Why does the body need a small appendage in the intestine, which scientists once recognized as useless? Why store something that is so easy to become inflamed and bring a person to the operating room? Maybe it's easier to remove the appendix right away? For clarification, we turned to therapist Alexandra Viktorovna Kosova, who prepared this article for the ABC of Health.

Why does a person have an appendix?

Appendix (synonym - vermiform appendix) is an appendage of the cecum extending from its posterolateral wall.

Rice. 1. Large intestine with appendix.

The appendix has a cylindrical shape, an average length of 8-10 cm, although it is shortened to 3 cm, sometimes it increases to 20 cm. Very rarely there is an absence of the appendix. The diameter of the inlet of the appendix is ​​1-2 mm.

The position of the appendage may be different (see Fig. 2), but the place of origin from the cecum remains constant.

Fig.2. Position of the appendix relative to the cecum.

Only mammals have a vermiform appendix, but not all of them. For example, it is found in sheep, horses, and rabbits. But cows, dogs and cats do not have it. And if there is no appendage, there is no appendicitis (inflammation of the appendix). In horses, the appendix is ​​very large (see Fig. 3), it is an important part of the digestive system: rough parts of plants (bark, hard stems) are thoroughly digested in it.

Rice. 3. Vermiform appendix in a horse.

Remove the appendix to…prevent appendicitis

Although the small appendix in humans is part of the gastrointestinal tract, it does not take part in the digestion process. But the risk of developing appendicitis remains. has always been and remains one of the most common surgical diseases of the abdominal cavity. That is why scientists of the last century came to the conclusion: it is necessary to remove the appendix for preventive purposes.

In general, the conclusions of scientists of the 19th-20th centuries were so quick and, so to speak, superficial that those organs for which they did not find use in the human body were declared rudimentary and subject to removal. “Rudimentum” from Latin means an underdeveloped, residual organ, which in the process of evolution has lost its original function, but in its infancy is passed on from ancestors to descendants. This direction of scientific thought was largely promoted by the evolutionary theory of Charles Darwin (1809 - 1882), according to which variability, as the cause of differences between ancestors and descendants, is due to the influence of the external environment and the characteristics of the organisms themselves. In other words, the vermiform appendix no longer performs its digestive function, because on the ladder of evolution man has risen one step higher than his animal predecessors (according to Charles Darwin’s theory, man descended from animals), and the human digestive system has become different from that of animals. Therefore, the appendix began to be considered a dangerous vestige, capable of causing a terrible disease - appendicitis.

In many countries, various methods have begun to be put into practice prevention of appendicitis. For example, in Germany in the 30s of the last century, for preventive purposes, babies decided to have their appendixes removed. But this was soon abandoned, because it was noticed that these children’s immunity decreased, the number of diseases increased and, as a result, mortality increased.

There was a similar sad experience in the USA. Americans began removing appendixes from babies. After the operation, such children were unable to digest mother's milk and were retarded in mental and physical development. It was concluded that such disorders are associated with impaired digestion - a determining factor in normal growth and development. Therefore, the Americans abandoned this method of preventing appendicitis.

Scientists of the 19th-20th centuries classified many organs as rudiments, the functions of which they could not determine: tonsils (tonsils - a misnomer from a medical point of view), thymus (thymus gland), spleen, etc. At the beginning of the 20th century, scientists counted about 180 rudimentary “useless” organs and anatomical structures in the human body. Nobel Prize winner Ilya Ilyich Mechnikov (1845 - 1916) believed that the human digestive system is poorly adapted to the modern diet. He expressed this idea at the beginning of the 20th century, when the idea of ​​poisoning the body with waste products of putrefactive bacteria living in the large intestine was widespread. That is why it is not surprising that in “Studies about Nature” I.I. Mechnikov wrote: “Now there is nothing daring in the assertion that not only the cecum with its appendage, but even all human colons are superfluous in our body and that their removal would lead to very desirable results.”

The British surgeon-surgeon of the early 20th century, Baronet Sir William Arbuthnot Lane, in contrast to I.I. Mechnikov did not limit himself only to discussions about the negative role of the large intestine in the human body. He removed the entire colon (and with it the putrefactive bacteria). The surgeon performed nearly 1,000 such operations, “leaving countless victims,” the researchers wrote. And only in the 30s. In the 20th century, W. Lane’s activities began to be criticized.

