Patients who had their appendix removed were more likely to develop Parkinson’s disease than those whose appendix remained in place, according to the largest study to address the relationship between the two conditions.
The retrospective study involving more than 62 million patient records from 26 health systems will be presented at Digestive Disease Week® (DDW) 2019.
An appendectomy is surgery to remove the appendix when it is infected.
This condition is called appendicitis.
Appendectomy is a common emergency surgery.
The appendix is a thin pouch that is attached to the large intestine. It sits in the lower right part of your belly.
If you have appendicitis, your appendix must be removed right away.
If not treated, your appendix can burst. This is a medical emergency.
There are 2 types of surgery to remove the appendix. The standard method is an open appendectomy. A newer, less invasive method is a laparoscopic appendectomy.
- Open appendectomy. A cut or incision about 2 to 4 inches long is made in the lower right-hand side of your belly or abdomen. The appendix is taken out through the incision.
- Laparoscopic appendectomy. This method is less invasive. That means it’s done without a large incision. Instead, from 1 to 3 tiny cuts are made. A long, thin tube called a laparoscope is put into one of the incisions. It has a tiny video camera and surgical tools. The surgeon looks at a TV monitor to see inside your abdomen and guide the tools. The appendix is removed through one of the incisions.
During a laparoscopic surgery, your provider may decide that an open appendectomy is needed.
If your appendix has burst and infection has spread, you may need an open appendectomy.
A laparoscopic appendectomy may cause less pain and scarring than an open appendectomy. For either type of surgery, the scar is often hard to see once it has healed.
Both types of surgery have low risk of complications.
A laparoscopic appendectomy has a shorter hospital stay, shorter recovery time, and lower infection rates.
Recently, some studies have suggested that intravenous antibiotics alone could cure appendicitis without the need for appendectomy.
These results remain controversial and appendectomy remains the standard of care.
“Recent research into the cause of Parkinson’s has centered around alpha-synuclein, a protein found in the gastrointestinal tract early in the onset of Parkinson’s,” said Mohammed Z. Sheriff, MD, lead author of the study and a physician at Case Western Reserve University and University Hospitals Cleveland Medical Center, Ohio.
“This is why scientists around the world have been looking into the gastrointestinal tract, including the appendix, for evidence about the development of Parkinson’s.”
Previous findings on appendectomies and Parkinson’s have been inconsistent, with some studies showing no relationship and a recent study from Europe showing patients who still had their appendix were more likely to develop Parkinson’s.
This contradiction prompted Dr. Sheriff and colleagues to seek answers to the question using U.S. data from an Ohio-based electronic health records company that draws data from 26 major integrated health systems.
Researchers analyzed electronic health records representing more than 62.2 million patients and identified those who had appendectomies and were diagnosed with Parkinson’s disease at least six months later.
They found that among 488,190 patients who had undergone appendectomies, 4,470, or .92 percent, went on to develop Parkinson’s. Of the remaining 61.7 million patients without appendectomies, they identified only 177,230, or .29 percent, who developed the disease.
According to this analysis, patients who had an appendectomy were more than three times as likely to develop Parkinson’s than those who had not.
They found that among 488,190 patients who had undergone appendectomies, 4,470, or .92 percent, went on to develop Parkinson’s. The image is in the public domain.
Researchers found similar risk levels across all age groups, regardless of gender or race.
Other than the six-month washout period programmed into their initial query of the database, researchers could not tell from the de-identified records exactly how much time passed after the appendectomy until Parkinson’s was diagnosed.
“This research shows a clear relationship between the appendix, or appendix removal, and Parkinson’s disease, but it is only an association,” Dr. Sheriff said. “Additional research is needed to confirm this connection and to better understand the mechanisms involved.”
Digestive Disease Week
Aimee Frank – Digestive Disease Week
The image is in the public domain.
Original Research: Mohammed Z. Sheriff, MD, will present data from the study, “Parkinson’s disease is more prevalent in patients with appendectomies: a national population-based study,” abstract 739, on Monday, May 20, at 4:18 p.m. PDT.