REED - Revista Española de Enfermedades Digestivas

Alerta del nuevo número	Contacto
Envío de artículos	Síguenos REEDigestivas_
English version

Año 2026 / Volumen 118 / Número 3
Revisión

Appendectomy and the risk of microscopic colitis - A systematic review and meta-analysis

156-166

DOI: 10.17235/reed.2025.10620/2024

Zhao Xu Tian, Hong Ying Tang, Yan Ri Duan, Hang Bin Jin,

Resumen

Background: microscopic colitis (MC), a chronic intestinal inflammatory disorder characterised by persistent watery diarrhoea, is categorised into collagenous and lymphocytic subtypes. Recent studies suggest that appendectomy influences the risk of MC, although the evidence remains inconclusive. This meta-analysis of available research was conducted to clarify the relationship between appendectomy and MC risk. Methods: in accordance with the PRISMA guidelines, a comprehensive search was conducted in the Web of Science, EMBASE, and PubMed up to January 2024, focusing on studies that explored the association between appendectomy and MC. Quality was assessed using the Newcastle-Ottawa Scale, with data synthesis using the DerSimonian and Laird random-effects model. Heterogeneity and potential biases were evaluated; subgroup analyses were performed to investigate specific associations. Results: six studies were analysed, including one cohort and five case-control studies involving 85,845 participants. The combined analysis showed no significant link between appendectomy and MC risk (OR: 1.20, 95 % CI: 0.91-1.58), despite moderate heterogeneity (I² = 59 %). Subgroup analyses indicated potential associations in specific contexts. Notably, significant associations were found in subgroups based on MC subtypes (CC: OR 1.59, 95 % CI: 1.20-2.10; LC: OR 1.45, 95 % CI: 1.34-1.58), unadjusted ORs (OR 1.42, 95 % CI: 1.17-1.73), healthy control groups (OR 1.51, 95 % CI: 1.38-1.67) and studies using medical records for appendectomy history (OR 1.50, 95 % CI: 1.28-1.75). Other subgroup analyses did not yield significant results. Conclusion: this meta-analysis did not support a significant association between appendectomy and increased risk of MC. These findings highlight the need for further large-scale, prospective studies to explore this relationship in greater detail, considering the potential for nuanced interactions and the impacts of various confounding factors.

Nuevo comentario

Comentarios

No hay comentarios para este artículo.

Bibliografía

CAI, S., FAN, Y., ZHANG, B., et al., 2021: Appendectomy is associated with alteration of human gut bacterial and fungal communities.- Frontiers in microbiology. 12: 724980.

DOI: 10.3389/fmicb.2021.724980

DELEU, S., MACHIELS, K., RAES, J., VERBEKE, K., & VERMEIRE, S., 2021: Short chain fatty acids and its producing organisms: An overlooked therapy for IBD?- EBioMedicine. 66.

DOI: 10.1016/j.ebiom.2021.103293

FEDOR, I., ZOLD, E., & BARTA, Z., 2021: Microscopic colitis: controversies in clinical symptoms and autoimmune comorbidities.- Annals of Medicine. 53(1): 1280-1285.

DOI: 10.1080/07853890.2021.1962965

FERNáNDEZ-BAñARES, F., DE SOUSA, M.R., SALAS, A., et al., 2013: Epidemiological risk factors in microscopic colitis: a prospective case–control study.- Inflammatory bowel diseases. 19(2): 411-417.

DOI: 10.1097/MIB.0b013e318281f3cc

FUMERY, M., KOHUT, M., GOWER-ROUSSEAU, C., et al., 2017: Incidence, clinical presentation, and associated factors of microscopic colitis in Northern France: a population-based study.- Digestive Diseases and Sciences. 62: 1571-1579.

DOI: 10.1007/s10620-016-4306-z

GIRARD-MADOUX, M.J., DE AGüERO, M.G., GANAL-VONARBURG, S.C., et al., 2018: The immunological functions of the appendix: an example of redundancy?- Seminars in immunology Elsevier. 36: 31-44.

DOI: 10.1016/j.smim.2018.02.005

GOEDERT, J.J., HUA, X., YU, G., & SHI, J., 2014: Diversity and composition of the adult fecal microbiome associated with history of cesarean birth or appendectomy: analysis of the American Gut Project.- EBioMedicine. 1(2): 167-172.

