When my appendix was removed, many years ago, I was assured by my doctor that it was just a useless vestige – all that remains, according to Darwin, of a much larger organ, the caecum.
However, recent observations and experiments have disproved Darwin’s theory, and suggest that the appendix may have a use after all – as a ’safe house’ where beneficial commensal bacteria can ride out bouts of diarrhoea, before emerging to repopulate the gut.
The internal walls of the intestine are coated by biofilm, a thin, delicate layer consisting of microbes, mucous and immune system molecules, the role of which is thought to be the protection of good bacteria. These biofilms extend into the appendix, where they are even more pronounced.
The location and position of the appendix are such that, even if diarrhoea is severe enough to flush away the entire contents of the bowels, including its biofilms, the beneficial bacteria within the appendix are likely to remain intact, and able to repopulate the lining of the intestine before more harmful bacteria can take over.
The appendix also has other benefits, such as the manufacture of white blood cells, antibodies and associated chemicals, and it’s presence reduces the risk of developing Crohn’s disease. Furthermore, it can, if necessary, be used in reconstructive surgery, to provide a substitute ureter, for example, or an effective sphincter for a reconstructed bladder. So this seemingly insignificant appendage is not something to be cast aside lightly.
The problem with the appendix is that it is prone to inflammation (appendicitis) which hospitalises 320,000 and kills up to 400 Americans each year. This inflammation has, since Darwin’s time, been thought to be due to a defect in the appendix, such as obstruction of its opening. However, it now appears that Darwin was probably also wrong about this, and it is much more likely that the appendix has fallen foul of the effects of the cultural changes and improved sanitation that are associated with industrialisation and which have left the human immune system with far fewer legitimate targets, thus exposing our own tissues, including the appendix, to its marauding agents.
The author of the first-ever historical study of the appendix suggests that, now that we have a better understanding of the function of the appendix and the effects on it of modern lifestyles, we should be looking for ways to challenge our immune system in much the same manner that it was challenged back in the Stone Age. He of course anticipates that this will eventually be achieved by the use of synthetic medicines, and is seemingly unaware that the immune system can already be effectively challenged by reintroducing some of the organisms that were, for millennia, the natural quarry of the immune system - ‘old friends’, such as helminths.
By reinstating a few benign intestinal worms (available from Autoimmune Therapies), we can introduce an effective mechanism for controlling inflammation throughout the body and thereby not only reduce the liklihood of our appendix becoming inflamed and needing to be removed, but also ensure that we will continue to benefit from the valuable functions that we now know are performed by this odd little organ.
