11 Facts About the Appendix

Illustration by Mental Floss / Images: iStock
Illustration by Mental Floss / Images: iStock

Despite some 500 years of study, the appendix might be one of the least understood structures in the human body. Here's what we know about this mysterious organ.

1. THE ANCIENT EGYPTIANS CALLED IT THE "WORM" OF THE BOWEL.

The human appendix is small, tube-shaped, and squishy, giving ancient Egyptians, who encountered it when preparing bodies for funerary rites, the impression of a worm. Even today, some medical texts refer to the organ as vermiform—Latin for "worm-like."

2. THE APPENDIX SHOWS UP IN LEONARDO DA VINCI’S DRAWINGS.

The earliest description of a human appendix was written by the Renaissance physician-anatomist Jacopo Berengario da Carpi in 1521. But before that, Leonardo da Vinci is believed to drawn the first depiction of the organ in his anatomical drawings in 1492. Leonardo claimed to have dissected 30 human corpses in his effort to understand the way the body worked from mechanical and physiological perspectives.

3. IT'S ABOUT THE SIZE OF A PINKY FINGER.

The appendix is a small pouch connected to the cecum—the beginning of the large intestine in the lower right-hand corner of your abdomen. The cecum’s job is to receive undigested food from the small intestine, absorb fluids and salts that remain after food is digested, and mix them with mucus for easier elimination; according to Mohamad Abouzeid, M.D., assistant professor and attending surgeon at NYU Langone Health, the cecum and appendix have similar tissue structures.

4. CHARLES DARWIN THOUGHT IT WAS A VESTIGIAL ORGAN …

The appendix has an ill-deserved reputation as a vestigial organ—meaning that it allegedly evolved without a detectable function—and we can blame Charles Darwin for that. In the mid-19th century, the appendix had been identified only in humans and great apes. Darwin thought that our earlier ancestors ate mostly plants, and thus needed a large cecum in which to break down the tough fibers. He hypothesized that over time, apes and humans evolved to eat a more varied and easier-to-digest diet, and the cecum shrank accordingly. The appendix itself, Darwin believed, emerged from the folds of the wizened cecum without its own special purpose.

5. … BUT THE APPENDIX PROBABLY EVOLVED TO HELP IMMUNE FUNCTION.

The proximity and tissue similarities between the cecum and appendix suggest that the latter plays a part in the digestive process. But there’s one noticeable difference in the appendix that you can see only under a microscope. “[The appendix] has a high concentration of the immune cells within its walls,” Abouzeid tells Mental Floss.

Recent research into the appendix's connection to the immune system has suggested a few theories. In a 2015 study in Nature Immunology, Australian researchers discovered that a type of immune cells called innate lymphoid cells (ILCs) proliferate in the appendix and seem to encourage the repopulation of symbiotic bacteria in the gut. This action may help the gut recover from infections, which tend to wipe out fluids, nutrients, and good bacteria.

For a 2013 study examining the evolutionary rationale for the appendix in mammal species, researchers at Midwestern University and Duke University Medical Center concluded that the organ evolved at least 32 times among different lineages, but not in response to dietary or environmental factors.

The same researchers analyzed 533 mammal species for a 2017 study and found that those with appendices had more lymphatic (immune) tissue in the cecum. That suggests that the nearby appendix could serve as "a secondary immune organ," the researchers said in a statement. "Lymphatic tissue can also stimulate growth of some types of beneficial gut bacteria, providing further evidence that the appendix may serve as a 'safe house' for helpful gut bacteria." This good bacteria may help to replenish healthy flora in the gut after infection or illness.

6. ABOUT 7 PERCENT OF AMERICANS WILL GET APPENDICITIS DURING THEIR LIFETIMES.

For such a tiny organ, the appendix gets infected easily. According to Abouzeid, appendicitis occurs when the appendix gets plugged by hardened feces (called a fecalith or appendicolith), too much mucus, or the buildup of immune cells after a viral or bacterial infection. In the United States, the lifetime risk of getting appendicitis is one in 15, and incidence in newly developed countries is rising. It's most common in young adults, and most dangerous in the elderly.

