion of experts no longer inculpates a faulty appendix as its cause. You may, in fact, be surprised at whom the finger has been pointed. It now appears that cultural changes due to an industrialized society and improved sanitation are the culprits. The appendix, as a storehouse of what had been good and healthy for our guts and immune systems, was rendered useless and obsolete by the very advances that contributed to our clinical and public health betterment as a society, those being widespread use of sewer systems and clean drinking water. With infection of the gut on the decline due to the latter, there was really no further need of an arsenal of good bacteria and white blood cells to defend us. Why maintain a large standing army when there are no wars to fight? So, the appendix was wrongly relegated to the ranks of a mere vestige. Now, all that has changed. With what has recently come to light on the normal function of our “long-lost friend,” we must look at the question of what can be done to prevent appendicitis, to the chagrin and reduced bank ledgers of general surgeons. If we can find the means to instigate the appendix in much the same way as in the past, and consequently incite our immune systems, through release by the former of good bacteria and white blood scavenger cells, then allergies, autoimmune diseases, and even appendicitis may go the route of imminent extinction. Wishful thinking? Perhaps. But then, again, it certainly is appealing. Darwin would be pleased.
ã 2009, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
9/07/2009 12:58:00 PM
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