Impact of tonsillectomy on irritable bowel syndrome: A nationwide population-based cohort study

Abstract

Tonsillectomy is a commonly performed surgical procedure worldwide; however, the possible long-term consequences have not been fully explored. The tonsils are secondary lymphoid tissue providing a defensive barrier against pathogens. There are few data in the literature on the relationship between prior tonsillectomy and the risk of irritable bowel syndrome (IBS). The aim of this study was to evaluate the risk of developing IBS in patients who underwent tonsillectomy using a nationwide longitudinal population-based cohort. We identified 1300 patients with tonsillectomy and 2600 matched controls from the Longitudinal Health Insurance Research Database of the National Health Insurance Research Database in Taiwan. Propensity score analysis was used for matching age, gender, comorbidities, medications, and index year at a ratio of 1:2. Multiple Cox regression analysis was used to estimate the adjusted hazard ratio of IBS. Furthermore, sensitivity tests and a stratified analysis were conducted. The incidence of IBS was 3 per 1,000 person-years in tonsillectomy patients, which was higher than the rate of 1.8 per 1,000 person-years found in non-tonsillectomy patients. After adjustment for patients' age, gender, comorbidities, and medications, patients who underwent tonsillectomy had a 1.84-fold risk of developing IBS compared to those without tonsillectomy (adjusted hazard ratio [HR]:1.84; 95% CI, 1.09-3.09). Stratified analysis revealed that a higher adjusted HR of 3.79 (95% CI, 1.35-10.64) in patients �50 years old, and there was a marginally significantly higher adjusted HR of 1.98 (95% CI, 0.99-3.95) of developing IBS when the follow-up period was longer than 3 years. Tonsillectomy was associated with a higher risk of developing IBS. Physicians should provide appropriate monitoring of IBS in patients undergoing tonsillectomy.

The Phenotypic Difference of IgA Nephropathy and its Race/Gender-dependent Molecular Mechanisms

“…Note that the GWAS for tonsillectomy demonstrated that rs2412971 is associated with a decreased risk of CD and IBD in the European population(75)(76)(77), revealing opposing effects of risk loci for IgAN in IBD. Epidemiologic studies with nationwide cohorts and a related meta-analysis primarily from European studies revealed that a tonsillectomy is associated with an increased likelihood of developing CD and IBD(78)(79)(80). These results call into question a direct influence of tonsillectomy on GALT.…”

Tonsillectomy as a risk factor of periodontitis: A population‐based cohort study

“…20,21 Overall, a significantly high risk of post-operative aggressive or acute periodontitis was observed after 4 years of follow-up in pediatric patients receiving tonsillectomy, which can be an overlooked long-term adverse event of tonsillectomy, aside from other well-established local and systemic complications of tonsillectomy. 4,[9][10][11][12] Our findings are interesting because of the fact that tonsillectomy is not conventionally considered to be drastically affecting the immune functions of children. 22,23 Particularly, although the short-term consequences of tonsillectomy are well documented and managed, its long-term side effects have not been fully investigated.…”

Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle

“…Looking for a common denominator one can hypothesize that relief is achieved due to intense pain exposure and general anesthesia that resets the brain circuits, somewhat similar to electroconvulsive therapy combining gate control. But it does not align with findings that tonsillectomy increases risk of IBS [ 165 ], that umbilical hernia repair surgery seems to predispose to IBS [ 166 ], and that patients with fibromyalgia have a higher incidence of suffering IBS after appendectomies [ 167 ]. Laparoscopic cholecystectomy has been shown to deeply influence fibromyalgia symptoms [ 132 ].…”