When infected, the appendix swells up as pus fills its interior cavity. It can grow several times larger than its average 3-inch size: One inflamed appendix removed from a British man in 2004 measured just over 8 inches, while another specimen, reported in 2007 in the Journal of Clinical Pathology, measured 8.6 inches. People with appendicitis might feel generalized pain around the bellybutton that localizes on the right side of the abdomen, and experience nausea or vomiting, fever, or body aches. Some people also get diarrhea.

7. APPENDECTOMIES ARE ALMOST 100 PERCENT EFFECTIVE FOR TREATING APPENDICITIS.

Treatment for appendicitis can go two ways: appendectomy, a.k.a. surgical removal of the appendix, or a first line of antibiotics to treat the underlying infection. Appendectomies are more than 99 percent effective against recurring infection, since the organ itself is removed. (There have been cases of "stump appendicitis," where an incompletely removed appendix becomes infected, which often require further surgery.)

Studies show that antibiotics produce about a 72 percent initial success rate. “However, if you follow these patients out for about a year, they often get recurrent appendicitis,” Abouzeid says. One 2017 study in the World Journal of Surgery followed 710 appendicitis patients for a year after antibiotic treatment and found a 26.5 percent recurrence rate for subsequent infections.

8. AN INFECTED APPENDIX DOESN’T ACTUALLY BURST.

You might imagine a ruptured appendix, known formally as a perforation, being akin to the "chestbuster" scene in Alien. Abouzeid says it's not quite that dramatic, though it can be dangerous. When the appendix gets clogged, pressure builds inside the cavity of the appendix, called the lumen. That chokes off blood supply to certain tissues. “The tissue dies off and falls apart, and you get perforation,” Abouzeid says. But rather than exploding, the organ leaks fluids that can infect other tissues.

A burst appendix is a medical emergency. Sometimes the body can contain the infection in an abscess, Abouzeid says, which may be identified through CT scans or X-rays and treated with IV antibiotics. But if the infection is left untreated, it can spread to other parts of the abdomen, a serious condition called peritonitis. At that point, the infection can become life-threatening.

9. SURGEONS CAN REMOVE AN APPENDIX THROUGH A TINY INCISION.

In 1894, Charles McBurney, a surgeon at New York's Roosevelt Hospital, popularized an open-cavity, muscle-splitting technique [PDF] to remove an infected appendix, which is now called an open appendectomy. Surgeons continued to use McBurney's method until the advent of laparoscopic surgery, a less invasive method in which the doctor makes small cuts in the patient's abdomen and threads a thin tube with a camera and surgical tools into the incisions. The appendix is removed through one of those incisions, which are usually less than an inch in length.

The first laparoscopic appendectomies were performed by German physician Kurt Semm in the early 1980s. Since then, laparoscopic appendectomies have become the standard treatment for uncomplicated appendicitis. For more serious infections, open appendectomies are still performed.

10. AN APPENDIX ONCE POSTPONED A ROYAL CORONATION.

When the future King Edward VII of Great Britain came down with appendicitis (or "perityphlitis," as it was called back then) in June 1902, mortality rates for the disease were as high as 26 percent. It was about two weeks before his scheduled coronation on June 26, 1902, and Edward resisted having an appendectomy, which was then a relatively new procedure. But surgeon and appendicitis expert Frederick Treves made clear that Edward would probably die without it. Treves drained Edward's infected abscess, without removing the organ, at Buckingham Palace; Edward recovered and was crowned on August 9, 1902.

11. THE WORLD'S LONGEST APPENDIX MEASURED MORE THAN 10 INCHES.

On August 26, 2006, during an autopsy at a Zagreb, Croatia hospital, surgeons obtained a 10.24-inch appendix from 72-year-old Safranco August. The deceased currently holds the Guinness World Record for "largest appendix removed."