What now?

Currently, scientists believe that it is time to abolish the list of “useless” organs, because Years of research show that previously called vestigial organs perform an important function, and sometimes more than one. According to biologists, the appendix has been preserved and evolved for at least 80 million years. Nature would not leave an unnecessary organ. Perhaps it is worth replacing the list of “unnecessary” organs with a list of organs whose functions are not yet known to us?

The appendix is ​​an important organ of the immune system

A more detailed study of the appendix revealed an abundance of lymphoid tissue- tissue that provides the protective abilities of the immune system. Lymphoid tissue makes up 1% of a person's body weight. Lymphocytes and plasma cells are formed in lymphoid tissue - the main cells that protect the human body from infection and fight it, if it does get inside. Lymphoid tissue is distributed in the body in the form of lymphoid organs: lymph nodes, spleen, thymus gland (thymus), tonsils, Peyer's patches in the digestive tract. A particularly large number of Peyer's patches are found in the appendix. It is not for nothing that the appendix is ​​called the “intestinal tonsil” (tonsils, like the appendix, are rich in lymphoid tissue - see figure).

Fig.4. Lymphoid tissue in the digestive tract:

1 - serous membrane (covers the intestine from the outside);

2 - muscular layer (middle layer of the intestine);

3 - mucous membrane (inner layer of the intestine);

4 - mesentery of the small intestine (anatomical structure in which vessels and nerves approach the intestine);

5 - single lymphoid nodules;

6 - group lymphoid nodule (Peyer's patch),

7 - circular folds of the mucous membrane.

Rice. 5. Cross section of the appendix (histological specimen). Hematoxylin-eosin staining.

1 - numerous depressions (crypts) in the mucous membrane of the appendix;

2 - lymphatic follicles (Peyer's patches);

3 - interfollicular lymphoid tissue.

Rice. 6. Microscopic structure of the palatine tonsil:

1 - tonsil crypts;

2 - integumentary epithelium;

3 - lymphoid nodules of the tonsil.

In other words, the appendix has a very powerful lymphatic system. Cells produced by the lymphoid tissue of the appendix are involved in protective reactions against genetically foreign substances, which is especially important considering that the digestive tract is a channel through which foreign substances constantly enter. Peyer's patches (a collection of lymphoid tissue) in the intestines and, in particular, in the appendix “stand” like guards at the border.

So, it has been absolutely proven that the appendix is ​​a very important organ of the immune system.

The appendix is ​​a repository of beneficial bacteria

In 2007, Duke University Medical Center (Durham, North Carolina, USA) published an article stating that the appendix is ​​a repository of good bacteria (“Appendix isn’t useless at all: it’s a safe house for good bacteria”). .

Microorganisms involved in digestion live in the human intestine. Most of them are beneficial (Escherichia coli, bifidobacteria, lactobacilli), and some are conditionally pathogenic, which cause diseases only with reduced immunity (nervous stress, physical overload, alcohol intake, etc.). Normally, a balance is maintained between opportunistic and beneficial microorganisms.

With intestinal diseases (for example, dysentery, salmonellosis and many others), accompanied by diarrhea (loose stools), as well as with the activation of conditionally pathogenic microflora, the number of “useful” microorganisms sharply decreases. But in the appendix, as a repository of “useful” bacteria, they remain and contribute to the new colonization of the intestines after recovery and cessation of diarrhea. People without an appendix are more likely to develop dysbiosis after an intestinal infection (compared to people who have a preserved appendix). However, this does not mean that such people are doomed. Currently, there is a group of prebiotics and probiotics that help a person restore normal intestinal microflora.

The entrance to the appendix, as mentioned above, is only 1-2 mm in diameter, which protects the appendix from the penetration of intestinal contents, allowing the appendix to remain a so-called “incubator”, a “farm” where beneficial microorganisms multiply. That is, the normal microflora of the large intestine is stored in the appendix.

Conclusion

To summarize, we can distinguish 2 main functions of the appendix:

1) it is an important organ of the immune system;

2) this is a place of reproduction and storage of beneficial intestinal bacteria.

