Appendix in ulcerative colitis pathogenesis and therapy: An updated narrative review

Figure 2 Appendectomy as a therapy for ulcerative colitis. The inflamed appendix may act as a niche for sustained inflammation, potentially driven by immune dysregulation, dysbiosis, and autophagy dysfunction in the colon and possibly in the appendix, thereby contributing to disease progression. Clinical studies, such as the ACCURE and COSTA trials, show that appendectomy can improve outcomes, reduce relapse rates, and achieve remission in selected patients, particularly those with refractory disease.