Appendicectomy, childhood hygiene, Helicobacter pylori status, and risk of inflammatory bowel disease: a case control study

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Abstract
Aims—To examine the relation between inflammatory bowel disease and appendicectomy, childhood domestic hygiene, andHelicobacter pylori infection.Methods—Case control study involving 213 patients with ulcerative colitis, 110 with Crohn’s disease, and 337 controls having elective surgery.Results—Nine patients with ulcerative colitis (4.5%) reported a previous appendicectomy compared with 57 controls (19%) (odds ratio (OR) 0.20, 95% confidence interval (CI) 0.1–0.4, pH pylori seroprevalence was positively associated with overcrowding (pH pyloriseroprevalence was no lower in patients who had been exposed to sulphasalazine than in controls or those not exposed.Conclusions—Our findings confirm the strong inverse association between previous appendicectomy and the development of ulcerative colitis and suggest that the protective effect is greater for appendicectomy performed in childhood.