TY - JOUR T1 - Appendectomy and risk for inflammatory bowel disease: effect of age and time post appendectomy – a cohort study JF - BMJ Open Gastroenterology JO - BMJ Open Gastro DO - 10.1136/bmjgast-2022-000925 VL - 9 IS - 1 SP - e000925 AU - Canisius Fantodji AU - Prévost Jantchou AU - Marie-Elise Parent AU - Marie-Claude Rousseau Y1 - 2022/07/01 UR - http://bmjopengastro.bmj.com//content/9/1/e000925.abstract N2 - Background and objective Appendectomy may modulate the risk of inflammatory bowel disease through an effect on the gut microbiota. This study investigated the associations between appendectomy and incidence of Crohn’s disease (CD) or ulcerative colitis (UC), with an emphasis on the influence of age and time post appendectomy.Methods This cohort study included 400 520 subjects born in Québec in 1970–1974 and followed until 2014. Administrative health data were used to ascertain appendectomy and cases of CD and UC. Cox proportional hazards models with time-dependent variables (appendectomy and time elapsed post appendectomy) allowed for the estimation of HRs and 95% CIs.Results A total of 2545 (0.6%) CD cases and 1134 (0.3%) UC cases were identified during follow-up. Appendectomy increased the risk of CD (HR=2.02; 95% CI: 1.66 to 2.44), especially when performed at 18–29 years of age. The risk of CD was increased in the first 2 years, and decreased significantly after ≥15 years post appendectomy. Appendectomy appeared to protect against UC (HR=0.39; 95% CI: 0.22 to 0.71). The risk of UC was not associated with age at appendectomy, but decreased with time elapsed post appendectomy (HR=0.21; 95% CI: 0.06 to 0.72, comparing ≥5 with 0–4 years after appendectomy).Conclusions The increased risk of CD related to appendectomy in young adults may result from detection bias, but physicians should have a low threshold for suspicion of CD in young symptomatic adults with a history of appendectomy. A strong protective effect of appendectomy against UC was observed after 5 years.No data are available. Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available. ER -