Do we really need our appendix? Most experts believe our ancestors used it to digest tough food like tree bark. We don’t eat tree bark anymore, so is it necessary to keep the tail-like end of the large intestine? And, if a life-altering disease could originate in it, is it wrong to want it removed?

While some research suggests it produces and stores microbes that boost gut health, most agree there isn’t any downside to having it removed even before it becomes acutely inflamed and impacted in appendicitis. What’s more, researchers propose that Parkinson’s disease may originate in the appendix after a recent study found that those who had the organ removed were less likely to develop the condition.

Researchers in Belgium and the US examined the medical records of around 25,000 Parkinson’s patients to determine if gut problems could be a warning sign of the neurodegenerative disease. They found that patients with constipation and irritable bowel syndrome (IBS) were twice as likely to develop Parkinson’s than those without them. 

However, the results also indicated that those who had their appendix removed — usually in response to an infection — were 52% less likely to be diagnosed with the neurodegenerative disease. Experts said the study suggests the organ is the origin of Parkinson’s, although, of course, more studies are required to confirm this finding.

The latest study submits that the appendix might be a source of a misfolded Alpha-synuclein, a protein that is found in the brain, heart, and muscle tissues, but when it becomes tangled, it forms toxic clumps that are thought to help Parkinson’s spread. 

Dr Tim Bartels, group leader at the UK Dementia Research Institute at UCL, said, “An interesting side point of the study is the seemingly protective association of appendectomy with Parkinson’s disease, implying in addition that the appendix might be the origin of the pathological insult [injury] that then spreads throughout the gut and ultimately to the brain. Since the latter association was within the range of potential surveillance bias, this has to be further validated, however.”

Clare Bale, associate director of research at Parkinson’s UK, said that the “findings add further weight” to the hypothesis and gut problems could be an early sign of the disease, adding, “Understanding how and why gut issues appear in the early stages of Parkinson’s could open up opportunities for early detection and treatment approaches that target the gut to improve symptoms and even slow or stop the progression of the condition.”

No matter what the cause is, knowing the symptoms of Parkinson’s can lead to earlier diagnoses and access to treatments that improve patients’ quality of life. The early warning signs can include (but are not limited to):

• Tremor – A tremor while at rest is a common early sign of Parkinson’s disease.
• Hyposmia (Loss of Smell) – Have you noticed you no longer smell certain foods very well? If you seem to have more trouble smelling foods with distinct or pungent odors, it may be time to call your doctor. Hyposmia is an under-recognized symptom, as it is not a common concern for doctors to ask about or for people with PD to report.
• Rigidity – Sometimes stiffness goes away as you move. If it does not, it can be a sign of Parkinson’s disease. An early sign might be stiffness or pain in your shoulder or hips. People sometimes say their feet seem “stuck to the floor.”
• Bradykinesia (slow movement) – This can be particularly frustrating because it is often unpredictable. One moment you can move easily, and in the next, you may need help performing everyday functions, such as buttoning a shirt, cutting food, or brushing your teeth.

Postural instability (balance problems) – There’s a host of balance and movement issues for people dealing with the early stages of Parkinson’s from regulating speed and sensory to freezing up altogether. Postural instability increases the risk of falls. Reassuringly, exercise has proven to improve gait and balance and reduce falls. Yet another reason we should all be exercising and actively seeking to improve our physical capacity!

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3551545/#:~:text=theorized%20that%20the%20vermiform%20appendix,reservoir%20(3%2C%204).
https://gut.bmj.com/content/early/2023/07/12/gutjnl-2023-329685?rss=1
https://www.parkinson.org/understanding-parkinsons/10-early-signs
https://www.parkinson.org/understanding-parkinsons/movement-symptoms/trouble-moving
https://www.mayoclinic.org/diseases-conditions/irritable-bowel-syndrome/symptoms-causes/syc-20360016
https://scienceofparkinsons.com/alpha-synuclein/