DOI: 10.1016/j.ebiom.2014.11.004

HEUTHORST, L., MOOKHOEK, A., WILDENBERG, M.E., et al., 2021: High prevalence of ulcerative appendicitis in patients with ulcerative colitis.- UEG Journal. 9(10): 1148-1156.

DOI: 10.1002/ueg2.12171

HIGGINS, J.P., 2008: Cochrane handbook for systematic reviews of interventions version 5.0. 1. The Cochrane Collaboration.- http://www. cochrane-handbook. org.

LAING, A.W., PARDI, D.S., LOFTUS JR, E.V., et al., 2006: Microscopic colitis is not associated with cholecystectomy or appendectomy.- Inflammatory bowel diseases. 12(8): 708-711.

DOI: 10.1097/00054725-200608000-00006

LARSSON, J., SONESTEDT, E., OHLSSON, B., MANJER, J., & SJöBERG, K., 2016: The association between the intake of specific dietary components and lifestyle factors and microscopic colitis.- European journal of clinical nutrition. 70(11): 1309-1317.

DOI: 10.1038/ejcn.2016.130

LAZENBY, A.J., YARDLEY, J.H., GIARDIELLO, F.M., JESSURUN, J., & BAYLESS, T.M., 1989: Lymphocytic (“microscopic”) colitis: a comparative histopathologic study with particular reference to collagenous colitis.- Human pathology. 20(1): 18-28.

DOI: 10.1016/0046-8177(89)90198-6

LINDSTRöM, C., 1976: 'Collagenous colitis' with watery diarrhoea--a new entity?- Pathologia Europaea. 11(1): 87-89.

LIU, X., XIAO, S.-Y., PLESEC, T.P., et al., 2013: Collagenous colitis in children and adolescents: study of 7 cases and literature review.- Modern Pathology. 26(6): 881-887.

DOI: 10.1038/modpathol.2012.227

MACAIGNE, G., LAHMEK, P., LOCHER, C., et al., 2014: Microscopic colitis or functional bowel disease with diarrhea: a French prospective multicenter study.- Official journal of the American College of Gastroenterology| ACG. 109(9): 1461-1470.

DOI: 10.1038/ajg.2014.182

MARET-OUDA, J., STRöM, J.C., ROELSTRAETE, B., et al., 2023: Appendectomy and Future Risk of Microscopic Colitis: A Population-Based Case-Control Study in Sweden.- Clinical Gastroenterology and Hepatology. 21(2): 467-475. e462.

DOI: 10.1016/j.cgh.2022.05.037

MASAHATA, K., UMEMOTO, E., KAYAMA, H., et al., 2014: Generation of colonic IgA-secreting cells in the caecal patch.- Nature communications. 5(1): 3704.

DOI: 10.1038/ncomms4704

MIEHLKE, S., GUAGNOZZI, D., ZABANA, Y., et al., 2021: European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations.- UEG Journal. 9(1): 13-37.

DOI: 10.1177/2050640620951905

MIEHLKE, S., VERHAEGH, B., TONTINI, G.E., et al., 2019: Microscopic colitis: pathophysiology and clinical management.- The Lancet Gastroenterology & Hepatology. 4(4): 305-314.

DOI: 10.1016/S2468-1253(19)30048-2

CAI, S., FAN, Y., ZHANG, B., et al., 2021: Appendectomy is associated with alteration of human gut bacterial and fungal communities.- Frontiers in microbiology. 12: 724980.

DOI: 10.3389/fmicb.2021.724980

DELEU, S., MACHIELS, K., RAES, J., VERBEKE, K., & VERMEIRE, S., 2021: Short chain fatty acids and its producing organisms: An overlooked therapy for IBD?- EBioMedicine. 66.

DOI: 10.1016/j.ebiom.2021.103293

FEDOR, I., ZOLD, E., & BARTA, Z., 2021: Microscopic colitis: controversies in clinical symptoms and autoimmune comorbidities.- Annals of Medicine. 53(1): 1280-1285.

