Jejunoileal Bypass: Change in the Flora of the Small Intestine and Its Clinical Impact

Corrodi, P

doi:10.1093/clinids/6.supplement_1.s80

Cited by 22 publications

(3 citation statements)

References 30 publications

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“…This has been well documented by many reports [12,15,25,42] and is responsible for much of the morbidity associated with intestinal bypass. Anaerobic organisms are largely responsible for abdominal bloating, foui flatus, bypass enteritis and pneumatosis intestinalis [43], polyarthralgia and polymyalgia [44], and other systemic inflammatory complications [45].…”

Section: Enteric Colonization and Its Consequencesmentioning

confidence: 77%

An epilogue to jejunoileal bypass

Baddeley

1985

World j. surg.

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The advantages of jejunoileai bypass performed for morbid obesity have been well reported, as have its undesirable side effects. Both early and long-term weight reduction are generally satisfactory. Problems can arise from an increased enteric circulation of bile salts, liver dysfunction, metabolic bone disease, malnutrition and metabolic failure, diarrhea and electrolyte disturbances, enteric colonization and its consequences, and renal calculi and failure. In the author's personal series of 255 patients, 62 have required restoration of intestinal continuity, largely for the complications of bacteriai colonization of the blind Ioop. Half the patients studied (55%) developed increasing hepatic steatosis during the first postoperative year, while 9% developed micronodular cirrhosis. Some degree of osteomalacia occurred in 35% of patients within 5 years of bypass.

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Section: Enteric Colonization and Its Consequencesmentioning

confidence: 77%

An epilogue to jejunoileal bypass

Baddeley

1985

World j. surg.

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“…It is able to achieve sustained weight loss and a great improvement in health benefits, particularly regarding lipid metabolism. However, due to its association with severe side-effects, such as electrolyte disorders, diarrhea, oxalate stones in the kidneys and progressive hepatic fibrosis with eventual liver failure (in which rapid weight loss, protein-caloric malnutrition, global malabsorption and endotoxin effects have all been implicated) [ 51 , 52 , 53 , 54 ], JIB has been progressively abandoned.…”

Section: Bariatric Surgerymentioning

confidence: 99%

Bariatric Surgery and Liver Disease: General Considerations and Role of the Gut–Liver Axis

et al. 2021

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Weight loss is a therapeutic solution for many metabolic disorders, such as obesity and its complications. Bariatric surgery aims to achieve lasting weight loss in all patients who have failed after multiple dietary attempts. Among its many benefits, it has been associated with the regression of non-alcoholic fatty liver disease (NAFLD), which is often associated with obesity, with evidence of substantial improvement in tissue inflammation and fibrosis. These benefits are mediated not only by weight loss, but also by favorable changes in systemic inflammation and in the composition of the gut microbiota. Changes in microbial metabolites such as short-chain fatty acids (SCFAs), capable of acting as endocrine mediators, and bile acids (BAs) as well as modifications of the gut-brain axis, are among the involved mechanisms. However, not all bariatric surgeries show beneficial effects on the liver; those leading to malabsorption can cause liver failure or a marked worsening of fibrosis and the development of cirrhosis. Nevertheless, there are still many unclear aspects, including the extent of the benefits and the magnitude of the risks of bariatric surgery in cirrhotic patients. In addition, the usefulness and the safety of these procedures in patients who are candidates to or who have undergone liver transplant need solid supporting evidence. This paper aims to review literature data on the use of bariatric surgery in the setting of chronic liver disease.

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“…Several of the serious morbidities associated with JIB were attributed to a ''blind-loop'' syndrome resulting from the presence of a long segment of bypassed small intestine lacking significant intraluminal flow of secretions [5]. The relative stasis and bacterial overgrowth within the bypassed segment was hypothesized to cause complications via direct mucosal injury, alterations in intestinal permeability to bacteria and their toxins, circulation and deposition of immune complexes [6], abnormal activation of complement, and excessive production of D-lactate by grampositive anaerobes.…”

Section: History Of Malabsorptive Weight Loss Surgerymentioning

confidence: 99%