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Outcomes of Bariatric Surgery in Patients with Inflammatory Bowel Disease

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Abstract

Background

Obesity has become prevalent in patients with inflammatory bowel disease (IBD). Bariatric surgery can be considered to be contraindicated in IBD patients. We aimed to evaluate feasibility, safety, and efficacy of bariatric surgery in IBD patients.

Methods

We retrospectively identified all morbidly obese patients with a known diagnosis of IBD, who underwent bariatric surgery between January 2005 and December 2012. Postoperative outcomes and status of IBD in patients on maintenance therapy for their disease were assessed.

Results

We identified 20 IBD patients including 13 ulcerative colitis (UC) and 7 Crohn’s disease (CD) patients with a mean age of 54.0 ± 10.5 years, BMI of 50.1 ± 9.0 kg/m2, and duration of IBD of 11.3 ± 5.2 years. Eleven patients were on medication for IBD at baseline. Bariatric procedures included sleeve gastrectomy (N = 9), gastric bypass (N = 7), gastric banding (N = 3), and one conversion of band to gastric bypass. There were no intraoperative complications, but two conversions to laparotomy due to adhesions. Mean BMI change and excess weight loss at 1 year was 14.3 ± 5.7 kg/m2 and 58.9 ± 21.1 %, respectively. Seven early postoperative complications occurred including dehydration (N = 5), pulmonary embolism (N = 1), and wound infection (N = 1). During a mean follow-up of 34.6 ± 21.7 months, five patients developed complications including pancreatitis (N = 2), ventral hernia (N = 2), and marginal ulcer (N = 1). Nine out of ten eligible patients experienced improvement in their IBD status.

Conclusions

Bariatric surgery is feasible and safe in morbidly obese patients suffering from IBD. In addition to being an effective weight loss procedure, bariatric surgery may help mitigate symptoms in this patient population.

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References

  1. Steed H, Walsh S, Reynolds N. A brief report of the epidemiology of obesity in the inflammatory bowel disease population of Tayside. Scotland Obes Facts. 2009;2(6):370–2.

    Article  PubMed  Google Scholar 

  2. Long MD, Crandall WV, Leibowitz IH, et al. Prevalence and epidemiology of overweight and obesity in children with inflammatory bowel disease. Inflamm Bowel Dis. 2011;17(10):2162–8.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Dietz DW, Bailey RH. Postoperative complications. In: Wolf BG, Fleshman JW, Beck DE, Pemberton JH, Wexner SD, editors. The ASCRS Textbook of Colon and Rectal Surgery. New York: Springer; 2007. p. 141–55.

    Chapter  Google Scholar 

  4. Aminian A, Daigle CR, Romero-Talamas H, et al. Risk prediction of complications of metabolic syndrome before and 6 years after gastric bypass. Surg Obes Relat Dis. 2014;10(4):576–82.

    Article  PubMed  Google Scholar 

  5. Brethauer SA, Aminian A, Romero-Talamas H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258(4):628–36. discussion 36–7.

    PubMed  PubMed Central  Google Scholar 

  6. Aminian A, Brethauer SA, Kirwan JP, et al. How safe is metabolic/diabetes surgery? Diabetes Obes Metab. 2015;17(2):198–201.

    Article  CAS  PubMed  Google Scholar 

  7. Versini M, Jeandel PY, Rosenthal E, Shoenfeld Y. Obesity in autoimmune diseases: not a passive bystander. Autoimmun Rev. 2014;13(9):981–1000.

    Article  CAS  PubMed  Google Scholar 

  8. Karmiris K, Koutroubakis IE, Xidakis C, et al. Circulating levels of leptin, adiponectin, resistin, and ghrelin in inflammatory bowel disease. Inflamm Bowel Dis. 2006;12(2):100–5.

    Article  PubMed  Google Scholar 

  9. Karagiannides I, Pothoulakis C. Substance P, obesity, and gut inflammation. Curr Opin Endocrinol Diabetes Obes. 2009;16(1):47–52.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Lascano CA, Soto F, Carrodeguas L, et al. Management of ulcerative colitis in the morbidly obese patient: is bariatric surgery indicated? Obes Surg. 2006;16(6):783–6.

    Article  PubMed  Google Scholar 

  11. Bertin B, Desreumaux P, Dubuquoy L. Obesity, visceral fat and Crohn's disease. Curr Opin Clin Nutr Metab Care. 2010;13(5):574–80.