DOI: 10.1080/07853890.2021.1962965

DOI: 10.1097/MIB.0b013e318281f3cc

DOI: 10.1007/s10620-016-4306-z

GIRARD-MADOUX, M.J., DE AGüERO, M.G., GANAL-VONARBURG, S.C., et al., 2018: The immunological functions of the appendix: an example of redundancy?- Seminars in immunology Elsevier. 36: 31-44.

DOI: 10.1016/j.smim.2018.02.005

DOI: 10.1016/j.ebiom.2014.11.004

HEUTHORST, L., MOOKHOEK, A., WILDENBERG, M.E., et al., 2021: High prevalence of ulcerative appendicitis in patients with ulcerative colitis.- UEG Journal. 9(10): 1148-1156.

DOI: 10.1002/ueg2.12171

HIGGINS, J.P., 2008: Cochrane handbook for systematic reviews of interventions version 5.0. 1. The Cochrane Collaboration.- http://www. cochrane-handbook. org.

LAING, A.W., PARDI, D.S., LOFTUS JR, E.V., et al., 2006: Microscopic colitis is not associated with cholecystectomy or appendectomy.- Inflammatory bowel diseases. 12(8): 708-711.

DOI: 10.1097/00054725-200608000-00006

DOI: 10.1038/ejcn.2016.130

DOI: 10.1016/0046-8177(89)90198-6

LINDSTRöM, C., 1976: 'Collagenous colitis' with watery diarrhoea--a new entity?- Pathologia Europaea. 11(1): 87-89.

LIU, X., XIAO, S.-Y., PLESEC, T.P., et al., 2013: Collagenous colitis in children and adolescents: study of 7 cases and literature review.- Modern Pathology. 26(6): 881-887.

DOI: 10.1038/modpathol.2012.227

DOI: 10.1038/ajg.2014.182

DOI: 10.1016/j.cgh.2022.05.037

MASAHATA, K., UMEMOTO, E., KAYAMA, H., et al., 2014: Generation of colonic IgA-secreting cells in the caecal patch.- Nature communications. 5(1): 3704.

DOI: 10.1038/ncomms4704

CAI, S., FAN, Y., ZHANG, B., et al., 2021: Appendectomy is associated with alteration of human gut bacterial and fungal communities.- Frontiers in microbiology. 12: 724980.

DOI: 10.3389/fmicb.2021.724980

DELEU, S., MACHIELS, K., RAES, J., VERBEKE, K., & VERMEIRE, S., 2021: Short chain fatty acids and its producing organisms: An overlooked therapy for IBD?- EBioMedicine. 66.

DOI: 10.1016/j.ebiom.2021.103293

FEDOR, I., ZOLD, E., & BARTA, Z., 2021: Microscopic colitis: controversies in clinical symptoms and autoimmune comorbidities.- Annals of Medicine. 53(1): 1280-1285.

DOI: 10.1080/07853890.2021.1962965

DOI: 10.1097/MIB.0b013e318281f3cc

DOI: 10.1007/s10620-016-4306-z

GIRARD-MADOUX, M.J., DE AGüERO, M.G., GANAL-VONARBURG, S.C., et al., 2018: The immunological functions of the appendix: an example of redundancy?- Seminars in immunology Elsevier. 36: 31-44.

DOI: 10.1016/j.smim.2018.02.005

DOI: 10.1016/j.ebiom.2014.11.004

HEUTHORST, L., MOOKHOEK, A., WILDENBERG, M.E., et al., 2021: High prevalence of ulcerative appendicitis in patients with ulcerative colitis.- UEG Journal. 9(10): 1148-1156.

DOI: 10.1002/ueg2.12171

HIGGINS, J.P., 2008: Cochrane handbook for systematic reviews of interventions version 5.0. 1. The Cochrane Collaboration.- http://www. cochrane-handbook. org.

LAING, A.W., PARDI, D.S., LOFTUS JR, E.V., et al., 2006: Microscopic colitis is not associated with cholecystectomy or appendectomy.- Inflammatory bowel diseases. 12(8): 708-711.

DOI: 10.1097/00054725-200608000-00006

DOI: 10.1038/ejcn.2016.130

DOI: 10.1016/0046-8177(89)90198-6

LINDSTRöM, C., 1976: 'Collagenous colitis' with watery diarrhoea--a new entity?- Pathologia Europaea. 11(1): 87-89.