The appendix continues to be studied to this day, so it is quite possible that in the near future we will learn about its other functions. But even now we can say that there is no need to remove the appendix without a good reason. And this cause is inflammation of the appendix - acute appendicitis. In this case, it is necessary to remove the appendix, because the risk of complications and their severity are very high. Earlier, when epidemics were frequent and the drug market was relatively small, the role of the appendix was extremely significant. Nowadays, damaged microflora can be restored with the help of medications. And acute appendicitis most often affects people aged 10-30 years, and their immune system is stronger than that of American and German infants.

Therefore, if symptoms of acute appendicitis occur, you should immediately consult a doctor!

therapist A.V. Kosova

The appendix is ​​a cone-shaped extension of the cecum, 6-12 cm long. It is attached to the organs of the abdominal cavity by the mesentery, which can have different lengths and causes the atypical location of the organ. This often complicates diagnosis and makes it difficult to perform surgery. The organ consists of the same lymphoid tissue as bone marrow cells. The functions of the appendix are associated with the restoration of intestinal microflora after infectious diseases, since beneficial bacteria are isolated in it. The latter die as a result of taking antibiotics, sugar, birth control pills, as a result of prolonged, severe stress. An organ becomes inflamed once in a lifetime and can only be treated surgically.

Functions of the appendix

Why does a person need an appendix? Why is it formed in the body? As a result of numerous studies of the appendage of the cecum, we found out what the main properties of the appendage are.

The appendix is ​​necessary for the regulation of water-salt metabolism. It actively produces murein, which releases amino acids, vitamins B and K, fatty and nucleic acids, and carbohydrates from food entering the intestines. This body:

• helps move stool through the colon;
• releases B lymphocytes;
• produces antibodies;
• produces sialic acid.

The appendix is ​​a vestige because it is one of several organs that have lost their main function during human evolution. They are laid in the embryonic period, but then stop developing. Vestigial human organs include hair, extra teeth and nipples.

Rudimentary formations confirm the long evolutionary development of people and perform many functions. Examples of rudiments:

• wisdom teeth - helped a person chew hard and rough food;
• coccyx - the remnant of the caudal region;
• pyramidal muscle of the abdomen - a muscle triangle that stretches the linea alba, is important only in marsupials;
• ear muscles - allowed ancestors to move their ears;
• epicanthus - a fold of skin on the upper eyelid that protected from wind, sun, sand and dust.

Sometimes vestigial human organs develop completely and require surgical removal.

Treatment of inflammation of the appendix remains the most common reason for abdominal surgery (89%).

Due to the influence of various reasons: decreased immunity, clogging of the opening of the appendage of the cecum with coprolites, waste products of helminths, seeds, bones, foreign objects, endocrine and hormonal changes, a pathological process begins in the appendix.

Appendicitis is accompanied by severe pain, mainly in the right side of the abdomen, nausea, vomiting, fever, flatulence, chills, and upset stool.

When you contact a specialist and perform an examination with palpation and specific tests, a diagnosis is established. If the location of the appendix is ​​atypical, CT, MRI, X-ray diagnostics, and ultrasound are used as additional studies. It is imperative to differentiate from ruptured abdominal muscles, gynecological problems, and gastrointestinal diseases.

The diagnosis of appendicitis requires urgent surgical intervention. This can be a classic appendectomy or laparoscopic removal of the appendix. In the first case, a scar up to 10 cm long remains, the second method allows for faster recovery and does not have significant external traces of the intervention. It's preferable. Hospital stay varies from 7 days to 40 days (if complications occur).

Undesirable consequences of appendicitis are abscess, peritonitis, the formation of adhesions, and intestinal obstruction. Without treatment, they can cause the death of the patient.

The rehabilitation period includes limiting physical activity, reducing the intensity of physical activity, as well as a ban on eating fatty, fried and overly spicy foods for up to 2 months.

Sick leave after treatment is issued for 1-2 weeks. If postoperative complications occur, it is extended.

The human appendix is ​​considered a rudiment. However, it restores normal intestinal microflora, performing barrier, secretory, and protective functions in the body. That's what the appendix is ​​for. Removing the appendix for preventive purposes will not bring health benefits, however, in case of appendicitis, only surgery can save a person.

What can the removal of appendicitis lead to? and got the best answer

Answer from Illusion[guru]
Now the dirt will not accumulate, and you will be dirt-free!