25 Amazing Facts About the Human Body

iStock.com/kali9
iStock.com/kali9

The human body is an amazing piece of machinery—with a few weird quirks.

  1. It’s possible to brush your teeth too aggressively. Doing so can wear down enamel and make teeth sensitive to hot and cold foods.

  2. Goose bumps evolved to make our ancestors’ hair stand up, making them appear more threatening to predators.

Woman's legs with goosebumps
iStock.com/MyetEck
  1. Wisdom teeth serve no purpose. They’re left over from hundreds of thousands of years ago. As early humans’ brains grew bigger, it reduced space in the mouth, crowding out this third set of molars.

  2. Scientists aren't exactly sure why we yawn, but it may help regulate body temperature.

  3. Your fingernails don’t actually grow after you’re dead.

  4. If they were laid end to end, all of the blood vessels in the human body would encircle the Earth four times.

  5. Humans are the only animals with chins.

    An older woman's chin
    iStock.com/mhelm3011
    1. As you breathe, most of the air is going in and out of one nostril. Every few hours, the workload shifts to the other nostril.

    2. Blood makes up about 8 percent of your total body weight.

    3. The human nose can detect about 1 trillion smells.

    4. You have two kidneys, but only one is necessary to live.

    5. Belly buttons grow special hairs to catch lint.

      A woman putting her hands in a heart shape around her belly button
      iStock.com/PeopleImages
      1. The satisfying sound of cracking your knuckles comes from gas bubbles bursting in your joints.

      2. Skin is the body’s largest organ and can comprise 15 percent of a person’s total weight.

      3. Thumbs have their own pulse.

      4. Your tongue is made up of eight interwoven muscles, similar in structure to an elephant’s trunk or an octopus’s tentacle.

      5. On a genetic level, all human beings are more than 99 percent identical.

        Identical twin baby boys in striped shirts
        iStock.com/BorupFoto
        1. The foot is one of the most ticklish parts of the body.

        2. Extraocular muscles in the eye are the body’s fastest muscles. They allow both of your eyes to flick in the same direction in a single 50-millisecond movement.

        3. A surgical procedure called a selective amygdalohippocampectomy removes half of the brain’s amygdala—and with it, the patient’s sense of fear.

        4. The pineal gland, which secretes the hormone melatonin, got its name from its shape, which resembles a pine nut.

        5. Hair grows fast—about 6 inches per year. The only thing in the body that grows faster is bone marrow.

          An African-American woman drying her hair with a towel and laughing
          iStock.com/GlobalStock
          1. No one really knows what fingerprints are for, but they might help wick water away from our hands, prevent blisters, or improve touch.

          2. The heart beats more than 3 billion times in the average human lifespan.

          3. Blushing is caused by a rush of adrenaline.

12 Intriguing Facts About the Intestines

When we talk about the belly, gut, or bowels, what we're really talking about are the intestines—long, hollow, coiled tubes that comprise a major part of the digestive tract, running from the stomach to the anus. The intestines begin with the small intestine, divided into three parts whimsically named the duodenum, jejunum, and ileum, which absorb most of the nutrients from what we eat and drink. Food then moves into the large intestine, or colon, which absorbs water from the digested food and expels it into the rectum. That's when sensitive nerves in your rectum create the sensation of needing to poop.

These organs can be the source of intestinal pain, such as in irritable bowel syndrome, but they can also support microbes that are beneficial to your overall health. Here are some more facts about your intestines.

1. The intestines were named by medieval anatomists.

Medieval anatomists had a pretty good understanding of the physiology of the gut, and are the ones who gave the intestinal sections their names, which are still used today in modern anatomy. When they weren't moralizing about the organs, they got metaphorical about them. In 1535, the Spanish doctor Andrés Laguna noted that because the intestines "carry the chyle and all the excrement through the entire region of the stomach as if through the Ocean Sea," they could be likened to "those tall ships which as soon as they have crossed the ocean come to Rouen with their cargoes on their way to Paris but transfer their cargoes at Rouen into small boats for the last stage of the journey up the Seine."