LIU, X., XIAO, S.-Y., PLESEC, T.P., et al., 2013: Collagenous colitis in children and adolescents: study of 7 cases and literature review.- Modern Pathology. 26(6): 881-887.

DOI: 10.1038/modpathol.2012.227

DOI: 10.1038/ajg.2014.182

DOI: 10.1016/j.cgh.2022.05.037

MASAHATA, K., UMEMOTO, E., KAYAMA, H., et al., 2014: Generation of colonic IgA-secreting cells in the caecal patch.- Nature communications. 5(1): 3704.

DOI: 10.1038/ncomms4704

DOI: 10.1177/2050640620951905

MIEHLKE, S., VERHAEGH, B., TONTINI, G.E., et al., 2019: Microscopic colitis: pathophysiology and clinical management.- The Lancet Gastroenterology & Hepatology. 4(4): 305-314.

DOI: 10.1016/S2468-1253(19)30048-2

MOHER, D., SHAMSEER, L., CLARKE, M., et al., 2015: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.- Systematic reviews. 4: 1-9.

DOI: 10.1186/2046-4053-4-1

CAI, S., FAN, Y., ZHANG, B., et al., 2021: Appendectomy is associated with alteration of human gut bacterial and fungal communities.- Frontiers in microbiology. 12: 724980.

DOI: 10.3389/fmicb.2021.724980

DELEU, S., MACHIELS, K., RAES, J., VERBEKE, K., & VERMEIRE, S., 2021: Short chain fatty acids and its producing organisms: An overlooked therapy for IBD?- EBioMedicine. 66.

DOI: 10.1016/j.ebiom.2021.103293

FEDOR, I., ZOLD, E., & BARTA, Z., 2021: Microscopic colitis: controversies in clinical symptoms and autoimmune comorbidities.- Annals of Medicine. 53(1): 1280-1285.

DOI: 10.1080/07853890.2021.1962965

DOI: 10.1097/MIB.0b013e318281f3cc

DOI: 10.1007/s10620-016-4306-z

GIRARD-MADOUX, M.J., DE AGüERO, M.G., GANAL-VONARBURG, S.C., et al., 2018: The immunological functions of the appendix: an example of redundancy?- Seminars in immunology Elsevier. 36: 31-44.

DOI: 10.1016/j.smim.2018.02.005

DOI: 10.1016/j.ebiom.2014.11.004

HEUTHORST, L., MOOKHOEK, A., WILDENBERG, M.E., et al., 2021: High prevalence of ulcerative appendicitis in patients with ulcerative colitis.- UEG Journal. 9(10): 1148-1156.

DOI: 10.1002/ueg2.12171

HIGGINS, J.P., 2008: Cochrane handbook for systematic reviews of interventions version 5.0. 1. The Cochrane Collaboration.- http://www. cochrane-handbook. org.

LAING, A.W., PARDI, D.S., LOFTUS JR, E.V., et al., 2006: Microscopic colitis is not associated with cholecystectomy or appendectomy.- Inflammatory bowel diseases. 12(8): 708-711.

DOI: 10.1097/00054725-200608000-00006

DOI: 10.1038/ejcn.2016.130

DOI: 10.1016/0046-8177(89)90198-6

LINDSTRöM, C., 1976: 'Collagenous colitis' with watery diarrhoea--a new entity?- Pathologia Europaea. 11(1): 87-89.

LIU, X., XIAO, S.-Y., PLESEC, T.P., et al., 2013: Collagenous colitis in children and adolescents: study of 7 cases and literature review.- Modern Pathology. 26(6): 881-887.

DOI: 10.1038/modpathol.2012.227

DOI: 10.1038/ajg.2014.182

DOI: 10.1016/j.cgh.2022.05.037

MASAHATA, K., UMEMOTO, E., KAYAMA, H., et al., 2014: Generation of colonic IgA-secreting cells in the caecal patch.- Nature communications. 5(1): 3704.

DOI: 10.1038/ncomms4704

DOI: 10.1177/2050640620951905

MIEHLKE, S., VERHAEGH, B., TONTINI, G.E., et al., 2019: Microscopic colitis: pathophysiology and clinical management.- The Lancet Gastroenterology & Hepatology. 4(4): 305-314.

