APPENDECTOMY AND TONSILLECTOMY IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE

Recent reports of reduced appendectomy rates in patients with ulcerati ve colitis have not distinguished between primary appendectomy (surger y for appendicitis) and incidental appendectomy (removal of the append ix for other reasons). In the present case control study, we examined the frequency of primary appendectomy in subjects with ulcerative coli tis (n = 197) and Crohn's disease (n = 117) compared to a control grou p of dermatology outpatients (n = 243). A reduced rate of primary appe ndectomy was found in the ulcerative colitis group (adjusted odds rati o 0.20, 95% confidence intervals 0.070-0.53, p < 0.0005) but not in th e Crohn's disease patients (adjusted odds ratio 0.93, 95% confidence i ntervals 0.39-2.18, p = NS). These data suggest that appendicitis occu rs less commonly than would be expected in individuals who develop ulc erative colitis. Environmental or immunoregulatory factors may be resp onsible. Tonsillectomy rates were also examined in each study group, b ut no overall differences were found between patients with inflammator y bowel disease and controls.