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When the appendix gets surgically removed, it's typically because it's in the process of dying and trying to take the patient out with it. So its usefulness has already ended at that point.

There are cases of appendicitis that are treatable with antibiotics, but in general it tends to come on too quickly and severely for that.

Fair enough.

What are the impacts to one's health living without an appendix, though?

>Now that the appendix's usefulness has been discovered, isn't it dangerous to deliberately remove it?

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No. People who have their appendix removed typically have no problems. The current thinking that the appendix harbors beneficial bacteria is primarily relevant in cases where the rest of the beneficial bacteria in the intestines are mostly lost for some reason. If they are not, then having an appendix does not appear to make much difference.

but this ends up being problematic in cases where I need to use a lot of heavy antibiotics, or c diff, a lot of diarrhea, etc.

It appears that the rate of infection is slightly higher for people without an appendix, but for most people without an appendix, there is no noticeable difference in quality of life.

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>So what does this mean for people who have had their appendix removed? Luckily, not much. “In general, people who have had an appendectomy tend to be relatively healthy and not have any major detrimental effects,” Smith says. (She herself had hers out at age 12.)
Some studies have shown, however, that people without an appendix may have slightly higher rates of infection than those with a functioning organ. “It may also take them slightly longer to recover from illness, especially those in which the beneficial gut bacteria has been flushed out of the body,” Smith added.

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https://time.com/4631305/appendicitis-appendix-gut-bacteria/

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Most people who have their appendix removed don't have problems.

Since appendectomies have been going on for a long time, with many thousands done every years, the evidence is pretty solid that it is generally not a serious problem to have it removed.

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>About 327,000 appendectomies were performed during U.S. hospital stays in 2011, a rate of 10.5 procedures per 10,000 population.

https://en.wikipedia.org/wiki/Appendectomy

With that rate of the surgery, there are millions of people without an appendix, and most of them have no discernible problems from it. So this is not something one should be particularly worried about.

Most people who have their appendix removed don't miss it at all.

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Good news: even without an appendix, your gut still recovers completely after massive diarrhea, antibiotics, etc. Your gut has other reservoirs for good bacteria.

The case against appendectomies is weak, but growing. We know the appendix does good stuff, but that good stuff is small and is significantly outweighed by risk.

Background: appendicitis is inflammation in one of your internal organs, usually resulting in catastrophic failure. The appendix is like a fragile balloon, the inflammation easily causes it to rupture, spilling bacteria and infection into your internal body cavity.

Pre-surgical intervention in ~1800 and something, it was close to 100% death.

Modern practice: three methods of treatment. (1) do nothing, observe, (2) strong dose of antibiotics, (3) surgical removal.

The timing for (2) is difficult and the consequences of failure are bad. There is a risk/reward calculation. Step (2) you avoid surgery, which has some small potential of things going wrong. But if it escalates, you are now starting stage (3) anyway but with slightly higher risk than earlier in the day. Roughly, 40% of antibiotic treatments need to progress to surgery. 10% of early patients have complications such as perforation (e.g. burst appendix, long recovery, more drugs), but 30% of late patients develop complications. If surgical resources are available, let's just do that now rather than let it get worse.

We evaluate all risks. Risk of early surgery, risk of later surgery, availability of resources, immediate and long term life style risks.

We know appendectomy changes your gut microbiome. Not necessarily worse, just different.

For instance, regular population about 35 people in 100,000 develop colo-rectal cancer. After an appendix, that goes up to ~70 in 100,000. Note: still a 99.9+% nobody develops that type of cancer.

Do you think I should use fermentable foods or probiotics to bring me closer to a more normal person with a microbiota who has an appendix? or maybe it makes me even better than a normal person? Perhaps if I have bowel complications or intolerances, FMT would be the way to go.

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