In order to investigate the possible role of fiber in the etiology of acute
appendicitis, 203 consecutive appendectomized children with histologically
proved appendicitis and 1922 controls were studied by the diet history met
hod. Statistics were performed by multivariate analysis of variance, discri
minant analysis and chi(2). Appendectomized children had statistically sign
ificant lower mean daily intake of fiber (17.4 g versus 20.4 g, P < 0.001)
including all fiber fractions: cellulose, uronic acid, pentose, exose and l
ignin. No statistical difference was found for energy, protein, carbohydrat
e and fat intake. Discriminant analysis proved that only cellulose and exos
e are independently correlated to appendicitis and lower fiber intake is th
ought to be the cause in 70% of the cases. Recurrent abdominal pain, chroni
c constipation and positive family history of appendectomy were more freque
nt in appendectomized children (P < 0.001). This study gives evidence that
low fiber intake could play an important role in the pathogenesis of append
icitis.