A figure I have recently stumbled upon suggests that about 7% of the world population will, or have, had appendicitis in their lifetime. Cutting out the appendix was impossible until very recently. Even if the appendix only just started, in evolutionary terms, being infectable, it would still be capable of wiping out an entire population in no time at all, meaning some other population would adopt an alternative. No matter what the benefits, the costs would be detrimental and most definitely outweigh the former. We've had at least a million years (correct me here if I'm wrong) to get rid of the appendix, but we didn't, even though it kept on killing. It seems very counterintuitive that it's still here. Can anyone explain, please?

Edit: I recognise that an appendix serves some purpose to the body. My question is: aren't the benefits much less significant than the costs?

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    $\begingroup$ Do you really think that appendicitis has been one of the major causes of death in the history of mankind? $\endgroup$
    – David
    Commented Mar 18, 2018 at 0:17
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    $\begingroup$ The appendix still serves multiple purposes, you may be interested in these questions, biology.stackexchange.com/questions/1502/… and biology.stackexchange.com/questions/55796/… $\endgroup$
    – John
    Commented Mar 18, 2018 at 0:34
  • $\begingroup$ Also you misunderstand something, appendicitis are not random, so there is no way they could wipe out the human population, that's like thinking heart attacks could eventually wipe out humanity. $\endgroup$
    – John
    Commented Mar 18, 2018 at 0:39
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    $\begingroup$ How can we explain what does not exist (your scenario)? $\endgroup$ Commented Mar 18, 2018 at 5:35
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    $\begingroup$ @GrahamChiu - Maybe a source to support that? Galen described "colic passion" below the umbilicus and to the right. $\endgroup$ Commented Mar 18, 2018 at 5:41

1 Answer 1


Appendicitis appears to a fairly modern disease likely caused by refined diets leading to slow bowel transit times resulting from low fibre content. We have some evidence to suggest that this is the case with no Bantu people recorded having any episodes of hospital admission for appendicitis in [1]

Hospital records from three Johannesburg hospitals were reviewed in Erasmus' study, from 1929-1937. Appendicitis and overall admissions were recorded according to racial groups. Using these figures, 4% of white inpatients were admitted for appendicitis, compared to 1% of coloureds and 0% of black inpatients.17 Although these figures do not represent the true incidence rates in the general population, as hospital access and utilisation patterns are likely to have differed between three racial groups, the important possibility of differential incidences between racial groups was raised. These trends were supported by findings from audits in Cape Town and Upington. [2]

The change in diet in urban african natives has also lead to appearance of diverticular disease, which was previously unknown in that population. Diverticulitis is also an infection of a colonic pouch. [3]

So, it seems these are both modern diseases of low incidence so both these factors mean little selection pressure exists especially with modern medicine and surgery.

  1. Erasmus JPF. The incidence of appendicitis in the Bantu. S Afr Med J. 1939;13:601-607.

  2. Acute appendicitis in South Africa: 2015 A systematic review

  3. Emergence of Diverticular Disease in the Urban South African Black

Disclaimer: I have had my appendix removed.


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