    Article  CAS  PubMed  Google Scholar 

  12. Ahn LB, Huang CS, Forse RA, et al. Crohn's disease after gastric bypass surgery for morbid obesity: is there an association? Inflamm Bowel Dis. 2005;11(6):622–4.

    Article  PubMed  Google Scholar 

  13. Hass DJ, Brensinger CM, Lewis JD, et al. The impact of increased body mass index on the clinical course of Crohn's disease. Clin Gastroenterol Hepatol. 2006;4(4):482–8.

    Article  PubMed  Google Scholar 

  14. Boutros M, Maron D. Inflammatory bowel disease in the obese patient. Clin Colon Rectal Surg. 2011;24(4):244–52.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Moum B, Jahnsen J. Obesity surgery in inflammatory bowel disease. Tidsskr Nor Laegeforen. 2010;130(6):638–9.

    Article  PubMed  Google Scholar 

  16. Keidar A, Hazan D, Sadot E, et al. The role of bariatric surgery in morbidly obese patients with inflammatory bowel disease. Surg Obes Relat Dis. 2015;11(1):132–6.

    Article  PubMed  Google Scholar 

  17. Romero-Talamas H, Aminian A, Corcelles R, et al. Psoriasis improvement after bariatric surgery. Surg Obes Relat Dis. 2014;10(6):1155–9.

    Article  PubMed  Google Scholar 

  18. Romero-Talamas H, Daigle CR, Aminian A, et al. The effect of bariatric surgery on gout: a comparative study. Surg Obes Relat Dis. 2014;10(6):1161–5.

    Article  PubMed  Google Scholar 

  19. Corcelles R, Daigle CR, Talamas HR, Batayyah E, Brethauer SA, Schauer PR. Bariatric surgery outcomes in patients with systemic lupus erythematosus. Surg Obes Relat Dis. 2015. doi:10.1016/j.soard.2014.10.006.

    Google Scholar 

  20. Suter M, Calmes JM, Paroz A, et al. Results of Roux-en-Y gastric bypass in morbidly obese vs superobese patients: similar body weight loss, correction of comorbidities, and improvement of quality of life. Arch Surg. 2009;144(4):312–8. discussion 8.

    Article  PubMed  Google Scholar 

  21. Lemanu DP, Srinivasa S, Singh PP, et al. Single-stage laparoscopic sleeve gastrectomy: safety and efficacy in the super-obese. J Surg Res. 2012;177(1):49–54.

    Article  PubMed  Google Scholar 

  22. Giordano S, Tolonen P, Victorzon M. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic adjustable gastric banding in the super-obese: peri-operative and early outcomes. Scand J Surg. 2015;104(1):5–9.

    Article  CAS  PubMed  Google Scholar 

  23. Blain A, Cattan S, Beaugerie L, et al. Crohn's disease clinical course and severity in obese patients. Clin Nutr. 2002;21(1):51–7.

    Article  CAS  PubMed  Google Scholar 

  24. Gustavsson S, Ilstrup DM, Morrison P, et al. Roux-Y stasis syndrome after gastrectomy. Am J Surg. 1988;155(3):490–4.

    Article  CAS  PubMed  Google Scholar 

  25. Woodard GA, Encarnacion B, Downey JR, et al. Probiotics improve outcomes after Roux-en-Y gastric bypass surgery: a prospective randomized trial. J Gastrointest Surg. 2009;13(7):1198–204.

    Article  PubMed  Google Scholar 

  26. Greco A, Caviglia GP, Brignolo P, et al. Glucose breath test and Crohn's disease: Diagnosis of small intestinal bacterial overgrowth and evaluation of therapeutic response. Scand J Gastroenterol 2015:1–6.

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Authors and Affiliations

  1. Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH, 44195, USA

    Ali Aminian, Amin Andalib, Maria R. Ver, Ricard Corcelles, Philip R. Schauer & Stacy A. Brethauer

Authors
  1. Ali Aminian
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  2. Amin Andalib
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  3. Maria R. Ver
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  4. Ricard Corcelles
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  5. Philip R. Schauer
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  6. Stacy A. Brethauer
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Correspondence to Ali Aminian.

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The authors declare that they have no conflict of interest.

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Aminian, A., Andalib, A., Ver, M.R. et al. Outcomes of Bariatric Surgery in Patients with Inflammatory Bowel Disease. OBES SURG 26, 1186–1190 (2016). https://doi.org/10.1007/s11695-015-1909-y

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  • DOI: https://doi.org/10.1007/s11695-015-1909-y

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