Friday 7 June 2013
I think that most everyone has heard of this disease, since not a single patient of mine has asked me "What's appendicitis?" when I've told them they have it. But I'm constantly amazed that more people don't ask what the appendix is for. Come on, people! I'm removing a piece of you! Granted it's a little piece (about the size of your little finger), but aren't you the least bit curious to know what the thing does and what's going to happen to you when you don't have it anymore?
If you're really curious...well, tough. The truth is that no one really knows. There are several theories out there, and most of them sound like complete and utter rubbish. Some researchers a few years ago announced that they believe the appendix acts like a "safe haven" for good bacteria which can then recolonise the colon after an infection, essentially "rebooting" the colon. That sounds like a very nice theory, doesn't it? That's wonderful! The human colon has a reset button! It's great, except for one problem - it doesn't. The bacterial flora of the appendix is exactly the same as the rest of the colon. This theory sounds like a bunch of shit to me. Pun intended.
Other researchers believe that it has some immune function, especially in fetuses. This theory is at least partially true - there is some immune tissue in the appendix, but when you look at all the other immune tissue you have, it's a tiny fraction, so it certainly doesn't contribute a whole lot. It's like peeing into a pond. Sure, you might be adding more water, but it's undetectable.
Most people believe the appendix is a vestigial organ - one that used to serve an important function but doesn't anymore due to evolution (THAT'S RIGHT! EVOLUTION! COME AT ME, CREATIONISTS! Please? Pretty please?). It may have contributed to digestion in some manner back when cavemen ate roots and leaves, but it doesn't need to do a whole lot with the burgers and pizza that we stuff into our faces these days.
So the bottom line is that we don't know. Regardless, that doesn't excuse the fact that most people don't even ask. For those rare few who do ask me, I have my own theory, one that I think very few general surgeons would refute:
The sole purpose of the appendix is to keep general surgeons busy and awake in the middle of the night. Fuck you, appendix. Fuck you.