Childhood appendectomy and subsequent psychiatric illness.

AIM: The appendix is considered a reservoir for the gut microbiome to restore the gut microbiota after disruptions. Therefore, removal of the appendix because of appendicitis, might result in long-term disruption of the microbiome with related health consequences. The aims of the study were to explore if there is an association between childhood appendectomy, the risk of psychiatric illness and healthcare consumption later in life.

METHODS

Individuals (N = 752) who underwent childhood appendectomy in a tertiary paediatric surgical department in Sweden were included, individually-matched to 5 non-exposed individuals (N = 3760). Data on psychiatric diagnoses, healthcare visits, and use of psychiatric drugs were collected from population-based registers. Stratified Cox and Poisson regression analyses were used, adjusted for antibiotics, proton pump inhibitors and non-steroidal anti-inflammatory drugs.

RESULTS

Median age at appendectomy was 11 (2-16) years and median follow-up time 15.5 (6-21) years. The risk of psychiatric illness in general (HR 1.19; 95% CI 1.04-1.37; p-value 0.013) and affective disorders (HR 1.20, 95% CI 1.01-1.42; p-value 0.038) was higher among those with appendectomy. Out- (IRR 1.20; 95% CI 1.18-1.23; p-value <0.001) and in-patient visits (IRR 1.19, 95% CI 1.10-1.28; p-value <0.001) were more common among those with appendectomy.

CONCLUSION

Childhood appendectomy was associated with an increased risk of psychiatric illness and healthcare consumption.