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De Novo Inflammatory Bowel Disease Following Bariatric Surgery: a Systematic Review and Meta-analysis

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abstract

The incidence of both obesity and inflammatory bowel disease (IBD) is rising globally. The influence of bariatric metabolic surgery (BMS) upon IBD development is largely unknown. This systematic review and meta-analysis aimed to evaluate the relationship between BMS and the risk of de novo IBD development following surgery. A systematic literature search and meta-analysis were performed using PubMed and Scopus databases. Inclusion criteria were any study reporting risk of de novo IBD development following BMS relative to an appropriate control cohort. Pooled odds ratios (POR) were calculated. A total of 31 articles were identified by the literature search. Four studies including 149,385 patients met the inclusion criteria and were included in the meta-analysis. Pooled estimation of a meta-analysis of risk ratios studies demonstrated a POR for the development of IBD following BMS of 1.17 (95% CI, 1.06–1.29). This indicates a 17% increase in relative risk of de novo IBD development for those patients receiving BMS compared to those treated by non-surgical methods. Based on the present data, there appears to be an association between BMS and risk of de novo IBD. Compared to the proven benefits of BMS on other aspects of patient health, this potential risk remains proportionally low but may be an important consideration for patients both pre- and post-operatively.

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Abbreviations

ASMBS:

American Society for Metabolic and Bariatric Surgery

AGB:

Adjustable gastric banding

BMI:

Body mass index

BPD/DS:

Biliopancreatic diversion with duodenal switch

CD:

Crohn’s disease

IBD:

Inflammatory bowel disease

JIB:

Jejunoileal bypass

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

RYGB:

Roux-en-Y gastric bypass

SG:

Sleeve gastrectomy

UC:

Ulcerative colitis

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Authors and Affiliations

  1. Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Kermansaravi

  2. Iran National Center of Excellence for Minimally Invasive Surgery Education, Tehran, Iran

    Mohammad Kermansaravi

  3. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran

    Rohollah Valizadeh, Behnood Farazmand, Ali Mousavimaleki & Mahsa Taherzadeh

  4. Department of Epidemiology, Student Research Committee, School of Public Health, Iran University of Medical Science, Tehran, Iran

    Rohollah Valizadeh

  5. University Hospitals Birmingham MHS Foundation Trust, Birmingham, UK

    Tom Wiggins & Rishi Singhal

  6. Medical Director, Healthier Weight, Birmingham, UK

    Rishi Singhal

Authors
  1. Mohammad Kermansaravi
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Correspondence to Mohammad Kermansaravi.

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Key Points

• There appears to be an association between BMS and risk of de novo IBD.

• IBD should be considered in patients with ongoing gastrointestinal symptoms following BMS.

• The risk of IBD development is outweighed significantly by the proven benefits of BMS.

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Kermansaravi, M., Valizadeh, R., Farazmand, B. et al. De Novo Inflammatory Bowel Disease Following Bariatric Surgery: a Systematic Review and Meta-analysis. OBES SURG 32, 3426–3434 (2022). https://doi.org/10.1007/s11695-022-06226-2

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