2. Leonardo da Vinci believed the intestines helped you breathe.

Leonardo mistakenly believed the digestive system aided respiratory function. In 1490, he wrote in his unpublished notebooks, "The compressed intestines with the condensed air which is generated in them, thrust the diaphragm upwards; the diaphragm compresses the lungs and expresses the air." While that isn't anatomically accurate, it is true that the opening of the lungs is helped by the relaxation of stomach muscles, which does draw down the diaphragm.

3. Your intestines could cover two tennis courts ...

Your intestines take up a whole lot of square footage inside you. "The surface area of the intestines, if laid out flat, would cover two tennis courts," Colby Zaph, a professor of immunology in the department of biochemistry and molecular biology at Melbourne's Monash University, tells Mental Floss. The small intestine alone is about 20 feet long, and the large intestine about 5 feet long.

4. ... and they're pretty athletic.

The process of moving food through your intestines requires a wave-like pattern of muscular action, known as peristalsis, which you can see in action during surgery in this YouTube video.

5. Your intestines can fold like a telescope—but that's not something you want to happen.

Intussusception is the name of a condition where a part of your intestine folds in on itself, usually between the lower part of the small intestine and the beginning of the large intestine. It often presents as severe intestinal pain and requires immediate medical attention. It's very rare, and in children may be related to a viral infection. In adults, it's more commonly a symptom of an abnormal growth or polyp.

6. Intestines are very discriminating.

"The intestines have to discriminate between good things—food, water, vitamins, good bacteria—and bad things, such as infectious organisms like viruses, parasites and bad bacteria," Zaph says. Researchers don't entirely know how the intestines do this. Zaph says that while your intestines are designed to keep dangerous bacteria contained, infectious microbes can sometimes penetrate your immune system through your intestines.

7. The small intestine is covered in "fingers" ...

The lining of the small intestine is blanketed in tiny finger-like protrusions known as villi. These villi are then covered in even tinier protrusions called microvilli, which help capture food particles to absorb nutrients, and move food on to the large intestine.

8. ... And you can't live without it.

Your small intestine "is the sole point of food and water absorption," Zaph says. Without it, "you'd have to be fed through the blood."

9. The intestines house your microbiome. 

The microbiome is made up of all kinds of microorganisms, including bacteria, viruses, fungi, and protozoans, "and probably used to include worm parasites too," says Zaph. So in a way, he adds, "we are constantly infected with something, but it [can be] helpful, not harmful."

10. Intestines are sensitive to change.

Zaph says that many factors change the composition of the microbiome, including antibiotics, foods we eat, stress, and infections. But in general, most people's microbiomes return to a stable state after these events. "The microbiome composition is different between people and affected by diseases. But we still don't know whether the different microbiomes cause disease, or are a result in the development of disease," he says.

11. Transferring bacteria from one gut to another can transfer disease—or maybe cure it.

"Studies in mice show that transplanting microbes from obese mice can transfer obesity to thin mice," Zaph says. But transplanting microbes from healthy people into sick people can be a powerful treatment for some intestinal infections, like that of the bacteria Clostridium difficile, he adds. Research is pouring out on how the microbiome affects various diseases, including multiple sclerosis, Parkinson's, and even autism.

12. The microbes in your intestines might influence how you respond to medical treatments.

Some people don't respond to cancer drugs as effectively as others, Zaph says. "One reason is that different microbiomes can metabolize the drugs differently." This has huge ramifications for chemotherapy and new cancer treatments called checkpoint inhibitors. As scientists learn more about how different bacteria metabolize drugs, they could possibly improve how effective existing cancer treatments are.

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