The cecum is a small pouch where the colon begins, in the lower right section of the abdomen. Wastes from the small intestine flow into the cecum through the ileocecal valve (theoretically a one-way valve.) The appendix is a narrow tube attached to the cecum, with a channel opening into the cecum.
Waste matter can get lodged in this channel, causing the appendix to become infected and inflamed. Immediate surgery must be performed to remove the appendix before it bursts. Otherwise, the result is usually fatal.
Why does the appendix get blocked with fecal matter? Did nature make a blunder in its design?
One clue comes from the field of epidemiology. Appendicitis is a disease of westernized countries, virtually unknown in the developing world.19,31 The reason is that the cecum was designed to be squeezed empty by the right thigh, in the squatting position. On a sitting toilet, it is physically impossible to compress the cecum.
Instead, one pushes downwards with the diaphragm, while holding one's breath. This maneuver inflates and pressurizes the cecum. It is analogous to squeezing a tube of toothpaste in the middle and causing the bottom of the tube to inflate. The pressure can easily force wastes into the appendix, with disastrous consequences.
The back-pressure can also overwhelm the ileocecal valve, whose purpose is to protect the small intestine from fecal contamination. Barium enema exams and intestinal surgeries routinely show the leakage of wastes into the small intestine.Crohn's Disease develops in the area soiled by this toxic backwash.
Despite all the straining, the cecum never gets evacuated. Residual wastes adhere to the colon wall, increasing the risk of cancer and inflammation (including appendicitis.)
By contrast, in the squatting posture, the right thigh squeezes the cecum from its base. Its contents are thoroughly expelled into the ascending colon, where peristalsis carries them away. There is no need to hold one's breath or push downwards, since the posture generates the pressure automatically.
The force is all directed upwards, so the appendix stays clean and the ileocecal valve stays closed. These organs were not "poorly designed" – as is currently taught in medical schools. Like the rest of the colon, they were designed with squatting in mind.
Historical Background of Appendicitis
The epidemiology of appendicitis poses many unanswered questions. Almost unknown before the 18th century, there was a striking increase in its prevalence from the end of the 19th century, with features suggesting it is a side effect of modern Western life.30In 1886, Reginald Heber Fitz, a Harvard Professor of Pathological Anatomy, became the first doctor to recognize and name the disease. He was also the first one to propose treating it by removing the appendix.18
The conservative British medical establishment resisted the novel appendectomy procedure until after the turn of the century, when it was used to save the new king's life. In 1901, the Prince of Wales, Albert Edward, underwent an emergency appendectomy, just two weeks before his scheduled coronation as King Edward VII. His successful recovery finally convinced British surgeons that this operation was the only way to save the victims of this "mysterious" new disease.20
Currently, 7% of the U.S. population will contract appendicitis at some point in their lifetime (according to www.emedicine.com). The figure would be even higher, except that 40,000 "incidental appendectomies" are performed each year (according to Harper's Index, Feb, 2002.) "Incidental" means there was nothing wrong with the appendix, but the surgeon happened to be operating on another organ nearby – in most cases performing a hysterectomy.
Appendicitis is the most common reason for a child to need emergency abdominal surgery. Young people between the ages of 11 and 20 are most often affected (according to www.KidsHealth.org).
Modern medicine recognizes that appendicitis is primarily a disease of the Western World.31 They attribute this to the (allegedly) greater amount of fiber in the diet of the Third World. However, the fiber theory has never been substantiated, as evidenced by this quote from www.KidsHealth.org:
There are no medically proven ways to prevent appendicitis. Although appendicitis is rare in countries where people eat a high-fiber diet, experts have not yet shown that a high-fiber diet definitely prevents appendicitis.Many residents of the developing world, not wanting to appear "backward", feel obliged to adopt western toilets. This trend is causing health problems that were previously unknown among squatting populations. Appendicitis is one example, as reported by webhealthcentre.com, a health care portal based in India:
The Indian type of toilet is more conducive to complete evacuation than the Western toilet. With the western style closets becoming popular in India, there is a risk of increased incidence of appendicitis.Unfortunately, western doctors have never made the connection between toilet posture and appendicitis. Their understanding of this disease has advanced little in the century since Dr. Frederick Treves performed his famous appendectomy (mentioned above) on the Prince of Wales.
Ironically, Sir Frederick (knighted for saving the king's life) lost his own daughter to appendicitis.27 Despite being highly skilled at surgery, he had no idea what causes the disease, or how to prevent it.
Now his successors have a chance to redeem their profession. By informing their patients (and their children) about the health hazards of the modern toilet, they can prevent a great deal of needless suffering.
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