Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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Potentially true Certainty of evidence: low provisional C-ORG-17

The appendix (like tonsils and adenoids) is removed far too readily from early childhood onward.

Safety note: Suspected appendicitis (worsening abdominal pain, fever, vomiting) is a medical emergency; untreated appendicitis can perforate.
Conclusion: Partly supported: surgery is not always necessary, but appendicitis always needs treatment.
  1. Original statement
  2. Scientific assessment
  3. In plain language
  4. Studies on this claim
  5. Regional context
  6. What applies in my country?
  7. References

Original statement

وانت لسه يا بيبي بتاخد لوز بتشيل لحميه بتشيل زايده بعديها تكبر شويه تعمل تكميم بعديها بحبه تستاصل مراره

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

The appendix (like tonsils and adenoids) is removed far too readily from early childhood onward.

Origin

Source status
Video transcript (own words)
Attribution
Elawady (machine transcript)
Video
Dr Diaa Al Awady د ضياء العوضي is live!جوع الخلايا للسكر -٢-الأحماض الامينية (Open source)
Published
21 October 2025
Timestamp
0:46:00 (location in the original video’s automatic YouTube caption track; confirms where the words occur, not who speaks)
Attribution uncertainty
Archive transcript (YouTube CC or AI-generated); wording may contain transcription errors; no timestamps available.
Claimed mechanism

Medicine's readiness to cut.

Claimed health effect

Unnecessary operations.

Population concerned

Children and adults

Geographic restriction by Elawady

none found

Scientific assessment

Potentially true – Some evidence points in favour of the statement, but it is not sufficient for a clear judgement.

Certainty of evidence: low – Further research is likely to change the assessment considerably.

1. What was claimed?

Appendectomy is done too readily.

2. What is demonstrably correct?

Antibiotic treatment was noninferior for overall health at 30 days (CODA, I-ORG-07); 61% of antibiotic-treated patients avoided appendectomy for 5 years (APPAC, I-ORG-08); Swedish data document historical over-use (incidental and negative appendectomies) that declined strongly with better diagnostics: appendectomy incidence fell from 189.3 to 105.6 per 100,000 (ages 0-19: 236.2 to 96.4) between 1987 and 2009 (A-ORG-05).

3. What is wrong or exaggerated?

Appendicitis still requires treatment: 29% of the antibiotic group needed surgery within 90 days, and complications were higher with appendicolith (CODA). The Swedish decline shows past over-use, not current routine over-use (A-ORG-05). This does not support avoiding treatment or replacing it with diet.

4. What remains unclear?

Rates of unnecessary appendectomy in Egypt.

5. Which studies support it?

I-ORG-07, I-ORG-08; A-ORG-05 (historical over-use only).

6. Which studies contradict it?

I-ORG-07 (limits).

7. What applies to Germany and Europe?

Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).

8. What is known about Egypt?

No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.

9. What practical conclusion is appropriate?

In uncomplicated appendicitis, antibiotics are an evidence-based alternative to discuss with a surgeon; appendicitis is an emergency either way.

Assessment details

Rationale for certainty of evidence

RCTs show that antibiotics can avoid appendectomy in many uncomplicated cases, and appendectomy rates fell in Sweden; but no data on 'unnecessary' appendectomy rates in Egypt were found.

Source quality

Transcript statement; general.

Regional transferability

European RCTs; Egyptian practice not assessed.

Individual exceptions

Appendicitis with appendicolith or complications usually needs surgery.

Regional scope of the claim
general (biological/medical)
Last reviewed
25 October 2026 provisional

In plain language

Elawady said appendix removal is done too easily. Trials show that many people with uncomplicated appendicitis can be treated with antibiotics instead of surgery, so surgery is not always necessary. But appendicitis must always be treated: about 3 in 10 people treated with antibiotics still needed an operation within three months.

Studies on this claim

Studies supporting the claim (2)

  • Antibiotics instead of surgery for appendicitis

    CODA Collaborative; Flum DR et al.. N Engl J Med 2020 · PMID 33017106 · DOI 10.1056/NEJMoa2014320
    Randomised controlled trialindependent cross-checkabstract only checked★ key study

    Antibiotics worked about as well for overall health at 30 days, but 29% still needed surgery within 90 days.

    The appendix (like tonsils and adenoids) is removed far too readily from early childhood onward.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Appendicitis treatment

    How was the study done?

    RCT

    How many people, animals or samples were studied?

    1552

    What was actually found?

    Antibiotics noninferior; many later surgeries

    How large was the observed effect?

    29% appendectomy by 90 d

    What do the results mean in everyday life?

    Surgery is not the only option, but appendicitis must be treated

    What are the study's limitations?

    Unblinded

    What does it say about Elawady's specific claim?

    Partly supports 'not always remove'

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Diet-based treatment

    Scientific details →

  • Finland: antibiotics for appendicitis after 5 years

    Salminen P et al.. JAMA 2018 · PMID 30264120 · DOI 10.1001/jama.2018.13201
    Randomised controlled trialindependent cross-checkabstract only checked

    About 61% treated with antibiotics never needed their appendix removed in 5 years.

    The appendix (like tonsils and adenoids) is removed far too readily from early childhood onward.

    Does the study support the specific claim? Partly · Methodological quality: high · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Long-term

    How was the study done?

    RCT follow-up

    How many people, animals or samples were studied?

    530

    What was actually found?

    39.1% recurrence

    How large was the observed effect?

    39.1%

    What do the results mean in everyday life?

    Many can avoid surgery

    What are the study's limitations?

    Open surgery comparator

    What does it say about Elawady's specific claim?

    Partly supports

    Do the results apply to Germany and Europe?

    European

    What can explicitly not be concluded from this study?

    Complicated appendicitis

    Scientific details →

Studies contradicting or limiting the claim (0)

No studies in this group.

Studies with mixed or unclear results (1)

  • Appendix removal and bowel cancer

    Song H et al.. PLoS One 2016 · PMID 26959234 · DOI 10.1371/journal.pone.0151262
    Cohort studycited by the Tayebat archivefull text checked

    No increased risk of stomach, colon or rectal cancer after appendix removal.

    The appendix (like tonsils and adenoids) is removed far too readily from early childhood onward.

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Cancer risk

    How was the study done?

    Register

    How many people, animals or samples were studied?

    480,382

    What was actually found?

    No excess

    How large was the observed effect?

    SIR EAC 1.32

    What do the results mean in everyday life?

    Appendectomy did not raise most GI cancers

    What are the study's limitations?

    SIR design

    What does it say about Elawady's specific claim?

    Contradicts archive summary

    Do the results apply to Germany and Europe?

    European

    What can explicitly not be concluded from this study?

    Small risks

    Scientific details →

Regional context

Germany / EU

Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).

Egypt

No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.

What applies in my country?

General scientific assessment

Potentially true Partly supported: surgery is not always necessary, but appendicitis always needs treatment.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis.. CODA Collaborative; Flum DR et al.. N Engl J Med 2020 · PMID 33017106 · DOI 10.1056/NEJMoa2014320
  2. Five-Year Follow-up of Antibiotic Therapy for Uncomplicated Acute Appendicitis in the APPAC Randomized Clinical Trial.. Salminen P et al.. JAMA 2018 · PMID 30264120 · DOI 10.1001/jama.2018.13201
  3. Risk of Gastrointestinal Cancers among Patients with Appendectomy: A Large-Scale Swedish Register-Based Cohort Study during 1970-2009.. Song H et al.. PLoS One 2016 · PMID 26959234 · DOI 10.1371/journal.pone.0151262

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