Reply from Danil Ushakov[expert]
Why is this nonsense in the top answers?

Reply from Noldor77777[master]
Appendix, vermiform appendix, cecum - all these are the names of one reductive appendix that a person inherited from his more ancient ancestors. The appendix has a clot of lymphatic tissue at its location and performs a function similar to the lymph nodes (immune). However, when it is removed, the immune system does not suffer in any way because the neighboring lymph nodes take the load, the operation is absolutely safe and, as a rule, proceeds without complications; in rare cases, adhesions may form after the operation, but I repeat that this happens very rarely. You can rest assured that after removal of the appendix, your body will not be harmed in any way.

Reply from Olga[guru]
...to the fact that peritonitis will not be his fault!! And since it is an immune organ, maybe the immunity will decrease a little, so you’re vitamin-loving!!))

Reply from Master master[guru]
The appendix is ​​the most unnecessary part of the body!!! It has no functions, it only causes harm! It can make itself felt at the most inopportune moment!
When traveling, on vacation, etc.

Reply from Ekaterina Malofeeva[guru]
it was once needed, but now it is attvism, which is clogged with toxins, so it has no special purpose, and now all waste will simply leave the body

Reply from Koshk[guru]
to a two-week diet on semolina porridge

Reply from Kamil Volzhsky[guru]
Straight out....

Reply from 3 answers[guru]

Not so long ago, the appendix was considered a useless and even harmful organ. It was removed for anyone who complained of sudden abdominal pain. And after the operation it often turned out that there was no trace of inflammation. But the doctors were in no hurry to admit the mistake: they say it was not removed in vain, anyway, sooner or later it would have become inflamed...

And only recently, a study of the results of this practice showed that children who had the appendage of the cecum unreasonably removed at an early age lagged behind their peers in both physical and mental development. In general, people with “accidentally” removed appendixes are more likely than others to suffer from a variety of diseases. Why, they were unable to explain then.

In the human body, the appendix does not take part in the digestion process, but this does not mean that it is not needed. Our vermiform appendix of the cecum (this is the full name of the appendix) is lymphoid tissue (like the tonsils in the throat) in which cells that perform important immune functions function.

In other words, the appendix takes an active part in all the body's defense reactions. This appendix reacts especially quickly to inflammatory disorders in the cecum and the entire gastrointestinal tract - it is not without reason that it is often called the “intestinal tonsil”. But it is precisely this feature that can turn the appendix into a vulnerable spot.

If the lymphoid tissue works frequently and intensively, then its walls swell, peristalsis is disrupted, the contents are retained, and an inflammatory process - appendicitis - begins to develop.

The size of the human appendix is ​​small, usually from 5 to 10 cm. In some people, the length of the appendix reaches 18 cm, but this is rare.
It should be said that although acute appendicitis (i.e. inflammation of the appendix) is the most common cause of surgical interventions, most people - 60% - live without knowing this problem at all.

Causes of inflammation

It is generally accepted that the appendix becomes inflamed when hard, indigestible particles enter it, for example, seed husks, etc. We repeat: this is a fallacy. The appendix opening is too small - 1-2 mm. Experienced surgeons can remember only isolated cases when an apple seed or an olive pit was found in the appendix.

The appendix becomes inflamed when it begins to “let in” bacteria that inhabit the intestines. First, suppuration occurs in the mucous membrane itself, and then in all layers of the wall of the appendix. This process is very active in the presence of fecal stones, constipation, and increased putrefactive fermentation in the intestines.

Modern experts tend to attribute the gastronomic preferences of modern people, as well as widespread allergization, to the causes of acute appendicitis. Oddly enough, appendicitis used to be rare - it is generally a relatively new disease. Doctors complain that we have begun to eat too much meat, and this is precisely the provoking factor.

Dangerous age

Statistics say that most often young, healthy people of working age end up on the operating table with acute appendicitis. Appendicitis is rare in children, as well as in people over 50 years of age. The most “appendicitis” period in a person’s life is from 15 to 39 years. Moreover, in this case, the hereditary factor plays an important role. It has been noticed that if one of the parents has had their appendix removed, then the likelihood of such an operation in children is high.

