Appendix: What Is It, and What Does It Do?

Appendix: What Is It, and What Does It Do?
Adobe Stock (2)
The appendix is a thin, roughly four-inch-long tube that’s part of your gastrointestinal (GI) tract.

The GI tract is a complex group of organs, each of which helps your body digest and absorb food.

Your upper GI tract includes your esophagus, stomach, and the first section of your small intestine, called the duodenum.

The lower GI tract is made up of most of your small intestine and all of your large intestine, which includes your colon, rectum, and anal canal.

Read on to learn more about the appendix, including some theories about its purpose, and some potential health issues associated with it.

What Is the Appendix?

The appendix is a finger-like tube in the lower right part of the abdomen. It is attached to the cecum, which is the first part of the large intestine, near the end of the small intestine.

Its role has long been a mystery, but some experts believe they’re closer to understanding its function. The appendix is perhaps best known because of appendicitis. This is a fairly common medical condition that can happen if the appendix becomes blocked or inflamed.

Where Is Your Appendix?

Your appendix is located in the lower right part of your abdomen, in an area that doctors refer to as McBurney’s point. If applying pressure on McBurney’s point results in pain or tenderness, your doctor may suspect you have appendicitis.

The finger-shaped appendix is attached to a part of your large intestine called the cecum — a small pouch typically considered to be the beginning of the large intestine.

What Is the Function of the Appendix?

The muscles lining your GI tract, along with the hormones and enzymes that the system produces, allow your GI tract to break down and process food. Your appendix doesn’t directly help with digestion either. Furthermore, removal of the organ doesn’t appear to have any negative health consequences.

So what exactly is its role? There are a few theories.

A Vestigial Organ

For many years, scientists believed the appendix was a vestigial organ — one that lost its original function through centuries of evolution.

Researchers thought that no other mammals had an appendix, aside from our closest ape relatives.

What’s more, the cecum (a part of the large intestine) of plant-eating mammals is far larger than it is in humans.

On this basis, Charles Darwin theorized that our distant ancestors also had large ceca, which allowed them to dine on leaves like the herbivores of today.

But as these ancestors shifted to a diet based on fruits, which are easier to digest, their ceca shrank. The appendix, Darwin believed, is just a shriveled up part of the cecum, which evolution hasn’t entirely eliminated.

The ‘Safe House’ Theory of the Appendix

Some scientists now believe the appendix is not useless after all, and may help our guts recover after a gastrointestinal disease strikes.

The appendix contains a particular type of tissue associated with the lymphatic system, which carries the white blood cells needed to fight infections. In recent years, scientists have found that lymphatic tissue encourages the growth of some beneficial gut bacteria, which play an important role in human digestion and immunity.

Studies have also shown that the lining of the gut contains a biofilm, or a thin layer of microbes, mucus, and immune system molecules — and these biofilms appear to be most pronounced in the appendix.

According to the so-called “safe house” theory, the appendix protects a collection of beneficial gut bacteria when certain diseases wipe them out from elsewhere in the GI tract. Once the immune system has rid the body of the infection, the bacteria emerge from the appendix biofilm and recolonize the gut.

A review of the relevant available research published in 2016 concluded that the appendix is not a rudimentary organ but an “important part” of the immune system.

Researchers have recently found that numerous animals, including great apes, other primates, opossums, wombats, rabbits, and certain rodents all have structures similar to the appendix.

 The appendix, it seems, may have independently evolved in different animals at least 32 times over the course of history, suggesting the organ does have an important function.

Appendicitis and Other Potential Health Issues

Sometimes, the appendix can become inflamed and infected, resulting in a condition called appendicitis.

Appendicitis is often the result of an abdominal infection that has spread to the tiny organ, or some kind of obstruction that has blocked the small opening of the appendix. Sources of blockage include, among other things:

  • Hard pieces of stool
  • Parasites or intestinal worms
  • Ingested objects, including air gun pellets and pins
  • Abdominal trauma
  • GI tract ulcers
  • Enlarged appendix lymphatic tissue

The infection or obstruction causes the bacteria in the appendix to grow out of control, and the organ can fill with pus and swell. Appendicitis causes intense abdominal pain and other GI symptoms, including vomiting and diarrhea.

