The occurrence of a fecalith in the appendix was thought to be attributed to a right-sided fecal retention reservoir in the colon and a prolonged transit time. However, a prolonged transit time was not observed in subsequent studies. Diverticular disease and adenomatous polyps was historically unknown and colon cancer was exceedingly rare in communities where appendicitis itself was rare or absent, such as various African communities. Studies have implicated a transition to a Western diet lower in fiber in rising frequencies of appendicitis as well as the other aforementioned colonic diseases in these communities. And acute appendicitis has been shown to occur antecedent to cancer in the colon and rectum. Several studies offer evidence that a low fiber intake is involved in the pathogenesis of appendicitis. This low intake of dietary fiber is in accordance with the occurrence of a right-sided fecal reservoir and the fact that dietary fiber reduces transit time.
thE OccurrENce Of a fecaLIth in THe apPeNdix Was THOught to Be ATtrIbuTeD to a Right-SiDed feCal rEtention Reservoir in tHe colon aNd A prOlongeD tRansit TiMe. however, A prOlOngEd transIT time wAs not observed iN subsequeNt sTudies. dIverticular diseAse aNd adENomatouS poLyps was hIstoricalLy unknown and coLon CancER was exceEdiNgLY raRe in coMMUniTies wHerE aPpeNdIciTis itseLF waS rArE Or aBSent, SuCH aS variouS AfrIcan COMmunitIes. studieS have ImpliCatEd a TraNsiTioN to a WeStErN diEt LOweR In fiber In risINg freQUeNciEs of appEndIcITiS As well AS thE OtHER aforementioneD colONic diSeases IN tHese comMunities. aND AcuTe ApPendiCItiS has bEEN ShoWn To ocCur AnTEcEdent TO cAncer iN tHE cOLOn and reCtuM. seveRal stUDIES oFfeR eVidEncE thAT a LOW fiBer intake is iNVoLved in THe pathogENEsIs Of appeNdIcitIs. thiS low intake of dietaRy Fiber IS in accordAncE with the OccurRENCe of a rIghT-sIded fecal REservoIr and tHE Fact ThaT diEtArY fibEr reducEs tRaNsit tIme.