Appendicitis in pregnant women

Acute appendicitis in pregnant women is not that uncommon. Can pregnancy trigger this painful condition? This option is not excluded, because during this period many body systems, including the immune system, are overloaded. An additional provoking factor may be the load on the abdominal organs. In addition, we have already mentioned that appendicitis “loves” young people.

But in any case, you should not panic. Similar operations were performed 50 years ago and very successfully: the children who were then in the mother’s womb have already grown up their own grandchildren. The operation is performed under general anesthesia. There is no need to be afraid of this - modern means allow you to avoid the negative effects of anesthesia on the fetus.

In two weeks, only a small pink scar will remain from the appendicitis, which you will soon forget to even think about. After all, your world is filled with wonderful anticipation and unique communication with an unborn but already living person!

Signs of appendicitis

It is difficult to recognize appendicitis by the first symptoms, because nausea, periodic abdominal pain and a slight increase in body temperature (up to 37.5? C) can be manifestations of many other diseases. For example, poisoning, flu, consequences of injury, etc. Sometimes vomiting or diarrhea (diarrhea) occurs with appendicitis.

In many patients, pain occurs not where the appendix is ​​located, but in the epigastric region (“under the stomach”). This suggests cholecystitis, gastritis and other diseases. The bad thing is that when such symptoms appear, the “heavy artillery” of all imaginable home remedies is used - choleretic tinctures, heating pads, enemas and gastric lavage. Such manipulations are dangerous!

Before the doctor arrives, you should not use painkillers or antibiotics. An enema can cause severe painful spasms and lead to intestinal perforation. Under no circumstances should you warm your stomach with a heating pad or a warm bath. You need to immediately consult a surgeon or call an ambulance.

You shouldn’t be patient and waste time - you won’t get a medal for courage, but it’s very easy to get into trouble. After all, appendicitis is not just inflammation, but inflammation that develops at a monstrous speed. It is advisable to have the operation done 6-8 hours after the first symptoms appear. A delay of a few more hours threatens tissue necrosis and severe inflammation of the abdominal cavity - peritonitis.

How to behave

Each person may have a special, individual manifestation of the disease, so you should not compare yourself with anyone and try to make a diagnosis yourself. This should be done by a doctor. A picture similar to appendicitis can be caused by kidney disease, gastritis, enterocolitis, acute inflammation of the ovaries, cysts of various locations, pneumonia, ectopic pregnancy, etc. As a rule, it will not be difficult for an experienced doctor to distinguish inflammation of the appendix from other pathology using special diagnostic signs when examining a patient.

Surgery and rehabilitation

The operation itself is not considered difficult if it is performed on time and there are no additional complicating circumstances. In mild cases it lasts 20-30 minutes. But sometimes there are anatomical features of the location of the appendix that make access to it difficult.

Excess weight and significant fat deposits are also an obstacle. But the most important thing for a successful operation is the condition of the patient in which he arrives on the operating table. It is very important to establish the correct diagnosis as early as possible.

And the very next day after the operation you need to get up and try to take at least a couple of steps. This prevents the formation of adhesions. For the first 2-3 days, patients are prescribed a diet - kefir, liquid porridge, pureed soup, steamed cutlets. Then you can gradually eat your usual food - everything except spicy dishes and smoked meats. After 7-10 days, the former patient is already “back in action.” But for another month, doctors recommend limiting physical activity.

This is interesting!

It turns out that not every God's creature inherited an appendix. Herbivores (sheep, camels, horses) have an appendix, and in some species it reaches impressive sizes - up to several meters. Unlike the human body, this is an important part of their digestive system.

A large amount of difficult-to-digest food (bark, hard stems, thorns) accumulates in it and undergoes thorough fermentation. After such additional processing, the toughest plant foods are easily digestible.

But cats do not have an appendix. Therefore, they are not at risk of appendicitis. In rabbits and guinea pigs, the appendix becomes quite inflamed. But diagnosing it in pets is extremely difficult, almost impossible - all hope lies in an experienced veterinarian.

The appendix is ​​a small extension of the cecum that has nothing to do with the digestive process. It supports the microflora of the large intestine, serves as a kind of incubator for E. coli, from which new portions enter the large intestine/

The most “appendicitis” period in a person’s life is from 15 to 39 years.

Statistics show that up to 9% of patients still die from inflammation of the appendix and the resulting complications!

