How Your Appendix Works

Posted on Jul 31, 2013 in Medical Rewind

This diagram shows the location of the appendix at the cecum. Unfortunately, that’s also a likely place for infection to occur.

Bodily Organ Image Gallery

Location, location, location. You’ve likely heard this phrase thrown around in the real estate world, but the truth is it can be used to describe the appendix, too. Except here’s the problem: The appendix is in a bad neighborhood. The location of the appendix is at the cecum — the beginning of the colon where the small and large intestines join — which places it in a prime spot for infection. The appendix resembles a closed end tube with an opening in the middle that can allow fecal matter to enter, so it’s easy to see how an infection in the appendix can quickly develop and become a health emergency. The appendix is only about 3 or 4 inches long, so why all the trouble from such a small organ?

Here’s another head-scratcher — the appendix doesn’t appear to have any function in the human body. Scientists theorize that the appendix is a remnant of an ancient digestive tract. They believe that it might have been used by early man to digest tough leaves and bark.

­Because doctors don’t really know the purpose of the appendix, they’re unable to determine what system it belongs in. It’s a simple structure that’s made up of two types of tissue. The outside of the appendix is muscle tissue, but given the lack of activity, the muscle is considerably weaker than the muscle tissues that make up other organs. The lining of the appendix is filled with lymphatic tissue, which produces antibodies, leading many to believe that the appen­dix may be part of the immune system. Another odd characteristic of the appendix: It manufactures and secretes a small amount of mucus. No doubt about it, the appendix is confusing.

Of course, it’s understood that the human body functions perfectly well without the appendix, but some scientists are still unwilling to declare the appendix useless.

Does the appendix have a function?

The appendix — an organ barely 4 inches long — causes much debate among medical professionals. In fact, doctors have trouble deciding if the appendix has any use to the body at all. While everyone agrees that the appendix can be removed without causing any adverse health consequences to the patient, some physicians and researchers believe that the appendix does serve a function as part of the immune system. Others feel that the appendix is a vestigial organ, a remainder from the time when humans regularly dined on tree bark and needed an additional organ to break down the roughage. Along with the disagreement over the true function of the appendix, there is no consensus if humans will always have this organ. Some doctors feel that the evolution of the human body will lead to the demise of the appendix, while others believe that the appendix will remain in the body, continuing to do whatever it does.

If the appendix has no purpose, yet is potentially subject to all of these dangerous — even life threatening — conditions, then why can’t we simply have a doctor remove our appendix as a preventative procedure?

With no clear determination of what the appendix does, there’s no agreement on whether prophylactic appendectomies — appendectomies performed to avoid possible future medical emergencies — are medically appropriate. For years rumors have circulated that astronauts had their appendixes removed before space travel to avoid a potential medical emergency while in orbit. For similar (yet more earthbound) reasons, many people wonder whether they should have theirs removed before boarding an international flight. There’s no truth to the rumor about astronauts, and most physicians do not recommend preventative appendectomies for world travelers either. Seven percent of the general population will have their appendix removed at some point in their lives. Given these low odds, and the fact that most insurance plans will not pay for a prophylactic appendectomy, they are generally not considered for the healthy traveler.

Prophylactic appendectomies are occasionally performed if the patient is undergoing other abdominal surgery. For instance, if the patient has an ovarian cyst removed or a hysterectomy, the doctor may perform an appendectomy at the same time. The reason for this is twofold. If the patient has a history of abdominal pain, such as with endometriosis, that pain can mask the symptoms of appendicitis. Additionally, recovering from abdominal surgery isn’t pleasant, and by removing the appendix at the same time as conducting other surgery, you minimize the likelihood of additional surgery.