Removal of the appendix (an appendectomy) is often the necessary course of action, though increasingly, antibiotics may be recommended and used to treat the infection without the need for surgical intervention — depending on the severity of the case and other health factors in the individual patient. If the problem is left untreated, the pressure in the organ will increase until the appendix ruptures, or bursts.

When the appendix bursts, it spreads its contents throughout the abdomen, potentially infecting the peritoneum, which is the silk-like membrane that lines the abdominal cavity. A peritoneum infection, called peritonitis, can then lead to sepsis, a complication that’s potentially deadly if not treated aggressively.

The Takeaway

The appendix is a small, fingerlike tube located near the lower right part of your abdomen. When this tube is inflamed or blocked, appendicitis develops. While the appendix was once thought to be useless, new research suggests that it might play a role in maintaining healthy gut bacteria after infections. If you experience persistent abdominal pain, contact your healthcare provider to find the cause.

Sanjai Sinha, MD

Medical Reviewer
Sanjai Sinha, MD, is a board-certified internal medicine physician and an assistant professor of clinical medicine and the director of the care management program at Weill Cornell Medical College. Helping patients understand health information and make informed decisions, and communicating health topics effectively both in person and through patient educational content, is a challenge that animates his daily life, and something he is always working to improve.

Dr. Sinha did his undergraduate training at the University of California in Berkeley, where he graduated magna cum laude. He earned his medical degree at the Albert Einstein College of Medicine in New York City in 1998 and completed his internship and residency training at the New York University School of Medicine in 2001. Subsequently, he worked with the Department of Veterans Affairs from 2001 to 2012 and held faculty appointments at both the Mount Sinai School of Medicine and Columbia University College of Physicians and Surgeons.

In 2006, he won the VISN3 Network Director Award for Public Service and a commendation from the secretary of Veterans Affairs for his relief work after Hurricane Katrina. He joined Weill Cornell Medical College in 2012, where he is an assistant professor of clinical medicine and the director of the care management program, as well as a practicing physician.

In addition to his work for Everyday Health, Sinha has written for various publications, including Sharecare and Drugs.com; published numerous papers in peer-reviewed medical journals, such as the Journal of General Internal Medicine; and presented at national conferences on many healthcare delivery topics. He is a fellow of the American College of Physicians.

Joseph Bennington-Castro

Author

Joseph Bennington-Castro is a science writer based in Hawaii. He has written well over a thousand articles for the general public on a wide range topics, including health, astronomy, archaeology, renewable energy, biomaterials, conservation, history, animal behavior, artificial intelligence, and many others.

In addition to writing for Everyday Health, Bennington-Castro has also written for publications such as Scientific American, National Geographic online, USA Today, Materials Research Society, Wired UK, Men's Journal, Live Science, Space.com, NBC News Mach, NOAA Fisheries, io9.com, and Discover.

EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Appendix. Britannica.
  2. Your Digestive System & How It Works. National Institute of Diabetes and Digestive and Kidney Diseases. December 2017.
  3. Appendix. National Cancer Institute.
  4. Appendicitis. Cleveland Clinic. September 2023.
  5. Phillips M. Appendicitis. MedlinePlus. May 2023.
  6. Barras C. Appendix Evolved More Than 30 Times. Science. May 2013.
  7. Randal Bollinger R et al. Biofilms in the Large Bowel Suggest an Apparent Function of the Human Vermiform Appendix. Journal of Theoretical Biology. December 2007.
  8. Guinane CM et al. Microbial Composition of Human Appendices From Patients Following Appendectomy. mBio. January 2013.
  9. Kooij IA et al. The Immunology of the Vermiform Appendix: A Review of the Literature. Clinical & Experimental Immunology. October 2016.
  10. McKie R. Is the Mystery of the Appendix Close to Being Unravelled? The Guardian. March 2012.
  11. Peritonitis. Mayo Clinic. April 2023.