De-novo Inflammatory Bowel Disease After Bariatric Surgery: A Large Case Series

Abstract

We described a case series of patients developing de-novo IBD after bariatric surgery. There appears to be a numerically higher incidence of Crohn's disease in this population. Confirmation of causality is required in larger patient cohorts.

Review article: the relationship between obesity, bariatric surgery, and inflammatory bowel disease

“…To date, 17 cases of ulcerative colitis (UC), 60 cases of CD and three cases of unclassified colonic IBD after gastrointestinal bariatric surgery have been reported in the literature, most of them with endoscopic and histological findings consistent with IBD . The available pertinent information regarding 17 UC patients, 54 CD patients and two patients with IBD unclassified (a total of 73 patients) is summarised in Table (detailed information in Table S1a).…”

“…The available pertinent information regarding 17 UC patients, 54 CD patients and two patients with IBD unclassified (a total of 73 patients) is summarised in Table (detailed information in Table S1a). No clinical data are available for one of the cases with unclassified colonic IBD and six cases reported in abstract form from an Austrian series; for this reason, they are not included in the table. The largest case series published from a study from the Mayo Clinic and the Washington University School of Medicine, included 44 incident cases after bariatric surgery .…”

“…No clinical data are available for one of the cases with unclassified colonic IBD and six cases reported in abstract form from an Austrian series; for this reason, they are not included in the table. The largest case series published from a study from the Mayo Clinic and the Washington University School of Medicine, included 44 incident cases after bariatric surgery . This study included a prospective database of 3709 patients undergoing bariatric surgery at the Mayo Clinic between 1996 and 2006, with a median follow‐up time of 5.1 (IQR, 1.9‐9.8) years, and a total follow‐up of 22 457 person‐years.…”

Editorial: de novo inflammatory bowel disease following bariatric surgery—potential implications for research and clinical practice

“…In an analysis of 8980 cases following bariatric surgery, they described 15 cases of IBD, with the majority being female patients with Crohn's disease (CD) who underwent Roux‐en‐Y surgery. Similarly, a recent paper from the Mayo Clinic and Washington University reported cases of both post‐bariatric CD and ulcerative colitis (UC) . It is interesting to note that all previous case reports of new onset IBD after bariatric surgery in the literature had been exclusively CD .…”

Editorial: de novo inflammatory bowel disease following bariatric surgery—potential implications for research and clinical practice. Authors’ reply

“…Alukaidey and Heerasing regarding our recent paper in Alimentary Pharmacology & Therapeutics . We agree that we cannot infer causality based on the current evidence from our study and a recent similar paper from the group at Mayo Clinic . Rather, as we note in our manuscript, this association needs to be explored further in prospective studies and additional studies on the physiologic changes that occur following bariatric surgery (microbiome, metabolic, etc.)…”