The Gallbladder and Vermiform Appendix Influence the Assemblage of Intestinal Microorganisms

Abstract

Surgical procedures for the symptomatic removal of the gallbladder and the vermiform appendix have been posited to adversely shift the assemblage of the intestinal microbiome increasing the risk of disease. The associated mechanisms have been linked with dysbiosis of the gut microbiota. Cholecystectomy causes changes of bile acid compositions and bile secretion patterns as bile acids interact with the intestinal microbiota in a bidirectional capacity. An appendectomy precludes the further recolonization of the proximal colon with a commensal biofilm that could maintain a stable intestinal microbiome. Epidemiological studies indicate that there is an increased risk of disease rather than causality following a cholecystectomy and appendectomy. This narrative review summarizes studies that report on the role that bile salts and the appendix, contribute to the assemblage of the intestinal microbiome in health and disease.

Keywords::

• bile salts
• gallbladder
• intestinal microbiome assemblage
• vermiform appendix

Financial and competing interests disclosure

Work by the authors leading to this narrative review has received no financial support from any educational institution or industry biotechnology facility. J Chen and L Vitetta are employed by Medlab Clinical and participate in probiotic research. L Vitetta has received National Institute of Complementary Medicine and National Health and Medical Research Council of Australia competitive funding and Industry support for research into probiotics and the microbiome. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

Work by the authors leading to this narrative review has received no financial support from any educational institution or industry biotechnology facility. J Chen and L Vitetta are employed by Medlab Clinical and participate in probiotic research. L Vitetta has received National Institute of Complementary Medicine and National Health and Medical Research Council of Australia competitive funding and Industry support for research into probiotics and the microbiome. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.