西方社会的急性阑尾炎发病率更高,可能与个人卫生改善和生活条件有关。[20]Barker DJ, Osmond C, Golding J, et al. Acute appendicitis and bathrooms in three samples of British children. Br Med J (Clin Res Ed). 1988 Apr 2;296(6627):956-8.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2545433/pdf/bmj00279-0012.pdf
http://www.ncbi.nlm.nih.gov/pubmed/3129107?tool=bestpractice.com
胃肠道微生物菌群的平衡对预防感染、消化和提供重要的营养素很重要。[21]Huis in 't Veld JH. Gastrointestinal flora and health in man and animal [in Dutch]. Tijdschr Diergeneeskd. 1991 Mar 1;116(5):232-9.
http://www.ncbi.nlm.nih.gov/pubmed/1901673?tool=bestpractice.com
抗生素的频繁使用和卫生条件的改善导致胃肠道微生物菌群暴露减少和/或失衡,这可能最终导致对病毒感染的应答减弱,进而引发阑尾炎。[22]Walker AR, Segal I. What causes appendicitis? J Clin Gastroenterol. 1990 Apr;12(2):127-9.
http://www.ncbi.nlm.nih.gov/pubmed/2157745?tool=bestpractice.com