DOI: 10.1016/S2468-1253(19)30048-2

MOHER, D., SHAMSEER, L., CLARKE, M., et al., 2015: Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement.- Systematic reviews. 4: 1-9.

DOI: 10.1186/2046-4053-4-1

MOONS, K.G., DE GROOT, J.A., BOUWMEESTER, W., et al., 2014: Critical appraisal and data extraction for systematic reviews of prediction modelling studies: the CHARMS checklist.- PLoS medicine. 11(10): e1001744.

DOI: 10.1371/journal.pmed.1001744

NICCUM, B., CASEY, K., BURKE, K., et al., 2022: Alcohol consumption is associated with an increased risk of microscopic colitis: results from 2 prospective US cohort studies.- Inflammatory bowel diseases. 28(8): 1151-1159.

DOI: 10.1093/ibd/izab220

PARK, S., YANG, S., KIM, M., et al., 2012: Long term follow-up of appendiceal and distal right-sided colonic inflammation.- Endoscopy. 44(01): 95-98.

DOI: 10.1055/s-0031-1291443

PIOVANI, D., DANESE, S., PEYRIN-BIROULET, L., et al., 2019: Environmental risk factors for inflammatory bowel diseases: an umbrella review of meta-analyses.- Gastroenterology. 157(3): 647-659. e644.

DOI: 10.1053/j.gastro.2019.04.016

SANDLER, R.S., KEKU, T.O., WOOSLEY, J.T., GALANKO, J.A., & PEERY, A.F., 2021: Medication use and microscopic colitis.- Alimentary Pharmacology & Therapeutics. 54(9): 1193-1201.

DOI: 10.1111/apt.16594

CAI, S., FAN, Y., ZHANG, B., et al., 2021: Appendectomy is associated with alteration of human gut bacterial and fungal communities.- Frontiers in microbiology. 12: 724980.

DOI: 10.3389/fmicb.2021.724980

Descargar en un gestor de citas

Descargue la cita de este artículo haciendo clic en uno de los siguientes gestores de citas:

Métrica

Este artículo ha sido visitado 118 veces.
Este artículo ha sido descargado 10 veces.

Estadísticas de Dimensions

Estadísticas de Plum Analytics

Ficha Técnica

Recibido: 29/06/2024

Aceptado: 19/12/2024

Prepublicado: 20/01/2025

Publicado: 06/03/2026

Tiempo de revisión del artículo: 169 días

Tiempo de prepublicación: 205 días

Tiempo de edición del artículo: 615 días

Este artículo aun no tiene valoraciones.

Valoración del lector:

Valora este artículo:

Envío y seguimiento de artículos

Normas de publicación

Artículos

Guías de práctica clínica

Revisiones

Artículos destacados

Envío de artículos

Información para los autores

Servicio de traducción

Tiempo editorial – Tiempo de publicación

Revista

Información para revisores

Información para anunciantes

Artículos

Guías de práctica clínica

Revisiones

Artículos destacados

Envío de artículos

Información para los autores

Servicio de traducción

Tiempo editorial – Tiempo de publicación

Revista

Información para revisores

Información para anunciantes

Artículos

Guías de práctica clínica

Revisiones

Artículos destacados

Envío de artículos

Información para los autores

Servicio de traducción

Tiempo editorial – Tiempo de publicación

Revista

Información para revisores

Información para anunciantes

Cookie	Finalidad	Caducidad	Tipo de cookie
ASP.NET_SessionId	Hacen posible el control de tráfico desde el servidor a múltiples usuarios a la vez, la identificación y el acceso como usuario.	Cierre de sesión / Fin de proyecto	Sesión
cookiesDirective	Hacen posible recordar la configuración de las cookies.	Cierre de sesión / Fin de proyecto	Sesión
vercookies	Hacen posible mostrar el aviso del uso de cookies.	Cierre de sesión / Fin de proyecto	Sesión

Descargar en un gestor de citas

Estadísticas de Dimensions

Estadísticas de Plum Analytics

Envío y seguimiento de artículos

¿Quieres recibir cada mes el boletín digital de la REED?

De acuerdo con la legislación vigente, esta publicación está destinada exclusivamente a profesionales del sector sanitario.