If symptoms of acute appendicitis appear, you should not use painkillers and antibiotics. An enema can cause severe painful spasms and lead to intestinal perforation. Under no circumstances should you warm your stomach with a heating pad or a warm bath. You need to immediately consult a surgeon or call an ambulance.

Even children probably know what appendicitis is. Maybe that’s why they’re not particularly afraid of him - well, they’ll cut him out and that’s it. But even a hundred years ago people died from appendicitis, and when surgeons learned to operate on it, it was a great achievement of medical science.

“Appendicitis occurs when a special organ of the human body becomes inflamed - the appendix, or in Latin - appendix, which means “appendage,” says surgeon Denis Kovalev. - The appendix is ​​located at the very beginning of the cecum.

This is a narrow winding tube about six centimeters long, which at one end opens into the lumen of the cecum, and the other end is closed. It turns out that the appendix really is some kind of awkward appendage - who needs a gut that leads nowhere?

For a long time, the appendix was treated as an “extra” organ. The founder of immunology, I. Mechnikov, believed that the process does not perform any useful function. The scientist reasoned as follows: firstly, removal of the appendix does not affect the physiological functioning of a person, and secondly, in old age it often completely atrophies.

But today the appendix has begun to command more and more respect for itself. In the submucosal layer of its walls, scientists discovered a large number of lymphatic follicles that protect the intestines from infection and cancer. Due to the abundance of lymphoid tissue, the appendix is ​​sometimes even called the “intestinal tonsil”.

This is a comparison that is not lame: if the tonsils in the pharynx are a barrier to infection rushing into the respiratory tract, then the appendix “inhibits” microbes that are trying to multiply in the contents of the intestine. New data forced doctors to change their attitude towards removing the appendix.

Our country has passed this epidemic, but just 15 years ago, a rare American newborn left the maternity hospital with his appendix intact: overseas doctors considered them to be “useless” and “dangerous” organs (these, in addition to the appendix, included the foreskin and palatine tonsils) need to get rid of it as soon as possible...

Unfortunately, anyone can have an inflamed appendix. The only condition for this is to be human, because animals simply do not have such an organ. The most “fruitful” age for appendicitis is thirty to forty years. And one more thing: vermiform appendages fail women twice as often as men.

In case of appendicitis, timely surgery ensures recovery for almost everyone; sad results occur only with severe complications - no more than 0.02-0.4% of cases.

Scientists are still arguing about the immediate causes of appendicitis. Everyone agrees that pathogenic microorganisms settle in the appendix and actively multiply, but there is no specific, “special” pathogen for appendicitis.

However, observations show that appendicitis is a greater threat to those who prefer meat foods (it causes stagnation in the intestines and promotes rotting and fermentation), and in children worms can push the appendix to inflammation.

Some scientists believe that appendicitis can develop if there are foci of chronic inflammation in the body (carious teeth, inflamed tonsils). The lymphoid tissue of the appendix can also “rush into the embrasure” of the fight against infection, which results in appendicitis.

And for any prolonged pain in the abdomen (and not necessarily on the left), you need to go to the hospital. The examination will be quick: doctors will need to find out what the content of inflammatory cells - leukocytes - is in the blood. If their number reaches twenty thousand per microliter (the norm is four to nine thousand), there is a high probability of appendicitis. If any doubts remain, ultrasound examination will resolve them.

Nowadays, appendicitis is rarely operated on under local anesthesia: although it does not hurt, it is scary. Doctors say: a person should not be present at his operation, and therefore they prefer general anesthesia using a mask.

The operation for appendicitis - appenectomy - is well established and usually lasts about fifteen to twenty minutes. You should not try to have the most experienced professor perform the operation: the qualifications of an ordinary surgeon are quite sufficient here. There is no other treatment other than surgery for appendicitis.

Typically, recovery after appendectomy occurs quickly: the sutures from the skin are removed after seven to eight days, and ten to twelve days after the operation, patients are discharged home. However, it will be early to go to work: at the clinic, the sick leave will be extended to three weeks, since a full recovery requires a certain period of time.

By the way, you shouldn’t use your sick leave time to do a bunch of things around the house. It is better to take a vacation from worries and treat yourself to peace.

In the future, the absence of the appendix does not threaten any trouble: it is not needed for digestion, and its role in the body’s immune defense will be taken over by other organs of the immune system.”