{
  "abstract": "Introduction Appendectomy is a frequently performed surgical procedure, however, its association with disorders of gut-brain interaction (DGBI) has not been systematically evaluated at the population level. This study aimed to report the worldwide prevalence of appendectomy and investigate its association with Rome IV DGBI.Methods Data from 54,127 adult respondents across 26 countries included in the Rome Foundation Global Epidemiology Study – a large-scale, internet-based cross-sectional survey conducted between 2017 and 2018 – were analysed. Validated instruments assessed psychological distress (patient health questionnaire-4 [PHQ-4]), somatic symptom burden (PHQ-12), and health-related quality of life (QoL) (PROMIS global-10 physical and psychological scores). The primary exposure was a self-reported history of appendectomy. Logistic regression models were used to estimate odds ratios (OR) and adjusted odds ratios (aOR), controlling for age, sex, PHQ-4, access to healthcare, and prior abdominal/pelvic surgeries. DGBI were analysed individually and across multiple anatomical regions (oesophageal, gastroduodenal, bowel, centrally mediated gastrointestinal pain, gallbladder and sphincter of Oddi, and anorectal disorders). Finally, participants were stratified into four groups: 1 (no DGBI and no appendectomy), 2 (no DGBI and appendectomy), 3 (DGBI and no appendectomy), and 4 (DGBI and appendectomy).Results Overall, the worldwide prevalence of appendectomy was 11.69%. Individuals with appendectomy had a higher prevalence of DGBI compared to those without (42.62% vs. 39.79%; aOR 1.14, 95% CI 1.08-1.21). While the prevalence of a single anatomical DGBI was similar between both groups (27.24% vs 27.37%; aOR 1.03, 95% CI 0.97–1.09), respondents with an appendectomy were significantly more likely to report DGBI spanning multiple anatomical regions, particularly four categories (1.45% vs 0.86%; aOR 1.60, 95% CI 1.25–2.02) (table 1). Across anatomical categories, an appendectomy was most strongly associated with esophageal disorders (aOR 1.26, 95% CI 1.13-1.40) (table 1). The proportion of participants with clinically significant anxiety (PHQ-4) increased from 10.57% in group 1 to 27.43% in group 4, while depression (PHQ-4) increased from 10.70% to 26.13%. The severity of non-somatic gastrointestinal symptoms was lowest in group 1 (mean PHQ-12: 4.06 [95% CI 4.02-4.10]) and highest in group 4 (mean PHQ-12: 7.13 [95% CI 6.98-7.27]). QoL followed an inverse pattern, with the highest PROMIS physical health scores in group 1 (15.20; 95% CI 15.17-15.22) and the lowest in group 4 (13.04; 95% CI 12.93-13.14). PROMIS psychological health scores were similar among groups with and without appendectomy; however, they were notably lower in groups with DGBI (group 3: 12.51 [95% CI 12.47-12.56] and group 4: 12.68 [95% CI 12.56-12.81]).Conclusion Appendectomy is associated with an increased prevalence and burden of Rome IV DGBI across multiple anatomical regions.Abstract P412 Table 1Prevalence and odds ratios of disorders of gut-brain interaction in individuals with and without a history of appendectomy",
  "authors": [
    {
      "affiliations": [
        "University of Nottingham, Nottingham, United Kingdom"
      ],
      "name": "Mohsin F Butt"
    },
    {
      "affiliations": [
        "Case Western Reserve University, Cleveland, United States of America"
      ],
      "name": "Daniel M Simadibrata"
    },
    {
      "affiliations": [
        "Mayo Clinic, Rochester, United States of America",
        "St. Francis Medical Center, Lynwood, United States of America"
      ],
      "name": "Ramesh Lamichhane"
    },
    {
      "affiliations": [
        "Case Western Reserve University, Cleveland, United States of America"
      ],
      "name": "Zaid Al-Fakhouri"
    },
    {
      "affiliations": [
        "Thomas Jefferson University, Philadelphia, United States of America"
      ],
      "name": "Laith Alomari"
    },
    {
      "affiliations": [
        "Universiti Sains Malaysia, Kota Bharu, Malaysia"
      ],
      "name": "Kueh Y Cheng"
    },
    {
      "affiliations": [
        "University of North Carolina at Chapel Hill, Chapel Hill, United States of America"
      ],
      "name": "Olafur S Palsson"
    },
    {
      "affiliations": [
        "Ben-Gurion University of the Negev, Beer-Sheva, Israel"
      ],
      "name": "Ami D Sperber"
    },
    {
      "affiliations": [
        "McMaster University, Hamilton, Canada"
      ],
      "name": "Shrikant I Bangdiwala"
    },
    {
      "affiliations": [
        "Universiti Sains Malaysia, Kota Bharu, Malaysia"
      ],
      "name": "Yeong Y Lee"
    }
  ],
  "title": "P412 Worldwide prevalence of appendectomy and its association with disorders of gut-brain interaction",
  "uid": "a54d6adf-d96b-5319-9930-a5e79e7fc2d8"
}